According to the Medicare Modernization Act 2003, the Medicare Advantage program that we know today was formed. These types of plans allow seniors and those eligible for Medicare due to disability to get health coverage from private health insurance companies. Private insurance companies offering Medicare Advantage (MA) plans are expected to offer the same benefits offered by Medicare Parts A and B. Part A covers hospital insurance while Part B covers medical insurance. Aside from coverage on both in-patient and out-patient services, Advantage plans typically cover some prescription drugs as well. That is why these plans are sometimes referred as Medicare Part C. They combine Medicare Part A, B and often Part D coverage.
Since MA plans have been available, they have become a popular alternative to Original Medicare. In the year 2010, approximately 25 percent of all Medicare beneficiaries were enrolled in Medicare Advantage plans. From an initial enrollment of 5.3 million, the enrollees have more than doubled and the numbers are still increasing every year.
Medicare Advantage plans have paved the way for beneficiaries to expand on traditional Medicare benefits. Ever since the beginning of the program, the success that Medicare Advantage plans have had among seniors has been a subject of debate. Recently, data was released regarding the quality of care that MA enrollees receive.
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Medicare Advantage Plans Offer Higher Quality Of Care
According to a study by Niall Brennan (Acting Director of the Office of Policy at the Centers for Medicare and Medicaid Services), and Mark Shepard (Ph.D. candidate in economics at Harvard University), MA plans offer higher quality of care compared to Medicare fee-for-service plans for hospital utilization and delivery of care using widely-accepted measurements of quality.
Some years back, when the first data on Medicare Advantage plans became available, Brennan and Shepard used 11 measurements to look at the underuse of effective care. Out of the 11 measurements, MA plans noticeably performed better than fee-for-service plans in 9 fee-for-service plans. Fee-for-service plans only outperformed Medicare Advantage plans on a couple of measurements, which were not that significant to overall care.
A similar study was conducted by an America’s Health Insurance Plans (AHIP) utilizing HEDIS (Healthcare Effectiveness Data and Information Set) measurements. The study shows quality improvements in health care for MA policyholders with diabetes and heart disease. The findings reveal that compared to fee-for-service plans, diabetic MA policyholders have fewer hospital readmissions and shorter hospital stays. As for heart disease patients, the trend was the same.