Enrollees in Medicare Advantage (MA) plans with no monthly premiums are three times more likely to be nonwhite compared to traditional Medicare counterparts, research from Harvard Medical School and software provider Inovalon shows.
They are also more likely to live in urban areas than fee-for-service Medicare enrollees.
“Our analysis can help Medicare Advantage and other health plans more effectively serve their member populations by offering tailored designs and features,” said Christie Teigland, Ph.D., vice president of research science and advanced analytics at Inovalon and co-lead researcher on the project, in a news release.
The teams' research suggests some MA plans with zero dollar premiums interest disadvantaged populations, in some cases appealing to people who don't speak English, don't own a home or car, have less education or are single.
"Our study findings suggest that the breadth of different MA plan types available to beneficiaries is a key part of MA’s appeal, and what allows MA to attract such a large proportion—more than 50% in 20231—of all Medicare beneficiaries," the authors said in the report.
Previous research from Harvard and Inovalon has found that MA enrollees have fewer hospitalizations, have greater challenge in overcoming social determinants of health, and have fewer inpatient hospital stays.
This white paper (PDF) also looks at enrollees in health maintenance organizations (HMOs), finding these individuals are three times more likely to be nonwhite than people in MA preferred provider organizations (PPO) plans. Additionally, utilization in HMOs is 29% lower than comparable MA PPO populations, meaning nearly $2,500 lower utilization per person.
“Our research challenges the misconception that Medicare Advantage is a monolith, revealing significant differences in plan designs and features and how those variables affect enrollment and outcomes,” said Boris Vabson, Ph.D., a health economist at Harvard Medical School and co-lead researcher on the project, in a statement. “By understanding the populations MA plans attract, policymakers and health plans can come together to incentivize and deliver superior, cost-effective outcomes for every Medicare enrollee.”
Inovalon says their insights can help insurers predict the types of beneficiaries that will enroll in different plans. This helps plans anticipate utilization and cost outcomes.