As Florida seniors weigh health coverage options, Medicare Advantage is beating traditional Medicare on quality of care

Medicare Advantage beneficiaries received 9.2% fewer needless, wasteful services than traditional Medicare enrollees.

With Medicare’s open enrollment period set to begin in October, a new study published by the Journal of the American Medical Association (JAMA) Health Forum found that seniors enrolled in Medicare Advantage received a higher quality of care than those enrolled in traditional Medicare.

The findings are particularly relevant in Florida, which is home to an outsized number of senior citizens who are dealing with the rising costs of health care and are increasingly opting for Medicare Advantage over what’s known as traditional “fee-for-service” Medicare.

Florida has the second largest number of Medicare Advantage enrollees in the United States (nearly 2.6 million people) and the third highest participation rate (52.75%) of all states trailing only Georgia and Illinois.

The study examined data from nearly 2.5 million Medicare beneficiaries. Researchers found that those enrolled in Medicare Advantage plans “received 9.2% fewer low-value services” compared with those in traditional Medicare. Notably, “MA beneficiaries had lower rates of low-value services across all 6 clinical categories” that the study’s authors examined.

Low-value care includes “tests, treatments, and procedures that provide little to no clinical benefit,” the authors explained, adding that low-value care “is a widespread and costly source of waste, inefficiency, and potential harm in the U.S. healthcare system.”

In other words, Medicare Advantage beneficiaries — who are enrolled in health plans offered by approved private coverage providers — received better care and experienced significantly fewer wasteful, needless procedures, treatments and tests than seniors enrolled in traditional Medicare.

Politicians on the far left, including U.S. Sen. Bernie Sanders of Vermont, have attacked Medicare Advantage as “privatization,” and have been working to undermine the popular program, which receives high marks from seniors. Last week, Sanders took to the floor of the U.S. Senate to demand that Americans do away with the existing pillars of our healthcare system — ending Medicare as we know it, eliminating the coverage Americans get through work, and forcing every American into a single, government-controlled system he calls “Medicare for All.”

But, despite this barrage of politically and ideologically motivated attacks, enrollment in Medicare Advantage continues to climb steadily, and has reportedly doubled over the last 10 years alone.

An August report by the non-partisan Kaiser Family Foundation found that nearly half of the eligible Medicare population has chosen to enroll in Medicare Advantage, a percentage that is projected to exceed 50% as soon as next year.

Proponents of Medicare Advantage attribute the program’s popularity, in part, to the cost savings it offers beneficiaries.

Research released by the Better Medicare Alliance, a pro-Medicare Advantage group, found that traditional Medicare enrollees pay nearly $2,000 more per year in total health care-related expenditures on average than beneficiaries in Medicare Advantage. And, according to the independent actuarial firm Milliman, the federal government spends more per recipient on fee-for-service Medicare than it does for beneficiaries of a similar health status in Medicare Advantage.

Meanwhile, research from Harvard University and the Commonwealth Fund in 2019 found that a majority of “seriously ill” traditional Medicare enrollees reported having significant problems paying medical bills while many also reported difficulty paying for prescription drugs. Unlike Medicare Advantage, traditional Medicare does not cover prescription drug costs or limit beneficiaries’ out-of-pocket expenses.

When it comes to beneficiaries’ access to quality care and seniors getting critical preventative treatments, the Kaiser Family Foundation previously found that nearly 10,000 doctors nationwide do not accept fee-for-service Medicare, and compared with Medicare Advantage, 11% fewer beneficiaries in traditional Medicare receive their flu vaccine and 49% fewer beneficiaries receive their pneumonia vaccine, according to a 2020 data analysis by Avalere Health.

Staff Reports

One comment

  • Mike Collins

    September 20, 2022 at 9:19 am

    This is a total crock. Medicare Advantage is great — unless you get really sick. And then you’ll find that you’re SOL when it comes to re-upping in traditional Medicare. Medicare Advantage is a scam so Republicans and their pals in the insurance industry can claim seniors are “turning their backs” on Medicare — and can privatize it. Don’t buy it.

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