Study: Medicare Advantage Has Unique Ability to Meet Needs of Cancer Patients and Survivors

Medicare Advantage delivers lower out-of-pocket costs and superior benefits to demographically diverse and socially disadvantaged cancer patients and survivors, analysis finds

WASHINGTON — New research released today demonstrates the unique ability of Medicare Advantage to provide comprehensive preventative care and cancer screening to diverse, low-income cancer patients and survivors while keeping premium and out-of-pocket costs low for beneficiaries when compared to Fee-for-Service (FFS) Medicare.

The research, conducted by ATI Advisory and commissioned by the Better Medicare Alliance, found that cancer patients and survivors in Medicare Advantage spend on average over $2,000 less annually on out-of-pocket health care costs, are equally or more likely to receive preventative care services, and experience social disadvantage at higher rates than FFS Medicare beneficiaries.

“Care coordination and navigation is especially critical for cancer patients, many of whom must navigate a new array of providers,” the research states. “Collectively, the flexibility available through Medicare Advantage gives the unique ability to see and meet the needs of cancer patients and survivors,” the research continues.

Preventative services, early detection, and reducing inequities in health care are all important planks of the recently announced White House National Cancer Plan which will help advance President Biden’s Cancer Moonshot.

Over one in three Medicare cancer patients and survivors enroll in Medicare Advantage, a vital part of the Medicare program which serves an estimated 7.4 million beneficiaries with a history of cancer, according to ATI Advisory.

“This study highlights how Medicare Advantage is working to improve outcomes for beneficiaries facing a cancer diagnosis by limiting the cost burden associated with cancer care and offering superior supplemental benefits such as in-home support services, meals, transportation and home-based palliative care for beneficiaries,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance. “With the staggering cost of cancer care, patients deserve access to the affordable, high-quality health care and supplemental benefits offered by Medicare Advantage.”

“Given the prevalence of cancer and past cancer diagnoses among the Medicare population, this research provides valuable insights into care approaches in Medicare Advantage that support cancer patients and survivors,” noted Sarah Rosenblum, study lead and Director at ATI Advisory. “Innovations and programs like holistic palliative care models, supplemental benefits to address social needs, and risk stratification models that consider cancer status in determining care management approaches can all be leveraged to provide high-quality whole-person care to Medicare Advantage cancer patients.”

“This new research from Better Medicare Alliance and ATI Advisory underscores the key role that Medicare Advantage stakeholders play in cancer care as increasing numbers of Medicare beneficiaries, particularly lower income and minority beneficiaries, turn to Medicare Advantage,” said Tom Hubbard, Senior Vice President of Policy Research of Network for Excellence in Health Innovation. “The care coordination and supplemental benefits offered by Medicare Advantage plans represent an innovative approach to addressing gaps in care for patients facing complex decisions at one of life’s most difficult times.”

Key findings from the ATI Advisory study include:

• Medicare Advantage beneficiaries with cancer are demographically different and experience social disadvantage at higher rates than FFS Medicare beneficiaries.
  • Among beneficiaries who received a cancer diagnosis, approximately half enrolled in Medicare Advantage have incomes below 200 percent of the Federal Poverty Level, compared to one third of FFS Medicare beneficiaries.
  • Approximately one-fifth of Medicare Advantage beneficiaries with cancer or survivors experience food insecurity compared to 14 percent of FFS Medicare beneficiaries. Medicare Advantage beneficiaries are also more likely to identify as Black or Latino compared to FFS Medicare beneficiaries.

• Medicare Advantage beneficiaries report similar or higher rates of preventative service use compared to FFS Medicare beneficiaries and rates are highest among cancer survivors and patients.
  • Medicare beneficiaries who have had a cancer diagnosis are more likely to be screened for cancer through a mammogram, colonoscopy, prostate blood exam, or fecal blood test than Medicare beneficiaries who have not been diagnosed with cancer.

• Medicare Advantage beneficiaries spend less on health care than FFS Medicare beneficiaries across cancer status.
  • The difference between the two programs is slightly larger among cancer survivors and patients; Medicare Advantage beneficiaries who have cancer or are cancer survivors report spending on average $2,095 less on their health care than FFS Medicare beneficiaries.

The ATI Advisory study is divided into two reports—one quantitative, and the other qualitative based on interviews with partners working in the cancer space. The qualitative brief describes how Medicare Advantage can tailor benefits to serve the needs of cancer patients and survivors, from risk assessments and screening, to care management and palliative care.

• Read the full quantitative analysis from ATI Advisory here.
• Read the full qualitative analysis from ATI Advisory here.

Better Medicare Alliance is a community of more than 1 million grassroots beneficiaries and 200+ Ally organizations working to improve health care through a strong Medicare Advantage. Learn more at www.bettermedicarealliance.org.