Cavulus CEO Says Rise in Popularity of "Special Needs" Plans Spurs Growth in Medicare Advantage

PITTSBURGH , March 17, 2022 /PRNewswire/ -- The Medicare Advantage (MA) program grew by 9% last year gaining 2.3 million new members. According to Patrick Phillips, CEO of Cavulus, a preeminent technology firm in the industry, a key factor in boosting enrollment was an expansion of Special Needs Plans or SNPs (pronounced "snip"). 

SNPs were created in 2006 and limit membership to people who meet certain criteria or have specific diseases. Currently there are three types of SNPs: I-SNP for institutionalized individuals, D-SNP for beneficiaries who are eligible for both Medicare and Medicaid, and C-SNP for people with certain chronic conditions. "SNPs tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve" according to Medicare.gov.

Earlier this year Phillips said he was "encouraged by the growth in chronic or C-SNPs created to serve members with conditions such as ESRD, diabetes, and cardiovascular disease". A new study conducted by the Chartis Group quantified that growth, revealing that SNP membership grew by 20% year-over-year to 4.5 million enrollees, representing 16% of all Medicare Advantage members.

"Special Needs Plans are an important tool for addressing disparities in health care coverage, whether it's a socio-economic or complex health need", noted Phillips. "These plans address the triple aim of healthcare: improving quality, improving health, and reducing costs."

Phillips explains that plan design is one of the few resources insurance providers have to respond to consumer demands, and MA organizations can introduce new offerings each year. "At Cavulus, we've designed our technology to accommodate all Medicare Advantage product types" he said, "so our clients can seamlessly roll out new plans and enroll members each Annual Election Period."

Moving forward into 2023, Phillips expects to see a plethora of new plan offerings, particularly C-SNPs. "Not only are clients adding or expanding SNP plans, but our company is currently talking with several start-ups exclusively focused on chronic special needs plans."

ABOUT CAVULUS - Cavulus is a technology driven specialist in Medicare Advantage insurance solutions. The Cavulus Cloud-based Medicare Advantage Platform (Cavulus MAP™) unifies marketing, sales and enrollment operations, and is utilized by many of America's top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, Johns Hopkins, Lumeris and United Healthcare. For details visit: www.cavulus.com.

Media Inquiries: 800-760-6915
Email: [email protected]

SOURCE Cavulus