The Apixio Blog

Five Intriguing Themes from the Latest Medicare Advantage Stats

The Better Medicare Alliance, a health insurance trade group with 43 members, recently published a series of research fact sheets on the government’s Medicare Advantage (MA) program. These fact sheets explore MA’s influence on primary care, chronic care, and overall quality, as well as the demographics of the MA program.  They provide an interesting, and sometimes unexpected, snapshot of the type of care the program provides and for whom. After going through the statistics, we came away with these themes:

  1. Chronic Care Management is a Strength: Diabetic MA patients have 19% fewer inpatient days and 28% fewer hospital admissions than traditional Fee-For-Service (FFS) Medicare diabetic patients. Additionally, MA program participants are 20% more likely to have an annual preventative care visit compared to FFS Medicare beneficiaries.
  2. Minorities Fare Relatively Well: The divide in mammography screening between minority and white women that is found in FFS Medicare does not exist in the MA program. After accounting for geography, 80% of Hispanic women and 75% of white women get mammograms in Medicare Advantage, versus 54% of Hispanic women and 61% of white women in FFS Medicare. In a potentially related finding, Hispanics choose MA more frequently than the population at large. While a third of all Medicare beneficiaries choose MA, 44% of Medicare beneficiaries who are Hispanic choose MA.
  3. Once You Choose MA You Don’t Go Back: 91% of MA beneficiaries are satisfied with their coverage. Year over year, 98% of MA beneficiaries remain in MA plans.
  4. Value-Based Care Is on the Rise: By 2020, Aetna aims to allocate 75% of its MA spending to value-based contracting. By 2017, Humana aims to have 75% of its MA enrollees in value-based care models.
  5. Enrollment is Growing: The Congressional Budget Office expects that the percentage of Medicare enrollees choosing MA will grow from 32% to 40% in the next ten years, an increase of almost 13 million beneficiaries.

These statistics powerfully demonstrate that MA and value-based care is a popular, growing program that does comparatively well at caring for minorities and those with chronic care needs.

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