Fewer Medicare Advantage plan members actively managed their care in 2020, and they had less communication with their health plans, a new report finds.
Data analytics firm J.D. Power wrote in its 2021 U.S. Medicare Advantage Study that the country's nine largest plans are still struggling when it comes to member communication and engagement. The seventh annual study found just 55% of MA members actively managed their care in the past year, a decline of nine percentage points from 2019.
The two most common ways plan members actively manage their care is by checking whether a treatment or service is covered and asking their doctor or pharmacist for a generic drug instead of a brand-name one, J.D. Power wrote.
"A lot of that has to do with the health plans aren't actively seeking to engage with their membership, which really is curious given it's Medicare Advantage," said James Beem, J.D. Power's managing director of global healthcare intelligence. "It's a full-risk, direct-to-consumer product."
A category that covers members' satisfaction with communication and information was the lowest-performing factor evaluated in the study. Beem noted that's despite the fact the category improved slightly year-over-year, just at a lower rate than other factors that drive satisfaction, like cost, coverage, networks and customer service. That's a trend J.D. Power has noticed in its studies since 2015, Beem said.
J.D. Power noted that plans' satisfaction scores are 54 points higher on a 1,000-point scale when members successfully engage with their plan to ask questions or solve a problem than when they have no engagement at all.
The study also found that new MA members tend to be in worse health and have lower incomes than established members.
Just 34% of new MA members—those ages 65 to 68 or in their first year of the program—said they are in "very good" or "better" health, and 46% said they have an annual income of $50,000 or more. That's compared to 39% of established plan members—those ages 69 and up and not in their first plan year—who say they are in "very good" or "better" health and 56% who earn more than $50,000 per year.
The trend of lower utilization among MA compared with traditional Medicare has been well documented in scientific literature, with estimates ranging from 10% to 60%.
A 2019 study in the American Economic Journal: Applied Economics, for example, found MA spending to be 30% lower than traditional Medicare per beneficiary per month.
The authors wrote MA insurers have a number of potential levers for keeping utilization low. That article found higher spending per emergency department patient in MA compared with traditional Medicare, indicating the MA patients are in worse health by the time they're admitted for care. The study also found MA patients are much less likely than traditional Medicare patients to be discharged from the hospital to post-acute care and much more likely to be discharged home. The study also noted lower rates of specialist visits in MA.
"Lower utilization in MA appears both for services where there are concerns about over-use, such as diagnostic testing and imaging, as well as for services where there are concerns about under-use, such as preventive care," the team of authors wrote in the 2019 study.
But there was some encouraging news; 78% of MA members are registered for their plan's member portal, up four percentage points from last year. Two-thirds of members have logged into their plan portal. Portal use is linked with higher plan satisfaction and improved engagement, J.D. Power noted.
Kaiser Foundation Health Plan performed highest on an overall consumer satisfaction rating, scoring 846 on a 1,000-point scale. Second was Highmark, with 834. Cigna HealthSpring and Humana tied for third, both scoring 822. At the bottom of the list, Centene scored 769. Just above that, Blue Cross and Blue Shield of Michigan scored 788. UnitedHealthcare and Aetna tied for third lowest at 795.
J.D. Power's study was based on responses from 3,359 MA members across the country. Fielded between January and March 2021, it includes nine plans that together cover about 70% of the Medicare Advantage market share, Beem said.