Health

Commonwealth Fund: MA, traditional Medicare beneficiaries face similar barriers in access to care

As open enrollment begins this week, new data show Medicare Advantage (MA) beneficiaries have a comparable care experience to those in traditional Medicare, including having to wait similar amounts of time to see a doctor.

But MA plans do offer more coordinated and managed care, such as developing treatment plans with their providers.

The study, released Thursday from the Commonwealth Fund, comes as beneficiaries will choose Medicare plans starting Friday and have more options in MA to explore. A key finding is that MA plans have more personalized care, but other types of care outcomes are similar to traditional Medicare.

“Historically, [MA] beneficiaries have been somewhat healthier than those in traditional Medicare, but our study shows that this is changing,” said Gretchen Jacobson, Commonwealth’s vice president of Medicare, in a statement.

The study looked at the 2018 Medicare Current Beneficiary Survey, the most recently available data on customer experiences after excluding beneficiaries in special needs plans.

The Commonwealth Fund found similar experiences among both MA and traditional beneficiaries in hurdles to accessing care. The study found that 33% of beneficiaries surveyed in 2018 reported high cost as a barrier to access compared with 30% of those in traditional Medicare. Another 17% of traditional Medicare beneficiaries found that the service wasn’t covered as an obstacle, only slightly above the 16% of those in MA.

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Traditional and MA beneficiaries also faced similar wait times for outpatient and physicians’ office visits. The study found that wait times averaged about three weeks for a hospital outpatient visit and over a month for a physician’s appointment.

However, there remains a high degree of satisfaction in the quality of care between MA and traditional Medicare. The survey found 96% of MA beneficiaries are satisfied with the quality of care, compared with 95% for Medicare.

Where MA plans shine is in coordinating care.

“A somewhat larger share of people in Medicare Advantage plans with diabetes or mental health conditions than the same groups in traditional Medicare felt confident they could manage their health conditions,” the study said. “Conversely, among people age 65 or older with cancer, a somewhat lower percentage of Medicare Advantage enrollees feel confident they could control and manage their condition.”

For example, 76% of people with diabetes in MA check their blood sugar compared to 70% of those in traditional Medicare.

People 65 and older in MA plans also were slightly more likely than those in traditional Medicare to report their physician always or often helped them coordinate or arrange care.

The study found that 76% of MA beneficiaries surveyed have discussed their goals for caring for a condition with their healthcare professional over the past year compared with 60% for those in traditional Medicare.

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In addition, 91% of those in MA plans have reviewed in the past year their medications with their physician compared to 84% for Medicare beneficiaries.

The study comes as questions have emerged on the payments given to MA plans, with an estimate from the Medicare Payment Advisory Commission that such plans get 4% more compared to the cost for covering a similar person in Medicare. Another analysis from the Kaiser Family Foundation estimated that Medicare has spent $7 billion more on MA compared to Medicare.

The Commonwealth Fund said the study presents a mixed bag on MA. For one thing, MA plans are doing a better job of managing enrollee care and providing additional care management.

“On the other hand, rates of hospitalizations and emergency room visits are similar for beneficiaries in Medicare Advantage plans and traditional Medicare—outcomes that question the impact of the added services on healthcare use, spending and outcomes,” the study said.

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