Saturday, September 23, 2023

MA Beneficiaries With Cancer Spend Less on Healthcare Than Traditional Medicare Beneficiaries – MedCity News

Medicare Advantage beneficiaries who have cancer or are cancer survivors spend more than $2,000 less on their healthcare compared to traditional Medicare beneficiaries with cancer, a new report found.

The report, published Thursday, was conducted by ATI Advisory and was commissioned by the Better Medicare Alliance, a research and lobby group for Medicare Advantage. The researchers relied on the 2019 Medicare Current Beneficiary Survey from the Centers for Medicare and Medicaid Services for the analysis.

They found that Medicare Advantage beneficiaries with a cancer diagnosis spend $3,996 on out-of-pocket costs and premiums annually, versus $6,091 for traditional Medicare beneficiaries with cancer. Medicare Advantage enrollees without a cancer diagnosis also spend less on healthcare ($3,458 on average, versus $5,365 for traditional Medicare beneficiaries).

In addition, traditional Medicare beneficiaries with a cancer diagnosis are more likely to be cost burdened by their healthcare expenses, meaning at least 20% of their income is spent on healthcare. About 23% of traditional Medicare beneficiaries with a cancer diagnosis are cost burdened, compared to 15% of Medicare Advantage enrollees with cancer. 

The lower total healthcare spending for MA beneficiaries could be partially driven by higher rates of preventive service use like cancer screenings. Among patients with cancer or cancer survivors, MA enrollees have higher rates of utilization for mammograms, colonoscopies, prostate blood tests and home fecal blood tests than traditional Medicare enrollees. Among those without cancer, people on MA plans have higher rates of utilization for mammograms, colonoscopies and home fecal blood tests, but traditional Medicare beneficiaries have a slightly higher rate of utilization of blood tests to detect prostate cancers.

“Higher rates of screening and preventative care among Medicare Advantage beneficiaries than FFS Medicare beneficiaries … contribute to cost savings, as identifying cancers early not only results in improved prognoses but also reduced long-term cost,” the report stated. “The impact of financial hardship on delayed or forgone care and poor medication adherence is well documented among patients with cancer. Therefore, controlling the out-of-pocket costs of health care for this population is especially critical.”

MA and traditional Medicare beneficiaries report receiving cancer diagnoses at similar rates. About 19% of Medicare Advantage enrollees and 20% of traditional Medicare enrollees have received a non-skin cancer diagnosis, while 19% of MA beneficiaries and 22% of traditional Medicare enrollees have received a skin cancer diagnosis.

The researchers also discovered that people with MA plans who have cancer are more likely to be socially disadvantaged than those with traditional Medicare. Cancer patients with Medicare Advantage coverage are more likely to have incomes under 200% of the federal poverty level, less likely to have a college degree and more likely to be food insecure. In addition, 19% of MA members with cancer are Black or Latino, compared to 12% of traditional Medicare enrollees with cancer. About 45% of MA beneficiaries with cancer are over the age of 75, versus 41% of traditional Medicare beneficiaries.

For the most part, beneficiaries with cancer reported the quality of their care at similar levels, with 96% of MA enrollees and 97% of traditional Medicare enrollees saying they are satisfied with the healthcare quality they receive.

The findings come when Medicare Advantage enrollment is on the rise and efforts to rein them in as well. More than half of eligible Medicare beneficiaries in 2023 have MA coverage, according to KFF.

Photo: designer491, Getty Images

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