According to Better Medicare Alliance (BMA), the research and advocacy organization, Medicare Advantage (MA) set the limit of $2,000 for the annual consumer savings.
Medicare Advantage has its ups and downs for home-based health care providers and their businesses and this report comes out in the midst of it. Furthermore, the lawmakers decided to follow closely to the development of these changes.
The BMA has come out with some other findings as well. They examined MA enrollment trends, health outcomes and consumer savings in order to best showcase the program. By looking at these stats, beneficiaries can determine more easily whether to opt in or not.
What is the trend?
Out of all the Medicare plans, the Medicare Advantage program is one of the most popular choices with 45% of the beneficiaries enrolled. This equates to 28.4 million, with the prediction of steady growth ahead. It is estimated that people will keep enrolling in Medicare Advantage plans in the years to come. By 2030, over half of the Medicare enrollees will have Medicare Advantage.
This is not surprising, considering that the number of enrollees doubled over the last decade.
What is it about Medicare Advantage that people find so appealing?
Medicare Advantage comes with an abundance of health insurance plans. Almost all Medicare users (99.7%) have at least one Medicare Advantage plan, no matter what their primary coverage is.
But the variety of plans isn’t the only aspect of Medicare Advantage that attracts people to opt for this plan. There’s also price. On average MA enrollees spend approximately $2,000 less on out-of-pocket costs and annual premiums. It is worth saying that the monthly premium is $19 for Medicare Advantage, which is one of the lower rates when it comes to Medicare plans.
To learn more about how much you save on a Medicare Advantage Plan, you can easily compare the best Medicare Advantage Plans from top insurance carriers over at MedicareConsumer today.
Mary Beth Donahue, president and CEO of BMA, said in the report: “It’s not hard to see why: seniors are saving nearly $2,000 per year, taxpayers are seeing lower per-beneficiary government spending, beneficiaries report a 94% satisfaction rate, and 99.9% of Medicare Advantage plans are offering supplemental benefits unavailable in fee-for-service Medicare.”
There’s data to support the superiority of the Medicare Advantage plan. Medicare Advantage Beneficiaries experienced a 43% lower rate of avoidable hospitalizations for any conditions since the start of the pandemic.
Speaking of COVID, the people who had access to this plan in particular also had a 19% lower rate of COVID-related hospitalization! Consequently, the number of COVID deaths was much lower as well compared to the other Medicare beneficiaries.
As shown, Medicare Advantage has multiple benefits over some other plans. First of all, there is a wide variety of choices that allows everyone to find what’s suitable for them. Secondly, Medicare Advantage allows enrollees to save up to $2,000 on out-of-pocket costs. Furthermore, with the monthly premium of $19, the plan is one of the most affordable ones offered. Last but not least, the plan has shown to be successful when it comes to hospitalizations and COVID hospitalizations and death rates. The Medicare Advantage beneficiaries ended up in hospitals at much lower rates compared to other plan users.
Despite all that, many providers remain skeptical of Medicare Advantage. For example, home care providers have started focusing much more on diversifying their payer mix and they no longer rely on private-pay revenue structures as they did in the past. But they aren’t the only ones who worry about Medicare Advantage plans. House lawmakers are asking for more oversight of these plans. The reason for it is that not all beneficiaries are receiving the care they need and there is an increasing cost for taxpayers. With more oversight, the lawmakers how to target MA plans that are limiting access to care.
“I am deeply concerned with recent reports that seniors in private sector Medicare Advantage plans are facing unwarranted barriers to accessing timely, medically necessary care,” Energy and Commerce Chairman Frank Pallone Jr. (D-N.J.) said during a hearing last month. “Several studies have raised concerns that insurance companies are denying beneficiaries’ access to treatment and imposing burdensome requirements that delay care. Improper claim denials and increased use of prior authorizations are preventing beneficiaries from receiving the care they need.”
Without getting the much-needed care, some beneficiaries are left stranded and this is something that must not happen. The lawmakers are also questioning CMS and whether it is doing enough to oversee the popular program.
“It’s a shame CMS did not agree to testify at this hearing to speak to the work the agency is doing to improve this program,” said Rep. Morgan Griffith, R-Virginia, ranking member of the subcommittee. “As Medicare Advantage takes on an even larger presence in the Medicare program and as the Medicare hospital insurance trust fund is projected to be insolvent by 2028 it will continue to be important to assess how well Medicare’s current payment methodology for MA is working.”
“While there are many plans that appear to be acting responsibly, some are not, and these bad actors are costing taxpayers money and, more importantly, jeopardizing the health of seniors,” said Rep. Frank Pallone, D-New Jersey, chairman of the full committee.
He added that some plans have found a way to get greater payments from Medicare “without necessarily providing better healthcare services to beneficiaries. In short, some insurance companies appear to have figured out a way to game the system.”
Although it is true that Medicare Advantage brings a lot of advantages to the beneficiaries that we have already listed earlier in the article, apparently there are some providers who are dishonest when it comes to providing the care enrollees paid for. We can only hope that the extra oversight will come into fruition and the problematic plans changed.