According to new data, Medicare managed care programs now seem to be keeping sicker individuals with more complex medical requirements after decades of criticism for favoring the healthiest people.
The study, which was published in the Journal of the American Medical Association (JAMA), found that Medicare Advantage, the increasingly well-liked managed care option for people 65 and over, was not more likely to disenroll older Americans with demanding health needs.
Medicare Managed Care Plans Draw Sicker Patients
Based on past experiences with Medicare managed care plans, many people would not anticipate this, according to senior author Wendy Xu of The Ohio State University’s College of Public Health.
According to Xu, this new study is the first of its kind to examine trends among beneficiaries with multiple chronic conditions as Medicare Advantage gains popularity.
It doesn’t appear to support the idea that as people get sicker, they grow dissatisfied with the managed care plan’s access to care and switch to traditional Medicare.
People who get chronic diseases used to move back to regular Medicare like crazy twenty or thirty years ago, but in our study, the switch-back rate was incredibly low, she added.
Read more: 3 Reforms: Lowering Medicare Costs And Enhancing Care
Study Analyzes Enrollment Data And Benefits
The research team looked at data on nearly 45,000 Medicare enrollees from 2009 to 2019, a period in which more people choose Medicare Advantage’s managed care alternatives, which more closely resemble the insurance plans most Americans of working age have.
This is distinct from the conventional fee for service Medicare approach, in which beneficiaries could see any Medicare eligible caregiver.
Eli Raver, the study’s lead author and a doctoral candidate at Ohio State’s College of Public Health, explained that these plans work with providers to get better rates for their members, so it’s a little more controlled and it also allows for other benefits that you can’t get through traditional Medicare, like dental care.
Read more: Advocates Urge CMS To Streamline Medicare Advantage Prior Authorizations