STORY

Medicare Advantage — Helping Achieve the Triple Aim

September 19, 2019

As National Medicare Education Week wraps up, it’s important to remember that Medicare spending is expected to nearly double over the next 10 years – a $700 billion projected increase by 2028. A great way to improve health outcomes, reduce costs and provide a better experience for seniors is through the successful public-private partnership of Medicare Advantage.

Why Medicare Advantage?

Medicare Advantage (MA) delivers private-sector clinical advancements and innovations in an effective, consumer-friendly manner. Research shows that MA beneficiaries have experienced improved outcomes compared to Medicare Fee-For-Service (FFS), with a 20% reduction in hospital readmissions1 and a 20% increase in primary care visits2. Additionally, 90% of MA beneficiaries report that they are highly satisfied with their coverage3.

By contrast, Medicare FFS has failed to keep pace with private-sector best practices since the program was created in 1965. Medicare FFS is still largely rooted in a volume over value approach that rewards wasteful spending and often fails to deliver access to high-quality, affordable, health care. For example, UnitedHealthcare members with specialized MA coverage had lower emergency department use than Medicare FFS beneficiaries, according to an American Journal of Managed Care study. In fact, the federal government could save $500 billion over 10 years by modernizing Medicare FFS.

Learn more about ways to build on Medicare Advantage’s successful public-private partnership that would help achieve the Triple Aim of health care: lower costs, improved health and better experiences for millions of seniors.

References

1: Sukyung Chung, Lenard I. Lesser, Diane S. Lauderdale, Nicole E. Johns, Latha P. Palaniappan and Harold S. Luft. Medicare Annual Preventive Care Visits: Use Increased Among Fee-For-Service Patients, But Many Do Not Participate. Health Affairs, 34, no.1 (2015):11-20.

2: Lemieux, Jeff; Sennett, Cary; Wang, Ray; Mulligan, Teresa; Bumbaugh, Jon. Hospital Readmission Rates in Medicare Advantage Plans. Am J Manag Care, 18, no. 2 2012:96-104. http://www.ajmc.com/journals/issue/2012/2012-2-vol18-n2/hospital-readmission-rates-in-medicare-advantage-plans/P-34.

3: Press Release: “2 Million Seniors and The Coalition for Medicare Choices Mobilize to Support Medicare Advantage,” The Coalition for Medicare Choices, 1/31/18.