Medicare Advantage Plans Achieve Better Outcomes Than Traditional Medicare, BMA Analysis Finds

Fierce Healthcare says a report funded by the Better Medicare Alliance looked at healthcare use, outcomes, and costs between Medicare Advantage (MA) and traditional Medicare plans. "Medicare Advantage beneficiaries had 49 percent and 11 percent higher rates of vaccination for pneumonia and the flu and the contrasts are even more pronounced among high-need, high-cost beneficiaries," said Better Medicare Alliance CEO Allyson Schwartz. "For example, beneficiaries with major complex chronic conditions had 57 percent lower rate of avoidable hospitalizations for acute conditions in Medicare Advantage than in traditional Medicare." MA also scored higher on clinical visits two weeks after a hospital discharge, with 74 percent of frail and senior MA participants having such a visit versus 52 percent of traditional Medicare beneficiaries in the same category. In addition, inpatient hospital costs were 9 percent to 23 percent lower among high-need, high-cost populations in MA relative to fee-for-service Medicare, while Part D drug costs were 38 percent to 44 percent lower. The report associated the better results to key features of the MA program like risk-adjusted capitation payments and strong value-based care performance incentives to "enable plans to offer care management interventions that help meet the complex care needs of vulnerable beneficiaries in ways that achieve positive health outcomes." The report added that MA also plans to have an incentive to push for more preventive services and care management to boost plan efficiency.