A new study is raising fresh questions about whether Medicare Advantage plans improve health outcomes for seniors with Type 2 diabetes, despite offering extras like grocery allowances, dental coverage and gym memberships. Researchers' findings published in JAMA Internal Medicine found that older adults with the condition who enrolled in Medicare Advantage did not experience better health outcomes than similar beneficiaries in traditional Medicare. In recent years, Medicare Advantage enrollment has continued to grow, and the privately administered plans now cover a majority of Medicare beneficiaries.
Medicare Advantage has become an increasingly important part of the Medicare program, accounting for about 55 percent of all Medicare beneficiaries this year. The plans are marketed as a lower-cost alternative to traditional Medicare and often include supplemental benefits not available through original Medicare. But the new study could add to ongoing debates in Washington over the value of Medicare Advantage plans, particularly as lawmakers and regulators scrutinize federal spending on the program.
The study, published this month in JAMA Internal Medicine, tracked about 35,000 adults with Type 2 diabetes over 3 1/2 years. Researchers evaluated whether participants who switched into Medicare Advantage experienced improvements in key health indicators associated with diabetes management. Researchers looked at hemoglobin A1C levels, LDL ("bad") cholesterol and blood pressure readings during the study.
However, 45 percent of participants who enrolled in a Medicare Advantage plan during the study period did not experience measurable improvements in those biomarkers compared with people who remained in traditional Medicare. The study’s authors did not identify a specific reason for the findings, though they suggested that some supplemental benefits may not be reaching beneficiaries as effectively as intended. Medicare Advantage, also known as Medicare Part C, is an option for beneficiaries to receive Medicare coverage through private insurance companies that contract with the federal government.
Unlike traditional Medicare, many Medicare Advantage plans offer supplemental benefits like: However, alongside these perks, beneficiaries often face more prior authorization requirements and limited provider networks. Medicare Advantage plans frequently attract enrollees with low or even zero-dollar monthly premiums, and the plans now cover about 55 percent of all Medicare beneficiaries. However, Ryan said this isn't a reason to automatically switch from Medicare Advantage to traditional Medicare.
What it does say is don't let a grocery card, gym membership or dental allowance make the Medicare decision for you. Doctors, prescriptions, networks, prior authorization and your ability to change coverage later matter more.” The study also points to earlier research finding that Medicare Advantage enrollment did not significantly improve health outcomes among seniors with diabetes. According to the researchers, evidence continues to show that increased spending on Medicare Advantage may not necessarily lead to better management of chronic illnesses.
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