Study: ‘Big Differences’ Between Medicare Advantage And Traditional Medicare But Seniors Like Both

Medicare Advantage is better about coaxing seniors to get preventive healthcare while traditional Medicare lands its beneficiaries in higher quality hospitals, an analysis of more than 60 studies shows.

“Enrollees in Medicare Advantage were more likely to get routine check-ups and immunizations, while those in traditional Medicare were more likely to receive care in the highest-rated hospitals,” the Kaiser Family Foundation said in its review of 62 studies published since 2016. “Rates of satisfaction were similar among both groups.”

The analysis comes as health insurers have escalated expansions of their private Medicare Advantage plans into new areas, pushing enrollment to record highs. Medicare Advantage plans added more than 2 million beneficiaries for this 2022 coverage year, boosting the program to 45% of all Medicare enrollment, according to a study earlier this year by The Chartis Group.

Established health insurers including UnitedHealth Group’s UnitedHealthcare, CVS Health’s Aetna, Cigna, Elevance Health, formerly Anthem, and Humana continue to expand into new regions and the business has been lucrative for them. Meanwhile, startups and smaller regional health plans are using funds from their financial backers and investors to launch expansion into new markets for next year, despite the competitive landscape and volatile financial markets.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs. And in recent years, the Centers for Medicare & Medicaid Services has allowed Medicare Advantage plans to cover more supplemental benefits, adding to their popularity among seniors.

But the Kaiser Family Foundation analysis, which comes ahead of the Oct. 15 beginning of open enrollment that allows seniors to change their Medicare benefits and pick a Medicare Advantage plan if they want that, found benefits to both.

“Both Medicare Advantage and traditional Medicare beneficiaries reported similar rates of satisfaction with their care and overall measures of care coordination,” authors of the analysis wrote. “Medicare Advantage outperformed traditional Medicare on some measures, such as use of preventive services, having a usual source of care, and lower hospital readmission rates. However, traditional Medicare outperformed Medicare Advantage on other measures, such as receiving care in the highest-rated hospitals for cancer care or in the highest-quality skilled nursing facilities and home health agencies.”

Here are some highlighted positives Kaiser cited for Medicare Advantage:

• “Medicare Advantage enrollees were more likely than those in traditional Medicare to report having a usual source of care. They were also more likely to receive preventive care services, such as annual wellness visits and routine checkups, screenings, and flu or pneumococcal vaccines.”
• “Medicare Advantage enrollees reported better experiences getting needed prescription drugs than traditional Medicare beneficiaries overall.”
• “Most studies found that utilization of home health services and post-acute skilled nursing or inpatient rehabilitation facility care was lower among Medicare Advantage enrollees than traditional Medicare beneficiaries, but were inconclusive as to whether that was associated with better or worse outcomes.”

Here are some benefits to traditional Medicare Kaiser highlighted:

• “Traditional Medicare outperformed Medicare Advantage on measures such as receiving care in the highest-rated hospitals for cancer care or in the highest-quality skilled nursing facilities and home health agencies.”
• “A somewhat smaller share of traditional Medicare beneficiaries than Medicare Advantage enrollees experienced a cost-related problem, mainly due to lower rates of cost-related problems among traditional Medicare beneficiaries with supplemental coverage.”