Study: Traditional Medicare, Medicare Advantage enrollee populations differ

The population enrolled in traditional Medicare has different characteristics than the Medicare Advantage population--a fact policymakers must keep in mind when shaping the future of the Medicare program, according to a new study published in JAMA Internal Medicine.

In a study of 9,385 senior citizens who died over a 14-year period, researchers from the University of Michigan Medical School found that those enrolled in Medicare Advantage programs were healthier overall and more independent than their fee-for-service Medicare counterparts in the last six months of their lives. Those with private Medicare plans were typically younger, more often city dwellers, more likely to be black and more often have an income that is too high to qualify for Medicaid.

The researchers were surprised at just how different the two populations were, according to a study announcement. And those differences have implications for federal policy, says researcher Elena Byhoff, M.D., given the fact that health policy is often based on federal Medicare enrollee data even though 31 percent of seniors are covered by private plans.

Thus, Byhoff says policymakers may be overestimating the severity of illness in studies of Medicare end-of-life care. "If we're going to have a national conversation on end-of-life care and the spending it drives, we shouldn't only base it on data from two thirds of the elderly population," she says in the study announcement. 

Indeed, as FierceHealthPayer previously reported, Medicare Advantage patients who become seriously ill often switch to traditional Medicare. In addition, some have questioned whether Medicare Advantage serves sick beneficiaries as well as it does those who are healthy, given that private plans tend to exclude some providers from their networks.

To learn more:
- here's the study announcement
- check out the study

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