Report: MA Performs Better Than Fee-for-service Medicare on Diabetes Care

Medicare Advantage patients may receive higher quality diabetes care than traditional fee-for-service Medicare beneficiaries, a new analysis found. This includes earlier detection of diabetes and higher utilization of preventive care.

The report was conducted by Avalere Health, a healthcare consulting firm, and commissioned by Better Medicare Alliance, an advocacy organization for Medicare Advantage. The study included nearly 400,000 MA and traditional beneficiaries with prediabetes, nearly 325,000 MA and traditional beneficiaries with incident type 2 diabetes and more than 2.2 million MA and traditional beneficiaries with chronic type 2 diabetes. 

It found that MA patients with prediabetes who developed type 2 diabetes received their diagnosis earlier than fee-for-service Medicare patients. The average time between the prediabetes index date (the first inpatient or outpatient diabetes event during the study period) and type 2 diagnosis was 401 days for MA patients and 543 days for fee-for-service patients.

The study also discovered that MA beneficiaries sought more preventive care. More MA patients filled prescriptions for diabetes medications to prevent progression, compared to traditional Medicare beneficiaries. For example, 46% of MA patients filled a prescription for insulin nine months after diagnosis, versus 35% of traditional. 

Additionally, MA beneficiaries with prediabetes and diabetes were found to have fewer emergency department visits and inpatient admissions than fee-for-service patients. Total medical spending was also lower among MA patients compared to fee-for-service, the report found.

“With nearly one-third of seniors who have a type 2 diabetes diagnosis, this study shows how Medicare Advantage is already at work engaging the unique needs of this beneficiary population, focusing on earlier detection and greater use of preventive care, resulting in fewer hospitalizations and lower total medical spending, and creating better opportunities to age with vitality and independence for all seniors who live with this condition compared to FFS Medicare,” said Mary Beth Donahue, president and CEO of the Better Medicare Alliance, in a news release.

Medicare Advantage is projected to become the predominant form of coverage for Medicare beneficiaries, according to Kaiser Family Foundation. Consumers often choose MA plans for the wider breadth of benefits, while others choose traditional Medicare for more provider options, a recent report by the Commonwealth Fund found.

MA plans have been coming under scrutiny recently, with some believing they are misleading for seniors and drive up costs for the Centers for Medicare and Medicaid Services.

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