The next decade of Medicare Advantage: 2025 and beyond

Medicare Advantage leaders must pivot to win in an era of stagnation and fierce competition

After years of steady growth, Medicare Advantage faces new headwinds. Carriers are struggling with rising acquisition costs, reduced member lifetime values, and increased complexity in delivering member services and refining go-to-market strategies. This paper examines the market forces behind these changes and provides actionable strategies for leaders to thrive by balancing financial discipline with data-driven agility.

This paper covers:

The five forces transforming Medicare Advantage: Rising costs, fewer age-ins, declining member lifetime values, stagnant innovation, and changing go-to-market dynamics.

• Declining member lifetime value (MLV): Driven by shrinking member tenure, stagnant CMS payments, and rising costs—together threatening profitability.
• Communication overload: Overwhelming member communications—from ANOCs to EOBs—lead to poor engagement and diminishing member trust.
• Digital transformation opportunities: Simplified and digitally assisted application processes can reduce switching and improve member retention.
• The aggregator impact: A media buying frenzy driven by aggregators has created confusion, high acquisition costs, and lower-quality members.
• Data-driven decision-making: Advanced analytics and democratized data quality empower carriers to make smarter decisions, while profitability-based audience targeting ensures channels are aligned to acquire and retain higher-quality members.

Download the paper now to learn how the next decade will reward Medicare Advantage leaders who embrace agility, analytics, and a member-first approach.