As the open enrollment period approaches, many Medicare beneficiaries will be faced with the decision of whether to choose a traditional Medicare plan or opt for Medicare Advantage (MA). A recent report shows that there is little difference between the plans, with beneficiaries showing similar satisfaction rates.
This month’s Kaiser Family Foundation report reviewed 62 studies published since 2016. The studies compared HA and traditional health insurance based on beneficiary experience, affordability, use and quality.
The report comes shortly after another analysis by KFF, which found that MA enrollees make up nearly half of all Medicare beneficiaries. As early as next year, that number could cross the 50% threshold, predicts the research body. Federal expenditures for MA enrollees was $321 more per person in 2019 than it would have been had they opted for traditional health insurance. While MA plans are rapidly gaining popularity, KFF said in the report that it’s important to see how well it performs compared to the traditional option.
“The growing role of Medicare Advantage and the relatively high spending on this program raises the question of how well private plans serve their enrollees compared to traditional Medicare,” KFF said.
KFF found that HI and traditional health insurance performed similarly across all quality measures. Additionally, there were no major differences in time spent in hospital for routine medical admissions.
For beneficiary experience measures, HI and traditional health insurance enrollees also experienced similar wait times, difficulty finding a GP, instances of being told that their health insurance was not accepted and they could not be accepted as a new patient.
However, some differences were found between HI and traditional health insurance. AD enrollees were more likely to have a usual source of care and were more likely to receive preventive care, including annual wellness visits, routine checkups, and screenings. They also had better experiences receiving prescription drugs.
Traditional Medicare enrollees, however, were more likely to use home health services, post-acute skilled nursing, or hospital care. Traditional Medicare also did better on measures of receiving care from top-rated cancer hospitals or the highest quality skilled nursing facilities.
Additionally, a slightly lower number of traditional Medicare beneficiaries experienced a cost-related issue compared to MA enrollees. One study showed that 15% of traditional health insurance recipients reported at least one cost-related issue, compared to 19% of IA recipients. This is largely because many traditional Medicare enrollees have supplemental coverage, such as Medigap. For Medicare beneficiaries without supplemental coverage, 30% reported cost-related issues.
As MA enrollments have become increasingly diverse, KFF noted in the report that only a few studies have analyzed certain subgroups, such as communities of color, rural areas, or recipients who are both eligible for Medicare and Medicaid.
“These data gaps for certain subgroups of Medicare beneficiaries are of particular concern given that approximately half of all Black and Hispanic Medicare beneficiaries are now enrolled in a Medicare Advantage plan,” KFF said.
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