Consumer / Employer, Payers

When it comes to satisfaction, only a few major differences exist between MA and traditional Medicare

Kaiser Family Foundation discovered Medicare Advantage plans and traditional Medicare had similar rates of satisfaction among enrollees. However, there were a select few differences between the plans, with MA enrollees more likely to get preventive care and traditional Medicare enrollees more likely to receive care from the highest-rated facilities.

Medicare, Medicaid, CMS, coverage

As the open enrollment period nears, many Medicare beneficiaries will be faced with the decision of choosing a traditional Medicare plan or going with Medicare Advantage (MA). A recent report shows that there are only a few differences between the plans, with beneficiaries showing similar rates of satisfaction.

The Kaiser Family Foundation report from this month reviewed 62 studies published since 2016. The studies compared MA and traditional Medicare based on beneficiary experience, affordability, utilization and quality.

The report comes shortly after another KFF analysis, which found that MA enrollees account for almost half of all Medicare beneficiaries. As soon as next year, this number could cross the 50% threshold, the research organization predicts. Federal spending for MA enrollees was $321 higher per person in 2019 than it would have been if they had opted for traditional Medicare. As MA plans rapidly gain popularity, KFF said in the report that it’s important to see how well it performs stacked up against the traditional option. 

“The growing role of Medicare Advantage and the relatively high spending on this program raise the question of how well private plans serve their enrollees compared to traditional Medicare,” KFF stated.

KFF discovered MA and traditional Medicare performed similarly across all quality measures. Additionally, there were no major differences in the amount of time spent in the hospital for common medical admissions. 

For beneficiary experience measures, enrollees for MA and traditional Medicare also experienced similar wait times, difficulties in finding a general physician, instances in being told their health insurance was not accepted and being informed they could not be accepted as a new patient.

However, there were a few differences found between MA and traditional Medicare. MA enrollees were more likely to have a usual source of care and were more likely to receive preventive care, including annual wellness visits, routine checkups and screenings. They also had better experiences in receiving prescription drugs.

Traditional Medicare enrollees, however, were more likely to use home health services, post-acute skilled nursing or inpatient facility care. Traditional Medicare also did better on measures for receiving care from the highest rated hospitals for cancer or highest-quality skilled nursing facilities.

Further, a slightly smaller number of traditional Medicare beneficiaries experienced a cost-related problem compared to MA enrollees. One study showed that 15% of beneficiaries in traditional Medicare reported at least one cost-related problem, compared to 19% of MA beneficiaries. This is largely due to many traditional Medicare enrollees having supplemental coverage, such as Medigap. For Medicare beneficiaries without supplemental coverage, 30% reported cost-related issues.

While MA enrollment has become increasingly more diverse, KFF noted in the report that only a few studies analyzed certain subgroups, such as communities of color, rural areas or beneficiaries who are dually eligible for Medicare and Medicaid.

“These gaps in data for certain subgroups of Medicare beneficiaries is especially concerning given that about half of all Black and Hispanic Medicare beneficiaries are now enrolled in a Medicare Advantage plan,” KFF said.

Photo: Vadzim Kushniarou, Getty Images

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