Protecting Medicare Advantage for Seniors in Underserved Populations
By Rose Maljanian, Chairman of Population Health Alliance and CEO of HealthCAWS, and Mary Beth Donahue, President and CEO of the Better Medicare Alliance
Medicare Advantage provides over 32 million seniors and people with disabilities with high quality, affordable care. This coverage includes supplemental benefits to meet beneficiaries’ total health needs, including medical, behavioral, and social care. Seniors have come to depend on this program, especially those from historically underserved populations.
Today, more than half of the overall Medicare population is choosing Medicare Advantage, including 69% of Latino Medicare beneficiaries, 65% of Black Medicare beneficiaries, and 60% of Asian Medicare beneficiaries, highlighting Medicare Advantage’s position as an inclusive and much-desired program for all senior populations. Medicare Advantage beneficiaries report an average of $2,400 in annual savings on premiums and out-of-pocket costs compared to those enrolled in fee-for-service Medicare—a critical expense reduction for seniors, many of whom are living on fixed incomes.
In addition to saving thousands on health care, Medicare Advantage beneficiaries get the simplicity of bundled coverage and receive irreplaceable value out of the program’s supplemental benefits. For example, 99.9% of Medicare Advantage plans offer dental, vision, and hearing coverage with either no, or low-cost, premiums. Seniors also benefit from a range of proactive services through their plans, including prescription drug coverage, transportation to and from doctor’s offices, and meal delivery.
Not only do these benefits help seniors access affordable care, they also translate into better outcomes. In fact, 43% of beneficiaries experience fewer avoidable hospitalizations compared to those in fee-for-service Medicare. And seniors with major complex chronic conditions experience a 57% lower rate of avoidable acute hospitalizations in Medicare Advantage compared to fee-for-service Medicare. This translates to cost savings for seniors and better quality of life, preserving healthy days to spend doing what they enjoy most.
Yet, a new analysis by Berkeley Research Group (BRG) shows that recently proposed changes to Medicare Advantage could jeopardize the program’s stability for the millions of beneficiaries who rely on it. If these proposals are enacted, the value of the Medicare Advantage program would drop by a national average of $33 per beneficiary every month—almost $400 annually. The proposed changes from the Centers for Medicare and Medicaid Services (CMS) could further impact our most vulnerable dual-eligible seniors (those who are eligible for both Medicare and Medicaid). These dual-eligible seniors may see a decrease in the value of their Medicare Advantage plan averaging $50 per month, or $600 annually. These cuts could result in plans needing to cut back supplement benefits that we, including CMS, have worked so hard to design and deploy to the benefit of seniors.
With so many seniors relying on the program, it’s critical that health care advocates speak up to prevent these changes and preserve the program’s added value for beneficiaries, which is more than offset by the savings on acute care ER visits and hospital stays. It’s important to protect the Medicare Advantage program for the millions of seniors who count on it—especially seniors in underserved and low-income populations whose needs and health care costs are increasing. We will continue to advocate for CMS protecting Medicare Advantage’s stability and ensuring that all seniors, especially our most vulnerable, have access to affordable, high-quality care.