Recent research by Dr. Tami Videon and Dr. Robert Rosati of VNA Health Group, funded by the 2023 Home Care Research Grant from the Research Institute for Home Care (RIHC), provides new insights into how Medicare Advantage (MA) plan enrollment types affect the utilization of health services and the demographics of Medicare beneficiaries. RIHC, a non-profit consortium of home care providers and organizations, supports such research to improve the delivery of quality, cost-effective, patient-centered care across the home care continuum.

The study, which analyzed data from the 2019 Medicare Current Beneficiary Survey (MCBS), revealed significant differences in the demographic makeup and service utilization patterns between MA beneficiaries and those in traditional Medicare. Notably, beneficiaries enrolled in zero monthly premium MA plans were found to be substantially more diverse. Hispanic beneficiaries, for example, were three times more likely to be enrolled in zero premium MA plans compared to those in traditional Medicare or premium-based MA plans. Similarly, Black beneficiaries were nearly twice as likely to choose zero premium MA plans over traditional Medicare.

• Research Briefing: Health Service Utilization by Medicare Plan Type Enrollment
• Research Briefing: Medicare Plan Type Enrollment: Sociodemographic Profiles of Beneficiaries

In terms of service utilization, the research found that all MA beneficiaries, regardless of whether they were in premium or zero-premium plans, were less likely to use home health care, inpatient, and outpatient services than their traditional Medicare counterparts. This trend may be linked to the restrictions and cost-sharing mechanisms inherent in many MA plans. Specifically, the study noted that MA enrollees with premium plans utilized vision, dental, and hearing services slightly more than those in traditional Medicare, while both groups used these services significantly more than beneficiaries in zero-premium MA plans.

The findings underscore the complexities of Medicare plan selection and its implications for patient outcomes and the broader health care system. As MA enrollment continues to grow, now encompassing more than 50% of Medicare beneficiaries, this research highlights the need for ongoing evaluation to ensure equitable access to high-quality care for all beneficiaries.

To explore the full details of this and other research funded by RIHC, click here.