Medicare Advantage Expansion Strategy

Medicare Advantage continues to create opportunities for health plans, but deciding where to expand requires more than identifying markets with enrollment potential. Plans must also determine whether a market can support a provider network that is buildable, operationally sustainable, and positioned to meet CMS network adequacy requirements.    

Claritev’s white paper, A Decision Framework for Medicare Advantage Network Expansion, provides a practical framework for evaluating expansion opportunities through a network strategy lens. It explores three critical questions: where to expand, when to expand, and how to govern the final go/no-go decision. 

For plans considering expansion, this framework can help bring network strategy into the decision-making process earlier before significant resources are committed to a new market.