It’s Medicare Advantage Bid Season... Which Health Plans Will Win?

By RaeAnn Grossman
It’s Medicare Advantage Bid Season... Which Health Plans Will Win?

As the healthcare industry gears up for the start of bid season for Medicare Advantage health plans, it's a critical time for product and actuarial teams to assess and strategize from last year’s lessons learned. The focus is on understanding medical cost trends, utilization patterns, clinical condition prevalence rates, and past benefit designs of competitors. In the quest for winning the open enrollment for 2025 and driving profitable growth, health plans are faced with the challenge of enhancing their PPO and HMO product lines, deciding on market entry or exit, and ultimately staying competitive. In this dynamic landscape, innovation in care delivery becomes paramount, and Luna is at the forefront of transforming the healthcare experience and we all know member experience drives member retention.

Luna's Role in Innovating Benefit Design and Care Delivery:

Luna, a pioneering force in healthcare innovation, is collaborating with several health plans to revolutionize benefit designs and care delivery, improve outcomes, and significantly lower Medical Loss Ratios (MLR). One of the standout offerings from Luna is the simplification of care through the introduction of outpatient therapy in-person and in-home.

Understanding the Value of In-Person, In-Home Outpatient Therapy

Luna's focus on in-home outpatient therapy as a new service offering holds immense potential in reshaping the Medicare Advantage landscape. This benefit design modification creates the opportunity for the service, which allows health plans to extend high-quality care to their members in the comfort of their homes, at the price point of traditional outpatient therapy. By incorporating Luna into their benefit design, health plans can create a win-win scenario for both themselves and their members.

Benefits for Health Plans

  • Cost Savings: Offering outpatient therapy in-home enables health plans to deliver care at the cost of traditional outpatient therapy, leading to substantial savings for both the plan and its members.
  • Improved Access: By bringing therapy directly to the member's home, Luna enhances access to care, overcoming barriers like transportation and mobility issues. This improved access is a key factor in member satisfaction and loyalty.
  • Better Adherence: Members are more likely to adhere to their care plans when the services are conveniently provided at home. Luna's in-home therapy fosters a stronger connection between the member and their care, leading to better adherence and, subsequently, improved outcomes.
  • Lower Total Cost of Care: Enhanced access and better adherence contribute to a reduction in the member's total cost of care. This aligns with the overarching goal of Medicare Advantage plans to provide high-quality care while controlling costs.
  • Improved Star Scores and Risk Adjustment Accuracy: Through improved outcomes and better member engagement, health plans incorporating Luna's in-home therapy can expect higher Star scores and more accurate risk adjustment factors, positively impacting their overall performance.

2025 is Almost Here!

As health plans prepare to file their 2025 Medicare Advantage bids with CMS, it's crucial to consider innovative solutions that not only meet the evolving needs of members but also drive better outcomes and financial success. Luna's in-person, in-home outpatient therapy emerges as a game-changer, offering a unique opportunity to stand out in a competitive market. Being the preferred provider for health plans, Luna not only signifies better access, adherence, and outcomes but also positions health plans as leaders in delivering cost-effective and member-centric care. As the bid season unfolds, health plans are presented with a chance to redefine the future of Medicare Advantage by embracing Luna's transformative approach to care delivery.