The Medicare Advantage program has been a profitable venture for insurers, with costs exceeding $500 billion this year. The program has faced recent regulatory challenges that could affect profitability. Under the Biden administration, insurers saw a significant payment increase, but changes in coding and audits have aimed to reduce overpayments and care denials. Despite expected growth, 2025 may bring thinner margins for insurers due to inaccurate predictions of needed care. Factors like delayed care during the pandemic and expensive treatments like specialty drugs are impacting the market. The industry is looking towards Trump’s return for a more favorable regulatory environment.
Source link
Medicare Advantage set to benefit under Trump
