Medicare Advantage enrollment hits 50% of beneficiaries
The growth in enrollment is due to a number of factors, said KFF, including the attraction of extra benefits offered by most plans.
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Medicare Advantage has been growing in popularity among Medicare beneficiaries, but now the offering has hit a milestone: According to recently released data from the Centers for Medicare and Medicaid Services, Medicare Advantage now provides Medicare coverage for just over half of eligible beneficiaries.
In January 2023, 30.19 million of the 59.82 million people with both Medicare Part A and Part B were enrolled in a private plan, the numbers show.
Medicare Advantage, the private plan alternative to traditional Medicare, covers Medicare Part A and B benefits (and typically Part D benefits), often for no additional premium other than the Part B premium. Insurance companies contract with the Medicare program and receive payments for providing these services.
WHAT'S THE IMPACT?
According to an analysis from the Kaiser Family Foundation, enrollment in Medicare Advantage has increased dramatically in recent years. In 2007, less than one in five (19%) eligible Medicare beneficiaries were enrolled in a private plan. The growth in enrollment is due to a number of factors, said KFF, including the attraction of extra benefits offered by most plans, such as vision, hearing and dental services, and the potential for lower out-of-pocket spending, particularly compared to traditional Medicare with the need for supplemental coverage.
Medicare Advantage plans also offer the simplicity of one-stop shopping, in that enrollees do not need a separate Part D prescription drug plan or supplemental coverage.
At the same time, Medicare Advantage plans typically use tools to manage utilization and costs that may limit access to care, such as prior authorization requirements and referrals for specialists and mental health providers, found KFF. For example, in 2021, Medicare Advantage enrollees submitted 35 million prior authorization requests. In addition, Medicare Advantage plans generally require enrollees to receive care from in-network providers or pay more out-of-pocket for out-of-network care.
As Medicare Advantage continues to grow, KFF analysts expect increased interest in how well the program serves enrollees who receive Medicare coverage from private insurers – an increasingly diverse group that includes a disproportionate share of Black, Hispanic and Asian and Pacific Islander beneficiaries.
A recent review of evidence on how Medicare Advantage compares to traditional Medicare found few differences between the programs. But gaps in data make it difficult to evaluate plan performance, including assessments of the program's impact on value and equity, said KFF analysts.
THE LARGER TREND
While Medicare Advantage is still growing, data published in February from Chartis showed that the pace of this growth is slowing.
In 2020, 2021 and 2022, Medicare Advantage enrollment grew by 1.9 million, 2.2 million and 2.3 million beneficiaries, respectively. This year, Medicare Advantage enrollment grew by just 1.5 million. While that's still significant growth, it does show evidence of a deceleration.
At the same time, original Medicare continues to decline, losing 339,000 enrollees this year – a significant but smaller loss than previous years. Special Needs Plans (SNP) enrollment accounted for two-thirds of total market growth. SNP enrollment is up 20% from 2022, driven by considerable D-SNP enrollment gains.
A total of 29.5 million beneficiaries are now enrolled in a Medicare Advantage plan, according to Chartis.
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
