Brooks Blog

Wednesday • July 12, 2017

Medicare: Where do we go from Fee for Service?

Medicare: Where Do We Go From Fee For Service?

At just over 50 years since inception, Medicare accounts for 15% of federal spending and covers over 57 million lives. With 10,000 baby boomers aging into the entitlement program every day, market growth will continue for this channel. However the per capita spending may not keep up with the private insurance markets.

Medicare Then …

The managed care trend affecting all channels led to the introduction of Medicare Part C (now called Medicare Advantage) giving Medicare beneficiaries the option to buy HMO and PPO plans through private insurers instead of the federal government. Just over ten years ago a prescription benefit (Medicare Part D) was added, covering the fastest increasing piece of healthcare spend and thus adding to the complexity and cost of Medicare.

What’s next?

… and Now

Complex coverage and payment trends such as quality-based payments, narrow networks, and changing out of pocket limits make understanding how this important channel will respond to drug pricing and cost sharing all the more difficult.

Let Brooks Group help you overcome these challenges. Learn about Medicare growth trends, market leaders, benefits and payment policies with The Brooks Group’s “Medicare: Gaining Insights into Market Dynamics and Future Growth” primer. Learn more here or email us directly for a sneak preview.

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