Medicare Advantage: 3 Questions Open Enrollment Can (And Can't) Answer

Who will dominate 2024 enrollment, what role will Humana's 2022 re-org play, and could Medicare Advantage plan stock prices skitter?

Half-way through Medicare Advantage (MA) open enrollment is a good time to ask what we know now and what we can only know later as the season progresses. CMS will post the first enrollment numbers on November 15, but until then . . .

1. Who will lead the market?

For years, a small group of health plans has led nationwide MA enrollment:

• UnitedHealthcare and Humana dominate, enrolling nearly half of MA members (47%)
• BlueCross BlueShield (BCBS) plans and CVS Health/Aetna follow, capturing another 25%
• Kaiser Permanente, Centene and Cigna trail, representing 6%, 4% and 2% of the market respectively

Don’t expect this picture to change significantly in 2024. United will continue to reign, but will Humana start to close the gap — it holds 18% of enrollment compared to United’s 29% — or remain closer to BCBS and CVS/Aetna (14%; 11%)?

It will be a telling year as market-watchers ask . . .

2. Will Humana’s re-org reap rewards?

In 2022, Humana made big moves. As part of its new “$1 billion value creation initiative,” the company reorganized into two business units — insurance services and health services — and reduced its lines of business.

After exiting the employer group commercial health market, as well as the Marketplace, a company spokesperson noted to HealthLeaders: “Humana's focus is its Medicare core (individual, group, supplement and prescription drug plans); Medicaid, Military, and Specialty dental, vision and life plans; and its CenterWell healthcare services business.”

Humana’s announcement came six months after the company’s stock price plunged on lower-than-expected MA growth projections. This prompts the question . . .

3. Who’s stock price will dip this year?

After Humana’s precipitous drop, healthcare’s 24-hour news cycle resembled TMZ. Industry media couldn’t get enough of the company’s 21% single-day tumble. HealthLeaders took the long view and sure enough, Humana’s stock not only rebounded but is up nearly 5% — 20% if you calculate from its late-October high.

Open Enrollment will always jostle the MA stock market. Who will be up and who will be down is uncertain and for how long but expect multiple insurers’ stock prices to move in sync again this year if projections shift.

Speaking of disruption, stay tuned for the next three questions that MA Open Enrollment can (and can’t) answer, including the impact of new marketing rules, new specialty-population plan designs, and how MA payers will behave now that they own more than half of the Medicare market.