A deeper dive into an issue driving the healthcare reform conversation.
Week in Review
VALUE OF MEDICARE ADVANTAGE The Medicare Advantage program provides critical value to more than 33 million American seniors.
Quick takeaway: Despite outperforming original Medicare Fee-for-Service (FFS) across a wide range of important metrics, Medicare Advantage (MA) continues to find itself under attack.
Digging deeper: MA plans prioritize care coordination, delivering better value than FFS in several ways:
- Costs: MA beneficiaries spend over $2,500 less per year than those in FFS.
- Quality: MA outperforms FFS on multiple quality metrics, including cancer screenings, heart health, diabetes, and rheumatoid arthritis.
- Demographics: MA serves seniors from historically underserved populations, including 69 percent of Latino beneficiaries, 65 percent of Black beneficiaries, and 60 percent of Asian beneficiaries.
MA also offers seniors access to supplemental benefits, which are linked to better health outcomes and improved healthcare utilization.
When compared to FFS, not only do MA plans provider higher quality of care, they also facilitate better use of critical preventive services, which can improve health and lower costs in the long term.
The MA program also plays a key role in addressing health disparities and promoting health equity.
Financially, research shows that every dollar spent by the government on MA provides beneficiaries with lower cost-sharing and additional benefits compared to FFS. In fact, if FFS were as efficient as MA, the life of the Medicare program could be extended by as much as 17 years.
What it means: Unfortunately, recently released data paints a concerning picture of the current state of MA.
Successive years of cuts and other changes to the program leave millions of American seniors facing an uncertain environment during this year’s Open Enrollment period, which runs through 7 December:
- Fewer Plans: Plan availability decreased by over 6 percent compared to last year, with 1.3 million beneficiaries currently enrolled in plans that will no longer be available.
- Higher Costs: The median out-of-pocket maximum will increase by 8 percent next year, while seniors in 19 states will see their premiums go up by more than 10 percent.
- Reduced Benefits: Many of the benefits that seniors rely on, such as fitness programs, in-home support services, meals, and transportation, will be reduced.
Call to Action: Given the ongoing threats to the program, lawmakers and regulators need to hear from beneficiaries about the importance of Medicare Advantage. Stay alert for ways to engage.
In the meantime, we’re always looking for “MA Champions” who are willing and wanting to do more to defend the program – so, be sure to let us know if you want to help protect Medicare Advantage.
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