Source: https://seekingalpha.com/news/4612389-medicare-advantage-bonus-payments-exceed-13b
There’s a difference between cutting costs and building capability. Lay off enough institutional knowledge and eventually the people who know how to improve quality, member experience, and operational execution are gone too.
The consequences don’t show up in the next town hall. They show up later on the scorecard.
Sarah said it loud and clear: ”When the market changes, we change.”
CMS had a different way of measuring change and just released its annual performance review.
UnitedHealth: $3.9B in Medicare Advantage quality bonuses. CVS: $2.0B. Humana: $1.5B. Kaiser: $1.2B, with virtually 100% of Medicare Advantage members in bonus-eligible plans.
Centene: $21.5M (yes MILLION) Just 6% of Medicare Advantage members are enrolled in bonus-eligible plans. Approximately 882,000 members are not.
Industry average: 68%
Kaiser: 100%
Centene: 6%
Overall Rating: Needs Improvement.
Performance Improvement Plan: Recommended.
Free advice to management: Organizations get exactly what they optimize for. If every decision favors short-term margins over long-term capability, don’t be surprised when competitors outperform you on the metrics that actually matter. You can’t outsource institutional knowledge or lay off your way to operational excellence. Institutional knowledge isn’t overhead. It’s the capability that drives quality, operational excellence, and sustainable results.