Critter Corner: How Does Medicare Advantage Compare to Traditional Medicare?

Dear Oakley,

It is Medicare Open Enrollment season, and I’m deciding whether I need a Medicare Advantage plan or if I want to stick with Traditional Medicare. Do you have any research you can share on the subject to help me make up my mind?

Thanks for your help!

Cam Pere

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Dear Cam,

On September 16, 2022, the Kaiser Family Foundation (KFF) released a report titled Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature. The report compared Medicare Advantage (MA) plans to Traditional Medicare (also called Original Medicare) on all of the measures mentioned in the title of the report. These are some of the findings:

Both Medicare Advantage and traditional Medicare beneficiaries reported similar rates of satisfaction with their care and overall measures of care coordination.
Medicare Advantage outperformed traditional Medicare on some measures, such as use of preventive services, having a usual source of care, and lower hospital readmission rates.
Traditional Medicare outperformed Medicare Advantage on other measures, such as receiving care in the highest-rated hospitals for cancer care or in the highest-quality skilled nursing facilities and home health agencies.

MA appears to perform worse than Traditional Medicare in certain areas, including:

Post-Acute Care: “lower rates of skilled nursing facility (SNF), inpatient rehabilitation facility (IRF), and home health use among Medicare Advantage enrollees, and shorter lengths of stay in SNFs and IRFs for Medicare Advantage enrollees than traditional Medicare beneficiaries”
Quality of Providers: “Medicare Advantage enrollees were less likely than traditional Medicare beneficiaries to receive care in the highest-or lowest-rated hospitals overall or in the highest-rated hospitals for cancer care, skilled nursing facilities (SNFs), and home health agencies.”
Affordability: “a somewhat larger share of Medicare Advantage enrollees than traditional Medicare beneficiaries experienced a cost-related problem, mainly due to lower rates of cost-related problems among traditional Medicare beneficiaries with supplemental coverage […] Medicare Advantage enrollees who are Black, under age 65 with disabilities, or in fair or poor health were more likely to report cost-related problems than their traditional Medicare counterparts.”

The areas in which MA appears to outperform traditional Medicare include “use of preventive services, more likely to report having a usual source of care, and MA enrollees reported better experiences getting needed prescription drugs than traditional Medicare beneficiaries overall, but among beneficiaries with specific conditions, findings were mixed. Hospital readmission rates were generally lower in Medicare Advantage than in traditional Medicare.”

Issues with Medicare Advantage

Medicare Advantage is projected to exceed more than half of all Medicare beneficiaries as soon as next year. At the same time, it is well documented that MA plans are overpaid, and such overpayments drive-up programmatic spending among other issues, as described in today’s “Ask the Expert” article. For more details on what was described in this article, read the entire study here.

As you are making decisions about Medicare during open enrollment, let us help! Click here to schedule your no-cost Medicare review with Retirement & Medicare Together today!

Hope this is helpful,

Oakley