New Study: Medicare Advantage Serves Beneficiaries with Higher Social Risk Factors

Washington, D.C. – Better Medicare Alliance (BMA), the leading research and advocacy organization supporting Medicare Advantage, released new research showing that Medicare Advantage serves a beneficiary population facing higher rates of social risk factors than those in Traditional Medicare.

The findings are part of a new Data Brief prepared for Better Medicare Alliance by ATI Advisory examining the role of social determinants of health in the Medicare and Medicare Advantage populations.

ATI Advisory’s analysis offers a comprehensive picture of the high-need, at-risk enrollees who entrust their care to Medicare Advantage; finding that Medicare Advantage beneficiaries are lower-income, face lower levels of education, are more likely to be non-English speaking, more likely to rent their home and more likely to be reliant on public transportation.

“Social determinants of health have been shown to impact as much as 50 percent of an individual’s health outcomes. This data brief finds that Medicare Advantage beneficiaries face higher social risks and real challenges to managing their health. These vulnerable seniors draw unique benefit from Medicare Advantage’s cost savings and cost protections, care coordination, extra benefits, and improved health outcomes,” said Allyson Y. Schwartz, President and CEO of the Better Medicare Alliance. “With high satisfaction rates among beneficiaries, this report shows that Medicare Advantage is the choice for increasing numbers of beneficiaries with significant social risk factors. We hope this report gives policymakers a clearer picture of the Medicare Advantage population and the importance of this coverage option to their health and wellbeing.”

BMA Ally organizations also praised the study’s findings:

“The National Hispanic Medical Association has long fought to expand and improve health care for lower-income seniors. This research shows that many of these individuals are actively choosing the high-value care uniquely found in Medicare Advantage,” said Elena Rios, MD, MSPH, President and CEO of the National Hispanic Medical Association. “Policymakers should look to these findings and know that when they stand up for Medicare Advantage, they are standing up for the health and financial security of their constituents who are most in need.”

“The Asian & Pacific Islander American Health Forum applauds Better Medicare Alliance’s work highlighting the role of social determinants of health in caring for our nation’s seniors,” said Kathy Ko Chin, President and CEO of the Asian & Pacific Islander American Health Forum. “As this data brief shows, Medicare Advantage serves a higher proportion of beneficiaries who are more likely to have social risk factors, including a higher representation of those who speak English as a second language or not at all. One-third of Asian Americans, Native Hawaiian, and Pacific Islanders have limited English proficiency and we are committed to ensuring they receive the same health care security as their peers. As we work to close the gap on longstanding disparities and achieve meaningful equity in health care, we appreciate the critical role that Medicare Advantage plays in providing quality, affordable coverage to underserved and at-risk beneficiaries.”

“This data brief shows that Medicare Advantage is serving a more complex and at-risk beneficiary population than many first knew – and yet it is consistently meeting their health coverage needs. At National Minority Quality Forum, we know that Black seniors continue to live with disproportionately higher social risk factors, and their care is of our utmost concern. Medicare Advantage provides crucial health and financial security to these vulnerable older Americans. With these findings in hand, we join Better Medicare Alliance in continuing to support a strong Medicare Advantage,” said Gary A. Puckrein, Ph.D., President and CEO of the National Minority Quality Forum.

Key Findings:

• Low-Income beneficiaries enrolled in Medicare Advantage are more likely to be racial or ethnic minorities than those in Traditional Medicare.
  • More than half of Medicare Advantage beneficiaries living below the poverty line are from a racial/ethnic minority, compared with 42% in Traditional Medicare. This higher percentage continues for beneficiaries in the next income bracket (100-199 percent FPL) with 31% minority representation in Medicare Advantage as compared to 20% in Traditional Medicare.
• Medicare Advantage beneficiaries have lower levels of education than those in Traditional Medicare.
  • 19% of all Medicare Advantage beneficiaries completed less than a high school degree, compared with 13.5% of Traditional Medicare beneficiaries.
• Medicare Advantage Beneficiaries Are More Likely than Traditional Medicare Beneficiaries to Speak English as a Second Language, or Not at All
  • 28% of Medicare Advantage beneficiaries living below the poverty line speak a language other than English in the home, compared to 24% in Traditional Medicare.
  • 18% of Medicare Advantage beneficiaries living below the poverty line speak little to no English, compared to 17% in Traditional Medicare.
• Lower-income Medicare Advantage beneficiaries are more likely to rent their home
  • 52% of the lowest income Medicare Advantage beneficiaries rent their home, as compared to 46% of Traditional Medicare beneficiaries. Only 6% of all Medicare beneficiaries in the highest income bracket rent their home.
• Medicare Advantage beneficiaries are more likely to face food insecurity
  • Nearly half of the lowest-income Medicare beneficiaries are food insecure. Among Medicare beneficiaries below the poverty line, 48% in Medicare Advantage and 44 percent in Traditional Medicare report not having enough money for food.
  • Importantly, health expenses are not the driving force in this challenge for Medicare Advantage beneficiaries. Separate BMA research conducted by ATI Advisory shows that Medicare Advantage beneficiaries are less cost-burdened by health coverage than those in Traditional Medicare – reporting nearly $1,600 a year in savings.
• Lower-income Medicare Advantage beneficiaries are more likely to use public transportation 
  • 10% of Medicare Advantage beneficiaries below the poverty line use public transportation, as compared to 8% in Traditional Medicare.
  • Supplemental benefits provided in Medicare Advantage, such as transportation to medical appointments, can help mitigate access barriers.

Read the full data brief HERE.