CMS released July enrollment data on Monday and it appears to be maintaining its ex-OEP trend, albeit slightly below the peak of 2019. Wild cards for maintaining the plateau are the reimbursement environment; cuts to MA plans are on the short list as offsets for reconciliation. Another factor to consider is the Medical Loss Ratios that are bound to go up in the face of high acuity from delayed care. Hospitalization in key states like Florida are being driven by COVID but also delay care that has patient presenting as acutely ill. The acuity levels may force some plans to make changes to their benefit structure or broker compensation to more closely control expenses in the face of what promises to be a durable higher cost trend.
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Emily Evans
