Medicare Advantage

On December 13, KFF released a snapshot analyzing the different types of coverage that people with Medicare have and the demographic characteristics of Medicare beneficiaries with these different coverage types, based on data from the 2021 Medicare Current Beneficiary Survey (MCBS). This snapshot of coverage highlights that roughly half of all beneficiaries are enrolled in traditional Medicare and about half are enrolled in a Medicare Advantage plan, such as an HMO or PPO. Among beneficiaries in traditional Medicare, most have some type of additional coverage that helps limit their exposure to Medicare’s cost-sharing requirements.

CMS has published this report which presents summary information on the quality of health care received by Medicare Advantage enrollees nationwide. The report highlights racial, ethnic, and gender differences in health care experiences and clinical care. The report highlights data regarding patient experiences and compares enrollees responses to national averages.

CMS released the Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the Rate Announcement). CMS will phase-in certain updates, and on average, CMS anticipates a payment increase for MA plans of 3.32% from 2023 to 2024, which is approximately a $13.8 billion increase in MA payments for next year. The Rate Announcement finalizes updates to MA payment growth rates and changes to the MA and Part D payment methodologies. These include technical and clinical updates to the MA risk adjustment model to keep it up to date and improve payment accuracy.

This report from CMS presents information on disparities in health care received by people using Medicare Advantage. The report looks at differences in quality of care based on race and ethnicity and sex as well as the intersections of race/ethnicity and sex. CMS uses data from the Consumer Assessment of Healthcare Providers and Systems and the Healthcare Effectiveness Data and Information Set in this report.

This blog post from the Better Care Playbook discusses Medicare Advantage (MA) plans that support family caregivers, specifically hightlighing UCare in Minnesota and UPMC Health Plan in Pennsylvania. The blog post explains the importance of supporting caregivers and explores the considerations around offering caregiver support as a supplemental benefit.

The CMS Office of Minority Health (OMH) has published a new report, Trends in Racial, Ethnic, Sex, and Rural-Urban Inequities in Health Care in Medicare Advantage: 2009-2018. Since 2015, CMS OMH has published annual reports highlighting inequities in the quality of care delivered to Medicare beneficiaries nationwide. Until now, these reports have focused on comparisons within a single year. This new report analyzes historical trends in inequities by race, ethnicity, sex, and geography among Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide.

The Urban Institute conducted a series of interviews with Medicare Advantage plans, Medicare Advantage experts, and social service providers to better understand how health plans were responding to CMS’s new flexibility with regards to supplemental benefits. This report presents the findings from these interviews. It also explores possible policy changes to further support supplemental benefits and describes what funding and resources are available for state to administer these benefits.

This technical assistance tool focuses on the new “information sharing” requirement for Dual Eligible Special Needs Plans beginning in 2021. The tool explains the new requirement as well as how to address the requirement in mandatory D-SNP contracts.

The AARP Public Policy Institute released a report outlining the recent changes to supplemental benefits in Medicare Advantage. The report explains the major changes in benefits present in the Bipartisan Budget Act of 2018.

This report analyzes disparities in the care received by Medicare Advantage beneficiaries during 2015-2016. The report was compiled using information from the Healthcare Effectiveness Data and Information Set (HEDIS) and the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. It looks at differences in care by race, ethnicity, and gender and also isolates racial and ethnic differences experienced by women and men.