Medicare Advantage 101: New policy series explains Medicare Advantage and its role within the Medicare system.
Last week, Kaiser Family Foundation released a report examining 62 studies published since 2016 comparing Medicare Advantage (MA) and Original Medicare. The studies measured beneficiary experience, affordability, utilization, and quality of care. The report notes that some findings varied between the studies, “likely due to differences in data and methodology,” but found that some differences were supported by strong data and were replicated across multiple studies.
Notably, both MA and Original Medicare beneficiaries reported similar satisfaction rates. Still, a larger share of MA enrollees opted to switch from MA to Original Medicare than those who switched from Original Medicare to MA. Rates of switching from MA to Original Medicare were “relatively higher among beneficiaries who are dually eligible for Medicare and Medicaid, beneficiaries of color, beneficiaries in rural areas, and following the onset of a functional impairment.” As the report highlights, “switching rates may be a proxy for dissatisfaction with current coverage arrangements.”
MA enrollees were more likely to receive preventative services and have a usual source of care, but people in Original Medicare were more likely to receive care in the highest-rated hospitals (generally or for cancer care), Skilled Nursing Facilities, or Home Health Agencies. Still, MA enrollees were less likely to receive care in the lowest-rated hospitals overall. These findings may demonstrate the benefits of some aspects of MA delivery design, including incentives to establish a primary care provider relationship, and some of the drawbacks, such as more limited networks and thus choice, for higher levels of care.
As more beneficiaries choose Medicare Advantage, it is increasingly important to closely examine how the program serves beneficiaries and how it falls short. MA plans must ensure that enrollees receive all the high-quality care to which they are entitled and that the government and taxpayers are not overpaying failing plans.
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