Medicare Advantage Is Living Up to Its Name!

Blog Article

Heritage policy analyst Kathryn Nix has analyzed research that shows that private health plans participating in Medicare Advantage are making strides in what Congress has tried—and failed—to achieve in traditional Medicare fee-for-service (FFS) for decades. Competition among private plans has maintained patient satisfaction, lowered costs, and increased the quality of care. Success is obvious and abundant in the MA program. Medicare Advantage (MA) is more advantageous to beneficiaries when compared to traditional FFS Medicare. It was created in 2003 to allow seniors to receive their Medicare benefits through a private health plan of their choice. The private plans are required to offer the same benefits as traditional FFS. MA has become increasingly popular, with almost 20 percent of the Medicare population enrolled as of 2010. The program’s popularity is justified by the astounding improvements to the quality of care. MA has led to the opportunity to compare the performance of participating plans with that of traditional Medicare. In a Center for Policy Innovation Research Summary, Nix analyzes two separate research studies that show MA outperforming FFS on several measures of health care quality:

  • MA performed better than Medicare fee-for-service on most measures reflecting patients’ receipt of appropriate care.
  • MA also performed better than FFS when assessed using discharge data on hospital utilization.
  • MA plans may be doing a better job of preventing unnecessary inpatient care by increasing use of outpatient services and office visits.
  • MA plans may be avoiding unnecessary re-admissions through superior discharge planning and coordination of care following an inpatient episode of care.

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Remember: At any time during the year, you can switch to a Medicare Advantage Plan or Medicare Prescription Drug Plan that has a 5-star rating. Plan ratings are based on member surveys, information from doctors and health care providers, and other sources. The plan ratings are scores that show the quality and performance of the plan, on a scale of 1 to 5 stars, with 5 being the highest rated plans.
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