Along with achieving better health outcomes, Medicare Advantage (MA) checks in at annual consumer savings of roughly $2,000. That’s according to a new report from the research and advocacy organization Better Medicare Alliance (BMA).
This news, as well as other findings from BMA, come at a time when more home-based care providers are being vocal about both the challenges and opportunities MA presents for their businesses, and as lawmakers are keeping a closer eye on the program.
The report from BMA examines MA enrollment trends, consumer savings and health outcomes, in an effort to describe the program.
Overall, MA enrollment is on the rise, having more than doubled over the last decade.
Specifically, MA has 28.4 million beneficiaries, or 45% of the Medicare population. By 2030, Medicare Advantage is expected to have over 52% of total Medicare enrollment.
The increase in enrollment is driven by more health plans offering Medicare Advantage. In fact, 99.7% of beneficiaries have access to at least one Medicare Advantage plan.
In terms of cost savings, Medicare Advantage beneficiaries spend almost $2,000 less on out-of-pocket costs and premiums annually. The average monthly premium in 2022 is $19, and MA provides $32.5 billion annually in additional value to beneficiaries and the federal government, according to the report.
“It’s not hard to see why: seniors are saving nearly $2,000 per year, taxpayers are seeing
lower per-beneficiary government spending, beneficiaries report a 94% satisfaction rate, and 99.9% of Medicare Advantage plans are offering supplemental benefits unavailable in fee-for-service Medicare,” Mary Beth Donahue, president and CEO of BMA, said in the report.
Beneficiaries saw a 43% lower rate of avoidable hospitalizations for any condition, and a 19% lower rate of COVID-19-related hospitalizations during the start of the pandemic. They also had a lower mortality rate when hospitalized for COVID-19, relative to fee-for-service Medicare beneficiaries.
Given the positive health outcomes, cost savings and continually spike in enrollment, one takeaway from the report is that home-based care providers should cultivate relationships with Medicare Advantage plans. At the same time, many providers are likely to remain skeptical.
Indeed, many providers are already working in this space. Home care providers, in particular, are relying less on private-pay revenue structures and are actively working to diversify their payer mix.
Aside from providers, House lawmakers have called for more oversight of Medicare Advantage plans. This is an effort to target MA plans that are limiting access to care and increasing costs for taxpayers.
“I am deeply concerned with recent reports that seniors in private sector Medicare Advantage plans are facing unwarranted barriers to accessing timely, medically necessary care,” Energy and Commerce Chairman Frank Pallone Jr. (D-N.J.) said during a hearing last month. “Several studies have raised concerns that insurance companies are denying beneficiaries’ access to treatment and imposing burdensome requirements that delay care. Improper claim denials and increased use of prior authorizations are preventing beneficiaries from receiving the care they need.”
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