4 Important Challenges Medicare Advantage Plans Must Address

Medicare Advantage Plans, sometimes called Plan C or MA Plans, are healthcare plans that are offered to adults with disabilities and those over the age of 65. While administered by private companies, MA Plans still follow the same guidelines set by the Centers for Medicare & Medicaid Services, the U.S. federal agency that oversees the Medicare program. These programs typically offer coverage for hospital and medical bills and prescription drugs, though there are also plans that include vision, hearing, and dental expenses.

Patients who qualify for MA Plans are given the assurance of medical care while keeping their yearly out-of-pocket costs under a certain threshold–a setup that provides them with plenty of advantages.

On the other side of the coin, healthcare and insurance companies must be able to provide the coverage that their beneficiaries require, maintain the quality of their services, and ensure the sustainability of MA Plans as a whole. To do this, they need a health insurance solution that can address pressing concerns about the program, which include the following:

Attracting Customers to Sign Up for Medicare Advantage

MA Plans have a very specific target market that insurance providers must be able to reach. Mobility challenges, distance, and a lot of other hurdles can prevent seniors and adults with disabilities from getting in touch with an insurance or healthcare provider that suits their particular needs, and this can dissuade them from signing up for a MA Plan. The use of digital tools like dedicated mobile apps and online platforms can facilitate the signup process for qualified beneficiaries and interested parties who might find it difficult to travel. This can also make it much easier for Plan C beneficiaries to get in touch with their providers and check their data in the comfort of their own homes.

Offering Patients Better Access to Provider Networks

Beneficiaries of Plan C can make the most of their respective programs if they are able to access medical professionals with experience in dealing with age- and disability-related health issues. Unfortunately, their options can be limited by the number of medical practitioners in their area that are also affiliated with their insurance provider’s network.

Providing a more accessible healthcare network to beneficiaries would be to everyone’s advantage. The availability of a medical professional with a deeper understanding of the health concerns of their local communities will encourage nearby MA Plan beneficiaries to seek medical attention at the first sign of trouble. This, in turn, will enable their doctors to quickly detect and address medical issues that have the potential to progressively impact a patient’s long-term health and well-being.

Implementing Coordinated Care Plans for Patients

While older adults and people with disabilities are not the only demographics that feel the negative effects of a disjointed medical care system, these two groups stand to gain much if they are able to sign up for a program that looks after their holistic well-being and physical health. The good news is that current technologies make it possible for insurance and healthcare providers to access and add details to patient medical information. In fact, these actions can be done in real-time using digital platforms and cloud-based patient data repositories.

In addition to giving medical professionals a more detailed overview  of the conditions of their patients, such a system of recordkeeping can also help patients better navigate the complex landscape of the American healthcare system. This reduces the possibility that the patient will go through redundant tests and treatments, a move that can save the insurance provider time, effort, and money without compromising the health and well-being of the community it serves.

Giving Patients More Time with General Practitioners

Family physicians serve as the bedrock of an effective healthcare system, as they are in the position to offer comprehensive and people-centered care. Generalists deal with individuals and communities, and they are at the forefront of preventing illnesses that can be brought about by unhealthy lifestyles and habits. They also play a significant role in urging the community to take precautionary measures against spreading communicable diseases.

However, family physicians are under a lot of pressure to prioritize the number of patients they see over the quality of care that they provide. This forces them to attend to more patients in less time, a situation that can prevent them from detecting and treating the possible causes of perceptible symptoms. The patients, then, are sent to see specialists who are likely to treat their symptoms in isolation from their other health issues and habits. The services of specialist doctors are often at a premium, and failing to address health issues in a holistic manner can have a negative impact on the patient’s future and quality of life.

The use of a modern health insurance solution, one that fully utilizes the capabilities of digital technologies and interconnected networks, can help address these pressing issues for MA Plan providers and beneficiaries alike. Once these challenges have been met, the community can expect improved quality of life and reduced cost of care in the long run, thus making the system more sustainable for all parties involved.