An inability to adapt to developing dynamics shaping the future of medical payment poses a threat to physician livelihoods. Whether it’s the consolidation trend of the last 20 years, the HMO movements of the 1990s, or the evolution of capital-intensive technology or high-cost facility components for care delivery, physicians have long faced a variety of direct existential threats to the way they perform and deliver optimal care — and get paid for their services. The physician has been and will continue to be the center of care delivery. As such, they also ultimately sit at the center of undulations in healthcare cost and payment tides.

So it seems appropriate for physicians to note a rising wave related to Medicare Advantage (MA). Medicare Advantage healthcare plans are an alternate way for eligible individuals to receive Medicare Part A, Part B, and often Part D (prescription) coverage that is “all-in-one” and offered by approved private companies following rules set by Medicare. MA plans often also provide dental, hearing, and vision coverage and attractive caps on out-of-pocket expenses. In many cases, covered patients need to use health care providers who participate in the plan’s network and service area for the lowest costs.

With the Centers for Medicare & Medicaid Services (CMS) charting MA on a path to utilization for more than 34 million lives in 2023 (up from 24 million in 2020), it is clear that MA is not just an experiment. It is the coming tide of what healthcare delivery and payments will look like, and we expect commercial markets to tack in this direction following the path laid out from CMS and existing MA models. This only advances the imperative for clinicians to engage seriously in these new mechanisms. Livelihoods depend on adaptation to evolution in a capitated world.