It's official: Medicare Advantage (MA) enrollment accounts for just over half of all Medicare beneficiaries, according to a new analysis from the Kaiser Family Foundation.
KFF researchers analyzed data from the Centers for Medicare & Medicaid Services and found that 30.19 million of the 59.82 million people enrolled in Medicare as of January 2023 were in an MA plan, the first time the program has crossed 50% of all Medicare enrollment.
Medicare Advantage has grown at a steady clip since its inception. Enrollment in private Medicare plans accounted for just 19% of the program in 2007, according to KFF. By 2019, enrollment had doubled to 39%.
"Enrollment in Medicare Advantage has increased dramatically in recent years," the KFF analysts wrote. "The growth in enrollment is due to a number of factors, including the attraction of extra benefits offered by most plans, such as vision, hearing, and dental services, and the potential for lower out-of-pocket spending, particularly compared to traditional Medicare without supplemental coverage."
In addition, MA coverage is attractive to many as it provides a one-stop shop for beneficiaries, since they will not need to shop separately for Part D coverage or supplemental plans, the researchers added.
The rapid growth has made MA a central focus for insurers, who generate significant profit in this space. Enrollment nationally is dominated by UnitedHealthcare and Humana.
That expansion has also led to far greater scrutiny on how insurers are managing the program along with concern that they're pocketing excessive dollars as MA grows. There is also a dearth of data on how MA compares to traditional Medicare in managing equity challenges and reaching underserved patient populations, the KFF researchers said.
Critics are also concerned about utilization management in the program, and the KFF report said that in 2021 alone MA members submitted 35 million requests for prior authorization.
"As the role of Medicare Advantage grows, so will interest in understanding how well the program serves the increasingly diverse group of enrollees who receive their Medicare coverage from private insurers," the KFF researchers said.