What Is The Difference Between Medicare Advantage And Medicare Supplement
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June 17, 2024 8:05 pm
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What Is The Difference Between Medicare Advantage And Medicare Supplement
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Bermuda Triangle” Of Medicare Advantage
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Types Of Medicare Advantage Plans (hmo, Ppo, Pffs, Snp)
The Medicare Open Enrollment Period (OEP) runs between January 1 and March 31 each year. This provides agents and brokers with a great opportunity to grow… OEP Compliance: Explained The growing role of Medicare Advantage in the Medicare program and the changing demographics of Medicare Advantage enrollees. There has been interest in how well individual plans serve their enrollees alongside traditional Medicare. To answer this question, we relied on a previous research review examining 62 studies published since 2016 that compared Medicare Advantage and traditional Medicare based on beneficiary experience, affordability, service utilization, and quality.
We found some differences between Medicare Advantage and traditional Medicare that are supported by strong evidence or replicated in many studies. Both Medicare Advantage and traditional Medicare beneficiaries reported similar levels of satisfaction with overall measures of their care and care coordination. Medicare Advantage outperforms traditional Medicare on some measures, such as use of preventive services, common sources of care, and lower hospital readmission rates. However, traditional Medicare outperformed Medicare Advantage on other measures, such as providing care at top hospitals or high-quality skilled nursing facilities and home health agencies for cancer treatment. In addition, a slightly higher proportion of traditional Medicare beneficiaries than Medicare Advantage enrollees experienced a cost-related problem, largely due to lower rates of cost-related problems with supplemental coverage among traditional Medicare beneficiaries. Several studies found lower use of post-acute care among Medicare Advantage participants, but it was unclear whether this was associated with better or worse outcomes. Research on the use of hospital care and other health services, including prescription drugs, and measures of quality of care have varied, likely due to differences in data and methods across studies. |
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Whenever possible, we emphasize research for specific subgroups of interest, such as beneficiaries in communities of color, living in rural areas, or dually eligible for Medicare and Medicaid. Notably, relatively few studies specifically examine these population subgroups, making it difficult to assess the strength of the findings or how broadly they apply. For example, one study found that black Medicare beneficiaries were more likely to be hospitalized in Medicare Advantage than in traditional Medicare. Although important, we were unable to identify additional analyzes comparing potential preventable hospitalization rates between Medicaid and traditional Medicare among Hispanic and other beneficiaries of color, beneficiaries living in rural areas, or beneficiaries who are eligible for Medicare and Medicaid. Additionally, despite the increased focus on alternative payment models in Medicare, we identified only two studies that did not refer traditional Medicare beneficiaries to accountable care organizations (ACOs) from traditional Medicare beneficiaries.
Satisfaction, access to care, care coordination, and prescription drug experiences: Beneficiaries in Medicare Advantage and traditional Medicare reported similar levels of satisfaction with their care and similar experiences with wait times, finding a new provider, and overall measures of care coordination. However, Medicare Advantage participants were more likely to report having a better experience with their usual source of care, receiving information during care, and obtaining needed prescription drugs.
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Switching: Overall, the switching rate between Medicare Advantage and traditional Medicare was low, although a slightly higher proportion of Medicare Advantage enrollees chose to switch from Medicare Advantage to traditional Medicare than beneficiaries who switched from traditional Medicare to Medicare Advantage. In addition, conversion rates from Medicare Advantage to traditional Medicare were relatively higher among beneficiaries who are dually eligible for Medicare and Medicaid, beneficiaries of color, beneficiaries in rural areas, and after the onset of functional impairment. Transition rates can be a proxy for dissatisfaction with current coverage arrangements
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A slightly smaller proportion of beneficiaries in traditional Medicare reported having cost-related problems than Medicare Advantage enrollees. Similar findings were observed for black beneficiaries, beneficiaries younger than 65, and beneficiaries in fair or poor health. Beneficiaries in traditional Medicare without supplemental coverage had higher rates of cost-related problems than beneficiaries enrolled in Medicare Advantage plans. Three studies examining beneficiaries with high needs, diabetes, or mental illness found no differences in measures of affordability between Medicare Advantage and traditional Medicare.
Preventive services: Medicare Advantage enrollees were more likely than traditional Medicare beneficiaries to receive preventive services, such as annual wellness visits and routine checkups, screenings, and flu or pneumococcal vaccines, with similar findings for people of color based on different studies. Beneficiary under 65 years of age
Hospital services: Differences in the use of hospital services between people on Medicaid and traditional Medicare vary depending on how hospital use is measured. Overall, there were no differences in total hospital admissions or mean length of general admissions based on evidence from five studies. Four studies found fewer hospitalizations among Medicare Advantage enrollees than traditional Medicare beneficiaries for at least some beneficiary groups. Differences in the proportion of beneficiaries with at least one hospitalization varied, with two studies finding no differences between Medicare Advantage and traditional Medicare, and two studies finding lower rates in Medicare Advantage. No studies have examined differences in hospital use between Medicare Advantage and traditional Medicare by race and ethnicity or other demographics.
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Post-acute care: Several studies have reported higher home health care utilization and shorter lengths of stay in SNFs and IRFs than in traditional Medicare among skilled nursing facilities (SNFs), inpatient care facilities (IRFs), and Medicare Advantage enrollees. Beneficiaries Seven studies that examined the relationship between post-acute care use, home health use and patient outcomes found that hospital readmission rates were generally lower.
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