Do Medicare Advantage Plans Improve Quality Of Care?

From the Medicare Modernization Act in 2003, the Medicare Advantage program that we know today was born. These types of plans allow seniors and people eligible for Medicare due to disability to get health coverage from private health insurance companies. Private insurance companies offering Medicare Advantage (MA) plans are required to offer the same benefits offered by Medicare Parts A and B. Part A covers hospital insurance while Part B covers medical insurance. Aside from coverage on both in-patient and out-patient services, Advantage plans typically cover some prescription drugs as well. That is why these plans are sometimes referred as Medicare Part C. They combine Medicare Part A, B and often Part D coverage.Since MA plans have been available, they have become a popular alternative to Original Medicare. In 2010 alone, approximately 25 percent of all Medicare beneficiaries were enrolled in Medicare Advantage plans. From an initial enrollment of 5.3 million, the enrollees have more than doubled and the numbers are still increasing every year.Medicare Advantage plans have paved the way for beneficiaries to expand on traditional Medicare benefits. Ever since the beginning of the program, the success that Medicare Advantage plans have had among seniors has been a subject of debate. Recently, data was released regarding the quality of care that MA enrollees receive.Medicare Advantage Plans Offer Higher Quality Of CareAccording to a study by Niall Brennan (Acting Director of the Office of Policy at the Centers for Medicare and Medicaid Services), and Mark Shepard (Ph.D. candidate in economics at Harvard University), MA plans offer higher quality of care compared to Medicare fee-for-service plans for hospital utilization and delivery of care using widely-accepted measurements of quality.Back in 2006 when the first data on Medicare Advantage plans became available, Brennan and Shepard used 11 measurements to look at the underuse of effective care. Out of the 11 measurements, MA plans noticeably performed better than fee-for-service plans in 9 fee-for-service plans. Fee-for-service plans only outperformed Medicare Advantage plans on a couple of measurements, which were not that significant to overall care.A similar study was conducted by America’s Health Insurance Plans (AHIP) utilizing HEDIS (Healthcare Effectiveness Data and Information Set) measurements. The study shows quality improvements in health care for MA policyholders with diabetes and heart disease. The findings reveal that compared to fee-for-service plans, diabetic MA policyholders have fewer hospital readmissions and shorter hospital stays. As for heart disease patients, the trend was the same.MA plans have done a better job of preventing unneeded hospital admissions by increasing the use of doctor visits and outpatient health care services. Readmissions are also down due to superior and well-planned discharge procedures and coordination of medical care.According to Kathryn Nix, a policy analyst at the Heritage Foundation, a lot of comparative studies have continually shown that Medicare Advantage plans offer above average medical services to their policyholders and result in better health outcomes for patients. The superior services offered by this program have contributed to the popularity of Medicare Advantage plans.

Leave a Reply

Your email address will not be published. Required fields are marked *