Medicare Advantage’s COVID edge over fee-for-service?

Medicare Benefit beneficiaries had been much less prone to be hospitalized and die from COVID-19 through the first 9 months of the pandemic in contrast with their fee-for-service counterparts, a brand new report finds.

From January to November 2020, people enrolled within the privatized Medicare plans made up 36% of hospitalizations amongst Medicare beneficiaries, regardless of representing 40% of eligible enrollees, in line with a research launched Thursday by analysis agency ATI Advisory.

In the meantime, conventional, fee-for-service enrollees represented 64% of Medicare hospitalizations regardless of making up 60% of all eligible enrollees, in line with the research, which is the third printed evaluation of how Medicare protection influences COVID-19 outcomes and entry to care. Half of all conventional Medicare members who had been hospitalized with coronavirus had been over 75-years-old, in contrast with 57% of Medicare Benefit members.

Those that had been enrolled in conventional Medicare additionally had a better mortality price than these in Medicare Benefit. Twenty-two % of fee-for-service beneficiaries hospitalized with coronavirus died throughout their go to, in contrast with 15% of Medicare Benefit enrollees.

The report depends on Medicare Present Beneficiary Survey information and is sponsored by Washington D.C.-based Higher Medicare Alliance, a Medicare Benefit advocacy group supported by well being insurers.

“Policymakers ought to discover what could be realized from Medicare Benefit as they work to enhance the Medicare program extra broadly,” stated Allison Rizer, principal and lead researcher at ATI, in a information launch.

Decrease utilization amongst Medicare Benefit members in contrast with conventional Medicare just isn’t new, nonetheless, with educational estimates starting from 10% to 60%. A 2019 research within the American Economic Journal: Applied Economics, for instance, discovered Medicare Benefit spending to be 30% decrease per member per 30 days than conventional Medicare.

Regardless of decrease hospitalization and mortality charges, practically twice as many Medicare Benefit beneficiaries, or 7%, who acquired a COVID-19 take a look at reported a optimistic end result, in contrast with 3% of fee-for-service members. The research stated that members enrolled in each packages had equal entry to testing providers. However racial and ethnic minorities enrolled in Medicare Benefit had been much less prone to really be examined.

Twenty-six % of Black Medicare Benefit members had been examined for COVID-19 by November, in contrast with 30% of conventional members; and 24% of Latinx Medicare Benefit members had ever been examined, in contrast with 29% of fee-for-service Latinx people. Each teams contracted the virus at increased charges and had been extra prone to die from COVID-19 than whites.

Medicare Benefit members had been additionally extra prone to be hesitant to obtain a COVID-19 vaccine, with 43% saying they felt reluctant getting inoculated in contrast with 40% of fee-for-service enrollees. The research was carried out earlier than any of the COVID-19 vaccines had been extensively accessible.

Whereas Medicare Benefit and conventional Medicare members reported the identical chance of accessing care through the pandemic, Medicare Benefit members had been extra assured they may get diagnostics, entry to dental care and obtain remedy for an ongoing situation. Nonetheless, there may be room for enchancment amongst Medicare Benefit plans.

Fewer members enrolled in privatized Medicare actively managed their care in 2020, with simply 55% managing their care final yr, down 9 proportion factors from 2019, according to a recent study by data analytics firm J.D. Power. The J.D. Energy research didn’t analyze how conventional Medicare members engaged with their suppliers.

For personal insurers, engagement amongst dual-eligibles represented a brilliant spot, the ATI research stated.

Amongst those that qualify for Medicare and Medicaid, 92% of dual-eligibles enrolled in Medicare Benefit plans reported entry to pressing care, in contrast with 84% of fee-for-service enrollees; 78% stated they may get diagnostics, in contrast with 66% of conventional beneficiaries; 68% of Medicare Benefit members acquired look after an ongoing situation, in contrast with 63% of fee-for-service; and 58% of Medicare Benefit members had been assured of their capacity to get an everyday check-up, in contrast with 43% in conventional Medicare.

Though fewer Medicare Benefit beneficiaries had entry to the web throughout this time, the research stated extra of them accessed telehealth through the pandemic, notably audio-only visits with their suppliers. Ninety-four % of Medicare Benefit beneficiaries had been in a position to entry clinicians through audio appointments, in contrast with 87% of fee-for-service Medicare beneficiaries.

Well being insurers and supplier teams have been lobbying the Facilities for Medicare and Medicaid Providers for everlasting protection of audio-only telehealth, though the 2 disagree over how the service ought to be reimbursed. Each agree that, with out protection, broadband entry represents a social determinant of well being.

“This research exhibits that Medicare Benefit outperformed fee-for-service Medicare in entry to non-COVID associated care amongst dual-eligible beneficiaries, who’re among the many most at-risk members of the Medicare inhabitants,” Better Medicare Alliance CEO Mary Beth Donahue stated in a information launch. “This consists of common check-ups, pressing care, and remedy for ongoing situations. Whereas COVID-19 uncovered shortcomings in lots of areas of well being care, these findings inform a strong story of how Medicare Benefit met the second and saved human lives.”

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