The number of Medicare beneficiaries enrolled in a Medicare Advantage plan is expected to rise from more than 31 million this year to 33.8 million next year, accounting for more than half of total Medicare enrollment, according to a report from the Better Medicare Alliance.1 Meanwhile, at $18 per month, the average monthly MA premium is the lowest it’s been in 16 years; most MA plans offer supplemental benefits including vision, hearing and dental care coverage; and enrollment in special needs plans is growing, according to the report.
MA serves a diverse population. According to the report:
- 27% of Medicare Advantage beneficiaries identify as Black, Latinx or Asian, compared with 17% of enrollees in conventional, fee-for-service Medicare
- 40% of Medicare beneficiaries who live in rural areas are enrolled in a Medicare Advantage plan
- Enrollment in special needs plans has grown to 5.4 million beneficiaries, over 90% of whom are also Medicaid-eligible
- 7 million people are enrolled in Medicare due to disability
Despite serving high-need populations, MA plans collectively have lower spending than FFS plans, enrollees in MA plans are more likely to receive preventive services and care, and MA enrollees with certain chronic conditions have lower rates of hospital inpatient and emergency department utilization.
MA plans achieve savings by keeping members out of hospitals through a comprehensive approach to member health and well-being — coordinating primary care, encouraging the use of screening and preventive services, and covering services that address behavioral, social and environmental needs.
MA enrollment will only grow as the number of eligible Americans approaches 95 million by 2060, and more than 54% of total Medicare enrollment is expected to be in MA by 2030.2 Competition within the MA market is ramping up along with demand, as the number of available plans has doubled over the past decade, and enrollment in special needs plans has tripled since 2014.
Plans can set themselves apart by ensuring their benefits meet the increasingly varying needs of their members and that they are addressing disparities and barriers to care.
“As America’s senior population grows and becomes increasingly diverse, the importance of addressing health disparities is magnified,” the report notes. “Medicare Advantage’s success in building trust with a diverse population of beneficiaries, delivering personalized coordinated care, and reaching out to beneficiaries in minority communities offers opportunities to meet challenges disproportionately faced by minority beneficiaries and the communities in which they live.”
The report singles out “innovative collaborations among providers, payers and community-based organizations” to deliver coordinated, patient-centered care. MA leads in the percentage of payments tied to advanced payment models, with 56.8% of payments in MA linked to APMs.3
MA plans that take a data-driven approach to care coordination and develop targeted, tailored outreach will have a competitive advantage as the market grows in both size and diversity.
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References
1 Better Medicare Alliance. State of Medicare Advantage 2023. Aug. 28, 2023. https://bettermedicarealliance.org/publication/state-of-medicare-advantage-2023/
2 Boards Of Trustees, Federal Hospital Insurance And Federal Supplementary Medical Insurance Trust Funds. 2023 Annual Report. https://www.cms.gov/oact/tr/2023
3 Health Care Payment and Learning Action Network. APM Measurement: Progress of Alternative Payment Models. 2022. https://hcp-lan.org/apm-measurement-effort/2022-apm/
