A new Kaiser Family Foundation review of 62 studies published since 2016 compares Medicare Advantage (MA) and traditional Medicare on measures of beneficiary experience, affordability, utilization, and quality.
The review found few differences that are supported by strong evidence or have been replicated across multiple studies. For example, beneficiaries in both MA and traditional Medicare reported similar rates of satisfaction with their care and overall measures of care coordination.
However, few studies examined specific subgroups of interest, such as beneficiaries from communities of color, living in rural areas, or dually eligible for Medicare and Medicaid. Analysts said this makes it difficult to assess the strength of the findings or how broadly they apply.
Noteworthy differences between MA and traditional Medicare
The research did find that:
- MA enrollees were more likely than those in traditional Medicare to report having a usual source of care. They were also more likely to receive preventive care services, such as annual wellness visits and routine checkups, screenings, and flu or pneumococcal vaccines.
- MA enrollees reported better experiences getting needed prescription drugs than traditional Medicare beneficiaries overall. However, among beneficiaries with diabetes, cancer, or a mental health condition, findings were mixed.
- Most studies found that utilization of home health services and post-acute skilled nursing or inpatient rehabilitation facility care was lower among MA enrollees than traditional Medicare beneficiaries but were inconclusive as to whether that was associated with better or worse outcomes.
- A smaller share of traditional Medicare beneficiaries than MA enrollees experienced a cost-related problem, due to lower rates of cost-related problems among traditional Medicare beneficiaries with supplemental coverage. (But traditional Medicare beneficiaries without supplemental coverage had the most affordability-related difficulties.)
- Traditional Medicare outperformed MA on 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.
Unremarkable differences between MA and traditional Medicare
In other areas, though, KFF reports that the findings were mixed or showed little difference between MA and traditional Medicare based on multiple studies:
- There were no differences in the aggregate number of hospital days or average length of stay for common medical admissions.
- Neither MA nor traditional Medicare consistently performed better across all quality measures.
- Additionally, two analyses of several measures of beneficiary experience found no differences between the two groups in experiences with wait times and in the share reporting trouble finding a general doctor, being told that their health insurance was not accepted, and being told they would not be accepted as a new patient.
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, KFF said in the study announcement.