A new analysis, conducted by Berkeley Research Group (BRG) and commissioned by the Better Medicare Alliance (BMA), a research and advocacy organization that supports Medicare Advantage, examines health outcomes of beneficiaries in Medicare Advantage and fee-for-service Medicare with a particular focus on Black, Hispanic, and Asian American and Pacific Islander beneficiaries.
The study was designed to better understand Medicare Advantage’s impact on preventive services, care coordination, and outcomes for these populations. BRG used 100 percent of Medicare Advantage encounter and fee-for-service claims data to compare outcomes between Medicare Advantage and fee-for-service beneficiaries with similar clinical profiles.
The research team found that Medicare Advantage beneficiaries, particularly those from Black, Hispanic, and Asian American/Pacific Islander communities, had higher rates of key preventive screenings, more frequent primary care visits, and lower rates of costly hospital readmissions.
“This research confirms what we hear from our beneficiary network every day: Medicare Advantage is keeping seniors healthier with better, more comprehensive care,” said Mary Beth Donahue, president and CEO of BMA, in the study announcement. “Investing in prevention and primary care isn’t just good for seniors—it’s also good for Medicare’s future, improving outcomes and ensuring smarter use of taxpayer dollars. Medicare Advantage is working, and it is critical that we protect this program for seniors.”
BMA said understanding how Medicare Advantage serves beneficiaries from different racial and ethnic backgrounds is critical to evaluating its effectiveness and informing future policy decisions.
Here are five main findings from the report:
Higher preventive screenings: Cardiovascular, breast cancer, and colonoscopy screenings are four to 12 percent higher for Medicare Advantage beneficiaries across minority groups compared to fee-for-service.
More primary care visits: Medicare Advantage beneficiaries receive Annual Wellness Visits at rates up to 21 percent higher than those in fee-for-service Medicare.
Stronger hospital recovery: Beneficiaries in Medicare Advantage have a primary care follow-up visit within seven days of a hospital discharge at rates up to 41 percent higher than fee-for-service beneficiaries.
Lower hospital readmissions: Readmission rates within 30 days of discharge are 38-43 percent lower for Medicare Advantage enrollees.
Fewer avoidable hospitalizations: Hispanic and Black Medicare Advantage beneficiaries experience six to 12 percent lower rates of potentially avoidable hospitalizations.
Areas for potential improvement
BRG researchers said the study revealed potential areas of improvement for Medicare Advantage plans: the rate of potentially avoidable hospitalizations for Asian American and Pacific Islander who are Medicare Advantage members was six percent above fee-for-service and Black Medicare Advantage beneficiaries had the same rate of nonemergent emergency department visits as fee-for-service beneficiaries.
Fewer avoidable hospitalizations: Hispanic and Black Medicare Advantage beneficiaries experience six to 12 percent lower rates of potentially avoidable hospitalizations.