What 8 recent studies found about Medicare Advantage

Recent studies have uncovered differences between networks, beneficiary characteristics and medications prescribed in Medicare Advantage and fee-for-service Medicare. 

Here are eight studies examining Medicare Advantage Becker's has reported on since June 30. 

1. Physicians who serve more patients dually eligible for Medicare and Medicaid and with higher risk scores are less likely to be included in Medicare Advantage networks, a study published in JAMA Health Forum found.
   
   
2. The neighborhood an individual lives in can affect their healthcare utilization, especially in the Medicare population, according to a study in the American Journal of Managed Care. The study found adults older than 65 residing in disadvantaged neighborhoods had a higher risk of utilizing high-cost medical care. The risk was lower among younger commercially insured adults in the same neighborhoods.
   
   
3. Nearly half of Medicare Advantage beneficiaries report having at least one health-related social need, a study published in Health Affairs found. The study, written by researchers at Humana, surveyed over 300,000 Humana Medicare Advantage enrollees. Beneficiaries who were dually eligible for Medicare and Medicaid were more likely to have health-related social needs, with 80 percent reporting at least one of seven needs.
   
   
4. There are several demographic and socioeconomic differences between individuals who select traditional Medicare coverage versus Medicare Advantage plans before they turn 65 and who have commercial insurance, according to a study from researchers at Harvard Medical School and software firm Inovalon.
   
   
5. The Medicare Advantage star rating system and its quality bonus payment program is failing to achieve its two main goals of helping beneficiaries select a plan and incentivizing payers to improve plan quality, according to a report from the Urban Institute.
   
   
6. "Look-alike" dual eligible Medicare Advantage plans — which primarily enroll people eligible for Medicare and Medicaid but are not regulated as D-SNP plans — grew significantly from 2013 to 2020, a study published in Health Affairs found.
   
   
7. Many Medicare Advantage plans have narrow networks for psychiatrists when compared to Medicaid managed care and ACA plans, a study published in Health Affairs found. The study found that two-thirds of psychiatry networks in Medicare Advantage were narrow, containing fewer than 25 percent of psychiatry providers in the plan's area.
   
   
8. Medicare Advantage members are less likely to be prescribed high-risk medications than their counterparts in fee-for-service Medicare, a study published in JAMA Health Forum found.