When it comes to satisfaction, there are only a few major differences between MA and traditional Medicare - MedCity News

Medicare, Medicaid, CMS, coverage

As the open enrollment period approaches, many Medicare beneficiaries will be faced with the decision of choosing a traditional Medicare plan or switching to Medicare Advantage (MA). Recently report shows that there are few differences between the plans, with beneficiaries showing similar levels of satisfaction.

This month’s Kaiser Family Foundation report reviewed 62 studies published since 2016. Studies compare MA and traditional Medicare based on beneficiary experience, affordability, utilization, and quality.

The report comes shortly after another KFF analysis which found that MA enrollees account for nearly half of all Medicare beneficiaries. As early as next year, this number could cross the 50% threshold, the research organization predicts. Federal spending for MA enrollees was $321 higher per person in 2019 than it would have been if they had chosen traditional Medicare. With MA plans quickly gaining popularity, KFF said in the report that it is important to see how well it performs compared to the traditional option.

“The growing role of Medicare Advantage and the relatively high costs of this program raise the question of how well private plans are serving their enrollees compared to traditional Medicare,” KFF said.

KFF found that MA and traditional Medicare performed similarly on all quality measures. Furthermore, there were no major differences in the time spent in hospital for routine medical appointments.

On measures of beneficiary experience, MA and traditional Medicare enrollees also had similar wait times, difficulty finding a general practitioner, being told their health insurance was not accepted, and being informed, that they cannot be accepted as a new patient.

However, there were several differences found between MA and traditional Medicare. MA enrollees were more likely to have a usual source of care and were more likely to receive preventive care, including annual health care visits, routine checkups, and screenings. They also had a better experience getting prescription drugs.

Traditional Medicare participants, however, are more likely to use home health services, skilled nursing services after emergency treatment, or hospital care. Traditional care also fared better on measures of receiving care from the highest-rated cancer hospitals or the highest-quality skilled nursing facilities.

Additionally, slightly fewer traditional Medicare beneficiaries had a cost-related problem than MA enrollees. A study showed that 15% of beneficiaries in traditional Medicare reported at least one cost-related problem, compared with 19% of MA beneficiaries. This is largely due to many traditional Medicare participants having supplemental coverage, such as Medigap. For Medicare beneficiaries without supplemental coverage, 30% reported cost-related problems.

Although enrollment in graduate programs is increasingly diverse, KFF notes in the report that only a few studies have analyzed specific subgroups, such as communities of color, rural areas or beneficiaries who are dually eligible for Medicare and Medicaid.

“These data gaps for certain subgroups of Medicare beneficiaries are particularly troubling given that about half of all blacks and Hispanics Medicare beneficiaries are now enrolled in a Medicare Advantage plan,” KFF said.

Photo: Vadzim Kushniarou, Getty Images

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