NEW STUDY: Medicare Advantage Beneficiaries See Lower Costs Across Sites of Care

Survey data shows Medicare Advantage saves beneficiaries on costs to inpatient and outpatient facilities as well as visits to medical providers.

Washington, D.C. – Better Medicare Alliance (BMA), the leading research and advocacy organization supporting Medicare Advantage, released an independent study finding that Medicare Advantage outperforms Traditional Medicare and other coverage options on out-of-pocket costs for inpatient facility stays, outpatient facilities, and office visits to medical providers.

The findings are part of a new data brief prepared for Better Medicare Alliance by ATI Advisory and based on 2017 Medicare Current Beneficiary Survey data, the most recent year available.

It offers an in-depth look at the value of Medicare Advantage and the consumers it serves; finding that Medicare Advantage beneficiaries are more socioeconomically disadvantaged and experience lower levels of education and employment than their Traditional Medicare counterparts. The data brief further reports that beneficiaries across all income levels experience lower cost burden for health coverage.

“As the coronavirus pandemic continues to take its toll, seniors are thinking about health care costs more than ever before. This analysis offers a comprehensive picture of who Medicare Advantage serves and the value that it delivers to cost-conscious beneficiaries,” said Allyson Y. Schwartz, President and CEO of the Better Medicare Alliance. “Medicare Advantage is serving a higher proportion of financially vulnerable enrollees and it is saving them money across every site of care – hospitalizations, outpatient stays, and doctor’s appointments alike.”

Schwartz continued, “While 28 percent of beneficiaries with Traditional Medicare and Medigap coverage experience cost burden from health care and almost 18 percent of those with only Traditional Medicare report the same, Medicare Advantage does better – with 13 percent reporting cost burden. Importantly, as this study is based on 2017 survey data, it does not account for the millions of Medicare Advantage enrollees today who benefit from $0 telemedicine visits and no co-payments for coronavirus  treatments – further highlighting the value of Medicare Advantage to low- and modest-income beneficiaries.”

Key Findings:

• At all income levels, Medicare Advantage beneficiaries are less likely to report being cost-burdened by health coverage than beneficiaries in Traditional Medicare.
  • Among Medicare beneficiaries earning between 100 and 199% of the federal poverty level (FPL), 16.6% of Medicare Advantage beneficiaries are likely to be cost-burdened, compared with 37.8% of Traditional Medicare beneficiaries.
  • Overall, 13% of Medicare Advantage beneficiaries report cost burden compared to 17.8% in Traditional Medicare and 28% for those with Traditional Medicare plus Medigap.
• For inpatient facility stays, Medicare Advantage beneficiaries see $15 average out-of-pocket costs per year, compared to $126 in Traditional Medicare and $69 for Traditional Medicare with Medigap.
• For outpatient facility visits, Medicare Advantage beneficiaries see $116 average out-of-pocket costs per year, compared to $201 in Traditional Medicare and $141 for Traditional Medicare with Medigap.
• For visits to medical providers, Medicare Advantage beneficiaries see $460 average out-of-pocket costs per year, compared to $673 in Traditional Medicare and $584 for Traditional Medicare with Medigap.NOTE: The above figures refer to non-dual Medicare Advantage only beneficiaries. Savings may be more significant for Medicare Advantage with Medicaid, as denoted in the data brief.

Read the full data brief HERE.

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