MAPD marketing opportunity in 2019

[kstein]

Since MAPD plans will be able to provide LTC services in home care and adult day care settings, is anyone proactively marketing towards these facliities in anticipation of some changes?

It seems like a great fit for all involved and might be similar to United of Omaha Plan N accepting people in nursing homes and needing pending surgeries where there are very specific niches that will be gold mines.

Thoughts?

 

[somarco]

Just a wag but I don't see carriers shoving to the front of the line to be the first to offer "LTC services". My guess is they will tiptoe into the water rather than going all in for 2019.

You reference the plan N debacle. Hoping for a sequel? MA carriers already take anyone (except renal failure). Some studies show numbers as high as 50% of SNF elderly have CKD.

If those figures are anywhere near accurate you can bet MA actuaries are weighing the cost of expanding their market to include folks with a high probability of becoming dead weight from a claims perspective.

Gold mine?

Don't think so.

 

[kstein]

Gold mine for brokers, not necessarily the carriers but I'm confident they will be fine Id be shocked if a carrier doesn't shoot the moon and try to get first mover advantages to gain marketshare.

I'm sure the deck is stacked in the favor of the MA companies in that they will be able to manipulate the risk score further to account for sicker patients. I'm thinking of approaching home care or adult day care facilities to create a relationship .if they can get paid the daily fee from insurers rather than out of pocket or having peipeoterm services early due to cost don't you think they would be receptive??

When omaha N came out, I had multiple snf facilities refer their mapd patients to me so they could go back to medicsre+supplement and they still refer patients 7+ years later .I just see some similarity in the narrow niche marketing side with this LTC option .

 

[kstein]

I'd love a repeat of a super competitive prices supplement without underwriting that paid full commission. Who wouldn't!?

Just a wag but I don't see carriers shoving to the front of the line to be the first to offer "LTC services". My guess is they will tiptoe into the water rather than going all in for 2019.

You reference the plan N debacle. Hoping for a sequel? MA carriers already take anyone (except renal failure). Some studies show numbers as high as 50% of SNF elderly have CKD.

If those figures are anywhere near accurate you can bet MA actuaries are weighing the cost of expanding their market to include folks with a high probability of becoming dead weight from a claims perspective.

Gold mine?

Don't think so.

 

[binky]

Do we have a list of carriers who will offer this with Medicare Advantage? Thanks

 

[Northeast Agent]

This story just popped up in my inbox!

Aetna Inc. is being acquired by CVS Health Corp. Cigna Corp. is acquiring Express Scripts Inc., a major pharmacy benefits manager. Humana is not currently being acquired, or making giant deals of its own.

Humana May Lead Aetna, Cigna in Medicare Advantage LTC Race
Bruce Broussard says his company is already thinking about the new chronic care benefits option.

Humana May Lead Aetna, Cigna in Medicare Advantage LTC Race | ThinkAdvisor

 

[Northeast Agent]

Probably not all the carriers, but maybe the big national players will? I attended a D-SNP training this morning with one who is just in four states (right now). When I brought up all the changes I heard are coming next year, such as CMS allowing groceries, air conditioning for those with asthma, OEP returning during the first quarter of 2019 (Open Enrollment Period Returning in 2019), none of the reps had any clue.

 

[somarco]

none of the reps had any clue.

What a shock!

Not .. . .

 

[Tim Resnick]

What a shock!

Not .. . .

You got that right Bob. I often get better answers here on the forum.