#medicare-advantage

#medicare-advantage

In 2025, we whiffed. You would have been wise to bet the anti-portfolio. While we (always 😂) think some of our predictions may still come true, an honest grading says we were Jets/Mets-like: just two out of 10. We nailed more payor CEOs losing their jobs (Andrew Witty and Lois Quam) and cell therapy coming back into fashion (four acquisitions, notably Capstan by Abbvie at $2.1B).

Low or $0 premiums plus supplemental benefits that traditional Medicare is not authorized by Congress to cover - dental, vision and hearing care - have attracted increasing numbers of seniors. The many disadvantages, including the need to get preauthorization for procedures or medicines your doctor has prescribed or the narrow group of health professionals that are in-network in many MA plans, are not mentioned in advertisements by brokers hired to recruit members.

Medicare Advantage enrollment jumped 32% year over year to 106,323 members, the clearest sign that Clover's technology-first model is resonating with both brokers and beneficiaries. Revenue growth of 34% from the prior year quarter underscores how scale is driving top-line expansion. What matters here is that the company achieved this growth during what management called a "3.5 star payment year," meaning reimbursement rates were compressed. That's a meaningful distinction.

Advocates for New York City retirees are preparing to rally at City Hall on Tuesday to push for a local law that would preserve the healthcare they and their families depend on. The rally is part of ongoing efforts to stop Mayor Eric Adams' attempts to switch the city's quarter-million retired municipal workers to a private Medicare Advantage plan. What makes this protest interesting is that it will occur a day after Adams' 65th birthday, Sept. 1.