Better Medicare Alliance Responds to Misleading Story in The New York Times

Washington, D.C.  – Better Medicare Alliance, the nation’s leading research and advocacy organization supporting Medicare Advantage, responded today to recent coverage of Medicare Advantage payment and billing practices in The New York Times:

“The story cherry-picks allegations– in some cases more than a decade old– to paint an inaccurate and incomplete picture of a vital part of Medicare that is providing better and far more affordable health care for 30 million seniors,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance. “The story ignores basic facts, including that Medicare Advantage saves seniors nearly $2,000 per year – savings that are particularly important for seniors on fixed incomes in a period of inflation on household costs. Today’s Medicare Advantage program also provides demonstrably superior care, while serving a lower-income, more diverse, and more clinically complex population than fee-for-service.”

The Value of Medicare Advantage for Seniors and Taxpayers:

Lower costs for taxpayers
-An October 2021 actuarial analysis from Milliman found that per-member, per-month spending in Medicare Advantage is nearly $7 lower than per-member, per-month spending for beneficiaries of a similar health status in FFS Medicare ($942.43 in Medicare Advantage vs. $949.39 in FFS Medicare).
-All told, Milliman’s findings show that Medicare Advantage provides approximately $32.5 billion annually in added value to seniors through lower out-of-pocket costs and additional benefits unavailable in FFS Medicare, leading the researchers to conclude that “the federal government pays less and gets more for its dollar in MA than in FFS.”

Lower costs for seniors
–Research from ATI Advisory finds that Medicare Advantage beneficiaries report spending nearly $2,000 less on out-of-pocket costs and premiums annually compared to FFS Medicare beneficiaries.
-The lower beneficiary costs in Medicare Advantage result in a 35% lower rate of cost burden (defined as spending 20% or more of one’s income on health expenses) than FFS Medicare.

Bringing coverage to a more medically complex, at-risk beneficiary populatio
-Data analysis shows that 52.7% of Medicare Advantage beneficiaries live below 200 percent of the Federal Poverty Level, compared to 38.3% of FFS Medicare beneficiaries.
-Medicare Advantage beneficiaries are more likelyto self-report having three or more chronic conditions, they are more likely to be food insecure, and they are more likely to self-report diagnoses of diabetes, COPD, congestive heart failure, or dementia, to name a few.
-Enrollment in Medicare Advantage among beneficiaries who are dually-eligible for Medicaid increased by 125%from 2013 to 2019 alone, even as it decreased by 5% in FFS Medicare.
-Avalere Health reports that “Medicare Advantage has a higher proportion of patients with clinical and social risk factors shown to affect health outcomes and cost than FFS Medicare.”

Better health outcomes
-Data analysis by Avalere Health shows that Medicare Advantage delivers a 43% lower rate of avoidable hospitalizations compared to FFS Medicare, a 5% lower rate of hospital readmissions, and higher rates of preventive care and screenings.
-Separate research found that, in the first nine months of the COVID-19 pandemic, Medicare Advantage had a 19% lower rate of COVID-19-related hospitalizations than FFS Medicare, and a lower COVID-19 mortality rate.

What seniors say
-A December 2021 poll shows that 88% of seniors say they oppose the federal government reducing the amount of money it contributes to Medicare Advantage, including 74% who are strongly opposed.
-92% of seniors on Medicare Advantage say a candidate’s support for Medicare Advantage is important when they cast their vote, while 93% of those surveyed said that protecting Medicare Advantage should be a priority for the Biden administration.

Learn more at MedicareAdvantageFacts.com.

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