Medicare Advantage (MA) has seen dramatic enrollment growth over the past six years, significantly outpacing traditional Medicare, according to a report commissioned by the Better Medicare Alliance released October 15.
The report, prepared by the actuarial firm Milliman, examined the growth in enrollment in MA and the similarities and differences between enrollees in that program and in traditional fee-for-service Medicare.
It found that between 2013 and 2019, MA enrollment rose from 14.8 million in 2013 to 24.2 million in 2019, growth of 60%. That figure did include enrollees in employer group waiver plans (EGWP), wherein employers subsidize retiree medical benefits, and Milliman did not include these enrollees in its subsequent analyses since they were not available to all Medicare beneficiaries.
But even allowing for these extra enrollees, the 60% stands in sharp contrast to the growth in traditional Medicare enrollment, which rose just 5% from 2013 to 2019, going from 38.3 million beneficiaries to 40.2 million.
MA also accounted for a growing share of the Medicare cohort from 2013 to 2019, growing each year to eventually capture 34.3% of the more than 64.4 million individuals covered by Medicare in 2019.
The report also found that in the 53 million beneficiaries in the 2013 Medicare cohort, there were more than 8 million switches between MA and fee-for-service by 2019, including people who made switches multiple times.
“However, 41 million maintained their original coverage for the entire period; approximately 81% of FFS beneficiaries and 85% of MA enrollees,” the report said. “Six million FFS beneficiaries joined MA, which represents 49% of the MA 2013 enrollment. Meanwhile 2.4 million joined FFS from MA, representing 6% of the 2013 FFS population.”
The report also found that MA has drawn increasing numbers of beneficiaries eligible for both Medicare and Medicaid, or dual-eligibles. There were 2.4 million full or partial dual-eligible beneficiaries enrolled in MA, compared with 7.2 million in traditional Medicare, in 2013.
In 2019, the number of full or partial dual-eligibles in MA rose to 5.4 million, while 6.8 million were enrolled in traditional Medicare.
“This represents an overall increase in dual eligibles from 2013 to 2019 of 28%, but MA grew by 125% while FFS dropped by 5.6%,” the report noted. “The large increase in MA enrollment for dual eligibles may have been driven, at least in part, by implementation of the Medicare-Medicaid demonstration plans in some states.”
The report used data from the 2013 to 2019 Centers for Medicare & Medicaid Services (CMS) 100% Medicare Research Identifiable Data Set.