MA’s Value Underscored In New Study
A new ATI Advisory analysis conducted on behalf of the Better Medicare Alliance finds that Medicare Advantage (MA) enrollees spend less on average than those in traditional Medicare fee-for-service (FFS) and yet have similar satisfaction rates.
Looking at files from 2021 to 2023, ATI found that MA enrollees spent $2,824, or 36%, less out-of-pocket on average in 2023 compared to those in FFS. That difference has increased over time, with savings 16% higher in 2023 than in 2022. Just 12% of MA enrollees said they faced a significant cost burden, or spent more than 20% of their income on healthcare, compared to 24% of those in FFS.
MA too cares for more lower income people – 54% in MA are at or below 200% of the federal poverty level vs. 30% in FFS. More than three-quarters of MA members have three or more chronic needs.
On the quality front, MA enrollees were 15% more likely than those in FFS to have had an annual wellness visit.
#medicareadvantage #medicare #quality
CBO: MA To Hit 57% in 2036
A new Congressional Budget Office (CBO) assessment says Medicare Advantage (MA) will account for 57% of overall Medicare enrollment by 2036, up from 51% this year. CBO says growth will be at a slower pace than before and growth could slow even more than in the past few years. MA’s share of federal spending on Medicare Part A and Part B benefits will rise from 54% in 2026 to 61% in 2036.
MA spending will grow 7% higher than in traditional Medicare. CBO also estimates that if a beneficiary switched from fee-for-service to MA, federal spending on that enrollee would rise roughly 15%. The agency attributed the increase primarily to coding intensity and favorable selection by insurers. Others argue that coding intensity has been reduced dramatically and favorable selection is a misnomer. Private estimates consistently say MA will grow more than government estimates.
#medicareadvantage #enrollment #riskadjustment #overpayments
KFF Updates Coverage Gap Calculations
Healthcare policy group has updated its analysis of uninsured Americans in the so-called coverage gap. Ten states have yet to expand Medicaid under the Affordable Care Act (ACA). In those states KFF says 1.2 million fall into the gap – too rich for Medicaid and too poor for Exchange subsidies. These states have uninsured rates nearly twice as high as expansion states – 14.5% vs. 8% uninsured.
If all remaining states adopted the expansion, KFF says 2.4 million uninsured adults would become eligible for Medicaid – the 1.2 million in the gap and another 1.2 million between 100% and 138% of the federal poverty limit but not currently enrolled in the Exchanges.
#healthcare #coverage #exchanges #medicaid
— Marc S. Ryan
