Study: More Lower-Income Seniors Choosing Medicare Advantage and Finding Better Access to Care
Dual-eligible beneficiaries in Medicare Advantage were more likely to have a usual source of care and more likely to receive key preventive services compared to FFS Medicare
New research commissioned by Better Medicare Alliance, the leading research and advocacy organization supporting Medicare Advantage, finds that a greater proportion of dual-eligible beneficiaries choose enrollment in Medicare Advantage, compared to fee-for-service (FFS) Medicare only.
Dual-eligible beneficiaries comprise 23% of the total Medicare Advantage population, compared to 17% in FFS Medicare. Likewise, 44% of all dual-eligible beneficiaries choose Medicare Advantage, compared to 35% of non-dually eligible Medicare beneficiaries.
Dual-eligible beneficiaries – Medicare recipients who also qualify for Medicaid – have incomes near or below the Federal Poverty Level and often present complex medical and social needs and limitations.
The study, conducted by ATI Advisory and based on Medicare Current Beneficiary Survey (MBCS) data, points to Medicare Advantage’s increasingly diverse, at-risk population and further shows that dual-eligible beneficiaries in Medicare Advantage experience better access to care compared to FFS Medicare.
Dual-eligible beneficiaries in Medicare Advantage are more likely to report having a usual source of care (91 – 93% in Medicare Advantage, 86% in FFS Medicare). They are also more likely to receive key preventive services including:
- mammograms (42% in Medicare Advantage, 34% in FFS Medicare)
- flu shots (68% in Medicare Advantage, 62% in FFS Medicare), and
- blood cholesterol screenings (92% in Medicare Advantage, 84% in FFS Medicare)
Findings also showed that dual-eligible beneficiaries in Medicare Advantage report more chronic conditions than dual-eligible beneficiaries in FFS Medicare. 72% of dual-eligible beneficiaries enrolled in a Medicare Advantage Special Needs Plan (SNP) report having three or more chronic conditions, as do 64% of dual-eligible beneficiaries enrolled in a non-SNP Medicare Advantage plan. By comparison, 56% of dual-eligible beneficiaries in FFS Medicare have three or more chronic conditions.
“This latest research is a powerful testament to Medicare Advantage’s capacity to meet the needs of an increasingly low-income, at-risk, and diverse population,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance. “While dual-eligible beneficiaries in Medicare Advantage often present even more complex needs than their FFS Medicare counterparts, Medicare Advantage is nonetheless delivering better results in pairing beneficiaries with a usual source of care and providing them with needed preventive services. That is why dual-eligible beneficiaries today are more likely to enroll in Medicare Advantage than FFS Medicare. Now, policymakers must ensure this coverage lifeline for some of our most impoverished seniors remains protected.”
“Dual eligibles are a medically, socially, and often functionally complex population. We continue to see Medicare Advantage closing gaps in care that exist in FFS Medicare, with higher rates of preventive service utilization, access to a usual source of care, and lower out-of-pocket costs among duals enrolling in Medicare Advantage,” said Allison Rizer, Principal and study lead at ATI Advisory. “As policymakers tackle inequity in health care, they should look to Medicare Advantage and Special Needs Plans as a mechanism to reach disadvantaged populations.”
“With this study, Better Medicare Alliance continues to shatter the old, outdated notions of whom Medicare Advantage serves. Seniors on Medicare Advantage are increasingly low-income and have greater burdens of chronic conditions. The differences are even more pronounced for those dually eligible who are enrolled in Special Needs Plans (SNPs),” said Cheryl Phillips, MD, AGSF, President and CEO of the SNP Alliance. “More importantly, these beneficiaries are finding a better health care future in Medicare Advantage SNPs, thanks in large part to SNPs’ care coordination structures and innovative supplemental benefits. With higher rates of a usual source of care, lower rates of dissatisfaction, and with ease of getting to the doctor, dually-eligible beneficiaries in Medicare Advantage SNPs have a better partner in their health plan to assist with self-management of chronic conditions, and a person-centered approach to coordinating services.”
“As this report shows, dual-eligible beneficiaries in Medicare Advantage are more racially and ethnically diverse than dual-eligible beneficiaries in FFS Medicare only,” said Martha A. Dawson, DNP, RN, FACHE, President of the National Black Nurses Association. “Given the disparity gaps in health outcomes that continue to plague too many minority and low-income individuals, we support these findings showing that dual-eligible beneficiaries in Medicare Advantage are more likely to receive preventive health services such as mammograms, flu vaccines, and blood cholesterol screenings. As nurses on the front lines of patient care, we stand with Better Medicare Alliance in working to ensure that Medicare Advantage remains a strong, viable option for these minority beneficiaries both now and into the future.”
Read the full data brief HERE.