With the Medicare open enrollment period set to begin Oct. 15, a perennial decision faced by Medicare beneficiaries is whether to get their coverage through traditional Medicare or the private plans known as Medicare Advantage.
A new KFF review of 62 studies published since 2016 that compares Medicare Advantage and traditional Medicare on measures of beneficiary experience, affordability, utilization, and quality finds few differences that are supported by strong evidence or have been replicated across multiple studies. For example, beneficiaries in both coverage types reported similar rates of satisfaction with their care and overall measures of care coordination.
Notably, relatively few studies specifically examined specific subgroups of interest, such as beneficiaries from communities of color, living in rural areas, or dually eligible for Medicare and Medicaid, making it difficult to assess the strength of the findings or how broadly they apply.
In some areas, however, the research identified noteworthy differences between Medicare Advantage and traditional Medicare, including:
In other areas, though, findings were mixed or showed little difference between Medicare Advantage and traditional Medicare based on multiple studies.
Among the findings:
Findings related to the use of other health care services, including hospital care and prescription drugs, and condition-specific quality of care measures varied – likely due to differences in data and methodology across studies.
Interest in how well Medicare Advantage plans serve their growing and increasingly diverse enrollee population has never been higher, as Medicare Advantage, for the first time, is projected to enroll more than half of all eligible Medicare beneficiaries next year, making it the main way that Medicare beneficiaries get their coverage and care. In comparison, just over a decade ago in 2010, 25 percent of the eligible population was in a Medicare Advantage plan.
The Medicare open enrollment period runs through Dec. 7.
The full analysis, Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature, as well as more data and analyses about Medicare Advantage, are available at kff.org.