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March 6, 2024
David Burda
Consumerism Policy System Dynamics

Spy vs. Spy? More Like Medicare vs. Medicare Advantage

If you follow my columns, blog posts and podcasts on 4sighthealth.com, you know that I’m not much for the Medicare Advantage (MA) program. So much so that I’ve publicly declared that I’ll choose traditional Medicare when my time comes in 2025.

You’ve read or heard my many reasons. But let’s find out from Medicare beneficiaries themselves thanks to a new report from the Commonwealth Fund.

The report is based on a survey of 3,280 Medicare beneficiaries conducted by the Commonwealth Fund from November 2023 through January 2024. The report didn’t disclose — or more likely I couldn’t find — the breakdown of how many respondents were in Medicare versus Medicare Advantage. But I do trust that the Commonwealth Fund researchers know what they are doing, especially after politely acknowledging that many beneficiaries didn’t know what type of Medicare coverage they had.

“For many beneficiaries, the various types of coverage offered — including traditional Medicare, Medicare Advantage plans, Medigap and other supplemental coverage — can be confusing and may lead beneficiaries to inaccurately identify their coverage,” the report said.

Whose fault is that? But I digress.

I’m going to highlight some of the differences in opinion of the respondents that the Commonwealth Fund researchers identified as statistically significant:

  • 22% of MA enrollees said their care was delayed because they needed their MA plan’s approval compared with 13% of enrollees in traditional Medicare.
  • 12% of MA enrollees said they couldn’t afford the care they needed because of the copayment or deductible amount compared with 7% of enrollees in traditional Medicare.
  • 49% of MA enrollees said their doctor discussed the results of their health assessments with them compared with 62% of enrollees in traditional Medicare.

Here are a few other survey results that I found significant, albeit not statistical:

  • 36% of MA enrollees said they waited more than a month to see a doctor compared with 34% of enrollees in traditional Medicare.
  • 28% of MA enrollees said they needed to find a new doctor within the past 12 months compared with 27% of enrollees in traditional Medicare.
  • Of the beneficiaries who said their Medicare coverage didn’t meet their expectation, 36% of MA enrollees said it was because their MA plan benefits didn’t cover what they needed compared with 33% of enrollees in traditional Medicare.
  • Of the beneficiaries who said their Medicare coverage didn’t meet their expectation, 33% of MA enrollees said it was because the costs were too high compared with 30% of enrollees in traditional Medicare.

Overall, in this survey, I’d give the edge to traditional Medicare for giving seniors what they want. And we all know that if you don’t give seniors exactly what they want, someone’s going to hear about it.

Thanks for reading.

To learn more about this topic, please listen to the Feb. 15, 2024, episode of our 4sight Health Roundup podcast, “Rethinking Medicare Advantage,” on 4sighthealth.com.

About the Author

David Burda

David Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personnel experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 40 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 40 years and his three children, none of whom want to be journalists or lobster fishermen.

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