Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Awards
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
    • Women in Healthcare
    • - Luminaries
    • - Top 25 Diversity Leaders
    • - Leaders to Watch
    • - Luminaries
    • - Top 25 Women Leaders
    • - Women to Watch
  • Events
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Transformation Summit
    • Women Leaders in Healthcare Conference
    • Social Determinants of Health Symposium
    • Leadership Symposium
    • Health Care Hall of Fame Gala
    • Top 25 Women Leaders Gala
    • Best Places to Work Awards Gala
    • Top 25 Diversity Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain Revenue Cycle
    • - Hospital at Home
    • - Workplace of the Future
    • - Strategic Marketing
    • - Virtual Health
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Medicare
May 18, 2021 04:18 PM

Study: Medicare Advantage dual-eligibles less likely to miss care

Nona Tepper
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Getty Images

    Dual-eligible Medicare Advantage beneficiaries were less likely to experience care disruptions during the COVID-19 pandemic than dual-eligibles in traditional, fee-for-service Medicare, despite representing a more vulnerable patient population, according to a new study.

    University of Chicago researchers analyzed more than 9,600 responses from a Medicare survey conducted from October to November 2020. They found 35% of Medicare Advantage dual-eligibles reported being unable to access a primary-care visit during the pandemic, compared with 51% of dual-eligibles enrolled in traditional Medicare, according to a study released on Tuesday. Dual-eligibles are individuals who qualify for Medicare and who also receive financial help and additional benefits from Medicaid.

    Access to care during COVID-19 was particularly critical for Medicare Advantage dual-eligibles, since they represent one of the most vulnerable patient populations, said Mairin Mancino, a study researcher and senior director of healthcare strategy at NORC at the University of Chicago. Compared with traditional Medicare dual-eligibles, members who opted into Medicare Advantage plans were more likely to be older, more ethnically diverse and have chronic conditions—all placing them at a greater risk for contracting COVID-19. Additionally, nearly 40% of Medicare Advantage respondents said they spoke a language other than English at home, compared with 26% of traditional Medicare dual eligibles.

    "I think there's a narrative out there that Medicare Advantage enrolls a healthy population and this study sheds light on the fact that those demographics today in 2021 look different than that prevailing narrative suggests," Mancino said.

    In addition to reporting greater access to annual check-ups, Medicare Advantage dual-eligibles were also more likely than fee-for-service beneficiaries to report access to diagnostic testing, treatment for ongoing conditions and urgent care for emergencies during the pandemic. Five percent of Medicare Advantage members reported being unable to access urgent care during the pandemic, compared with 18% of traditional Medicare members; 24% of Medicare Advantage members said they were unable to get treatment for a chronic condition during the time period studied, compared with 36% of fee-for-service dual eligibles. And 28% of privately managed dual-eligibles reported they couldn't get a diagnostic screening or medical test, compared with 38% of traditional Medicare dual-eligibles.

    Medicare Advantage dual-eligibles were also more likely to report access to services related to the social determinants of health than traditional Medicare beneficiaries, with more Medicare Advantage dual-eligibles saying they had greater access to nutritious food and financial resources than those in traditional Medicare. As members' deferred care led insurers to generate excess profits, many payers invested in benefits around the social determinants of health for members, rather than returning the excess cash to CMS.

    Private payers also, in some cases, invested in providers' ability to connect with members virtually, reflecting a need to capture members' risk scores, a measure that essentially attempts to quantify how sick a patient will be. CMS pays Medicare Advantage insurers a set advance fee each month to cover the expected cost of enrollees' care based on these risk scores, which are derived from diagnosis codes submitted by the providers.

    As the COVID-19 pandemic tore through the nation last spring and fall, Medicare Advantage members increasingly deferred care. During the fourth quarter of 2020, Humana, for example, reported a 15% drop in doctors visits among its Medicare Advantage enrollees. One way the Louisville, Ky.-based insurer aimed to promote access was to launch two Atlanta-area plans that paid for members' cellular data service to make sure they could connect with their providers virtually. SCAN Health Plan in California, meanwhile, set up a technology support line to teach Medicare Advantage members how to access their doctors electronically. NORC found increased connectivity for Medicare Advantage dual-eligibles across the industry.

    The study said 63% of Medicare Advantage respondents said they accessed their provider virtually during COVID-19, compared with 52% traditional Medicare enrollees.

    "As we see our healthcare system embracing value-based payments, it's really important to understand how a program like Medicare Advantage is meeting the needs of this vulnerable population, as compared to the fee-for-service population," Mancino said.

    This study was sponsored by the America's Health Insurance Plans and conducted independently by researchers from NORC at the University of Chicago.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Copy of states hospital costs_WEB_i.jpg
    The wonky Medicare proposal worrying safety-net hospitals
    stethoscope istock_i.jpg
    United Physicians creates joint venture with national company for Medicare patients
    Sponsored Content
    Daily Dose Newsletter: Sign up to receive a late afternoon weekday roundup of that day’s breaking news and developments in healthcare.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2022. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Nominate/Eligibility
      • 100 Most Influential People
      • 50 Most Influential Clinical Executives
      • Best Places to Work in Healthcare
      • Excellence in Governance
      • Health Care Hall of Fame
      • Healthcare Marketing Impact Awards
      • Top 25 Emerging Leaders
      • Top 25 Innovators
      • Diversity in Healthcare
        • - Luminaries
        • - Top 25 Diversity Leaders
        • - Leaders to Watch
      • Women in Healthcare
        • - Luminaries
        • - Top 25 Women Leaders
        • - Women to Watch
    • Events
      • Conferences
        • Transformation Summit
        • Women Leaders in Healthcare Conference
        • Social Determinants of Health Symposium
        • Leadership Symposium
      • Galas
        • Health Care Hall of Fame Gala
        • Top 25 Women Leaders Gala
        • Best Places to Work Awards Gala
        • Top 25 Diversity Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain Revenue Cycle
        • - Hospital at Home
        • - Workplace of the Future
        • - Strategic Marketing
        • - Virtual Health
      • Webinars
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing