The Next Big Thing in Health is a podcast where we explore the new big ideas that will help make health care more affordable, more available, and more effective.
A special episode of the Next Big Thing in Health podcast celebrates Medicare Advantage topping 30 million enrollees. AHIP President and CEO Matt Eyles was joined by Mark Hamelburg, AHIP’s Senior Vice President, Federal Programs, for a discussion on the significance of the 30 million milestone and the value and benefits of Medicare Advantage.
Eyles:
Hi, I'm Matt Eyles, president and CEO of AHIP. And welcome to a special episode of the Next Big Thing in Health, and we've just hit a big milestone for the Medicare Advantage program. Now more than 30 million seniors and people with disabilities, about half those eligible for Medicare, are choosing Medicare Advantage for their health care coverage. Just 10 years ago, Medicare Advantage had just 13 million enrollees, and since then, the program has seen huge growth and is a model of public-private partnerships that are working together, improving affordability, access benefits, and satisfaction for patients, consumers and taxpayers.
Spotlight: CMC Senior:
It's exciting to see that over 30 million Americans are now enrolled in Medicare Advantage. As a member for over five years. I've always spoken highly of the coverage Medicare Advantage offers. It seems like each year the program has become more popular, and for good reason. I'm happy to see that more seniors are realizing the benefits of Medicare Advantage and hope that will continue for years to come.
Eyles:
I'm here today with Mark Hamelburg, AHIP senior vice president for federal programs, who will tell us more about why Medicare Advantage has become so important to Americans. Mark, thanks for joining me today.
Hamelburg:
Well, thanks for inviting me, Matt. It's a real pleasure to be able to celebrate this incredibly important milestone for the MA program.
Eyles:
Why don't we go ahead jump into the first question, which is just why are more Americans choosing Medicare Advantage?
Hamelburg:
Well, if I had to sum it up, I'd say that they recognize that Medicare Advantage (MA) provides them with real value. For example, a couple of the key elements MA plans provide more financial peace of mind than the original Medicare program, because they lower costs for many services and they cap annual out-of-pocket costs. People can also obtain important coverage for services that are not available in the original program. That includes things like care coordination, disease management, and in many cases, plans offer services like vision, hearing, or dental care, transportation, meal delivery services, companion care, just to name a few. And while the coverage is better, 98% of Medicare Advantage enrollees have access to a plan that doesn't charge them any more for these extra benefits. Plus for plans that do charge premiums, average cost actually can continue to go down over time rather than up. And of course value isn't just about costs. Numerous studies show that the MA program improves patient care on clinical quality measures, provides better access to preventive care, and leads to better outcomes for patients with specific chronic diseases. So to sum up, again, seniors people with disabilities and their families, they increasingly recognize all these benefits and it's why more than ever they're choosing MA.
Eyles:
The senior population has been growing for a long time. We know baby boomers have been turning 65, aging into the program. What do seniors have to say about Medicare Advantage?
Hamelburg:
Well, I think it's fair to say they love MA, and they want it protected. And the numbers on these points really are pretty staggering. 93% of seniors are satisfied with their MA plan. Even more nearly 96% would recommend it to their friends and families. In terms of protecting the program, again, the numbers are really impressive. Three in four, say it's important for the federal government to protect MA funding, and two in three would be more likely to vote for a member of Congress who supports more MA funding.
Eyles:
Those are some pretty telling statistics about how seniors value MA, but let's ask the question, is it a great value for taxpayers, too?
Hamelburg:
In a word, absolutely, Matt, it is a great value. The analysts at MedPAC consistently report that MA plans are far more efficient at providing coverage for the same sets of benefits than the original Medicare program. And these efficiencies are used to finance all these extra benefits that I was mentioning. And recently AHIP commissioned a study that looked at the costs for the same eligible enrollees and made certain other adjustments to make sure we were making an apples-to-apples comparison between that and the original Medicare program. And what that study found is that total average payments to MA plans are significantly less than original Medicare, which is saving Americans billions of dollars every year. And there are studies that show as more people enroll in MA, it actually reduces growth and costs in the original Medicare program as providers adopt practices that carry over to other populations. And as I mentioned, MA outperforms original Medicare on numerous clinical quality measures. So, more benefits, better care, better value. It's a win-win for enrollees and taxpayers.
Eyles:
Can you remind us who Medicare Advantage serves? I think it's really important for those listening and watching today to understand who's served by the program.
Hamelburg:
Absolutely. It's a very diverse group of people. Just to throw out a couple of numbers to demonstrate, 57% of MA enrollees are women. About 9 million MA enrollees have income below 200% of the federal poverty level. It covers a more racially diverse population than the original Medicare program. In fact, nearly half of all racial and ethnic minorities who are eligible for Medicare end up choosing MA.
Eyles:
So it sounds like this is a pretty good model of both choice and value. Wouldn't you say?
Hamelburg:
Indeed, Matt. Indeed it is. And in fact, speaking of choice, it's important that we remind people that the program as it continues to grow, enrollees continue to have many different options to choose from. In 2022, for example, the average beneficiary had access to 39 Medicare Advantage plans, which is an increase from the prior year, and what these choices mean is that people can find the coverage that best meets their needs.
Eyles:
Well, thanks for joining us today, Mark, that was really helpful.
Hamelburg:
My pleasure.