Medicare Advantage

Medicare’s annual open enrollment period ends Thursday, December 7. During this time, people with Medicare can compare coverage options, like Traditional Medicare and Medicare Advantage, and choose health and drug plans for 2024. Medicare Advantage and Part D plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices and decide on the options that best meet their health needs. Coverage changes made during the open enrollment period take effect January 1, 2024.

The Kaiser Family Foundation's new report, “Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature,” details their findings from an analysis of 62 studies published since 2016 comparing traditional Medicare to Medicare Advantage. The analysis reviewed beneficiary experience, affordability, service utilization, and quality measures. According to the report, the review “found few differences between Medicare Advantage and traditional Medicare that are supported by strong evidence or have been replicated across multiple studies. Both Medicare Advantage and traditional Medicare beneficiaries reported similar rates of satisfaction.

Prior work has shown that home health providers strategically provided therapy visits and recertified episodes in order to maximize payment under traditional Medicare (TM). However, Medicare Advantage (MA) has more flexibility in terms of how they pay for home health care. This mixed-methods study examines changes in patterns of post-acute and community-admitted home health care use between 2011 and 2016, focusing on differences between MA and TM and across MA contract types.

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.

In 2021, under a recently released rule from CMS, D-SNPs will be required to notify the state or state’s designee when enrollees experience Medicare-covered hospital or skilled nursing facility admissions in order to ensure timely transitions of care. The Integrated Care Resource Center has released a brief that examines approaches from three states – Oregon, Pennsylvania, and Tennessee – to develop and implement information-sharing processes for their D-SNPs that support care transitions.

The GAO released a report to the Chairman of the Committee on Ways and Means summarizing findings of a survey sent to State Health Insurance Assistance Programs (SHIP) directors about the usability of the Medicare Plan Finder (MPF) website. The MPF website is a resource for comparing Medicare coverage options to help beneficiaries make informed decisions about their coverage. The report also includes other areas of improvement to make the website more user-friendly.

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 brief summarizes how recent changes to Medicare Advantage may enable AAAs and other CBOs to form new partnerships with Medicare Advantage plans. These partnerships can be used to provide supplemental benefits, such as home-delivered meals and transportation, to beneficiaries. The updated brief covers additional guidance from CMS on the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act.

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.