AHIP Study on the Advantages of MA Over Medicare

More than 32 million seniors and people with disabilities choose Medicare Advantage (MA) because it delivers better service, better access to care, and better value. Medicare Advantage has been proven to provide better access to preventive health care, helping to reduce disease risk and detecting illnesses at an early stage.

In the brief, AHIP examines how often clinical guidelines were met in original Medicare versus Medicare Advantage, focusing primarily on measures of preventive and chronic disease care for major chronic conditions. Higher performance on key preventive and chronic disease care measures suggests Medicare Advantage enrollees received higher quality care than those in original Medicare.

Study & Findings

To assess differences in quality of care and utilization of services and medication, AHIP compared performance results for certain Healthcare Effectiveness Data and Information (HEDIS) measures focused on preventive and chronic disease care in original Medicare and Medicare Advantage in 2019. Across 11 HEDIS measures, Medicare Advantage outperformed original Medicare in all but one.

One standout measure highlighted in the study is cancer screenings. Overall, a higher share of Medicare Advantage enrollees were screened for 2 common forms of cancer than their original Medicare counterparts. Specifically, compared to those enrolled in original Medicare, a higher share of Medicare Advantage beneficiaries received screening for breast cancer (73.3% vs 69.9%) and colorectal cancer (38.9% vs 33.1%). Across many other areas of preventive care, Medicare Advantage outperformed original Medicare.

Use of preventive services is one important factor in maintaining good health and keeping chronic health conditions from getting worse. The findings presented in the study show that Medicare Advantage enrollees have higher rates of use across a wide range of preventive services than their original Medicare counterparts, consistent with prior studies showing Medicare Advantage plans have higher performance on HEDIS preventive measures than original Medicare.

To find out more, read the study in full by clicking here.