Findings of a just-released Kaiser Family Foundation study, At Least Half of New Medicare Advantage Enrollees Had Switched from Traditional Medicare During 2006-11, disputes the popular misperception that Baby Boomers’ overwhelmingly choice of private plans accounts for the steady rise in Medicare Advantage enrollment. Instead, Study reports that seniors switching from traditional Medicare account for the majority of new enrollees in Medicare Advantage each year.
According to the study published January 5, 2015 in the journal Health Affairs, fewer than one-quarter of people newly-eligible for Medicare enrolled in Medicare Advantage from the outset, and these newly-Medicare eligible comprised less than half of all new Medicare Advantage enrollees each year between 2006 and 2011. However the study also reports that the share of seniors who switch between traditional Medicare and Medicare Advantage is relatively small, reinforcing the notion that most Medicare beneficiaries make a coverage choice and stick with it.
Other findings reported in the study include:
- The share of people newly eligible for Medicare that elected Medicare Advantage plan coverage instead of traditional Medicare at initial enrollment rose slightly from 15 percent in 2006 to 22 percent in 2011;
- In each year between 2006 and 2011, the majority of new Medicare Advantage enrollees were people who had switched from traditional Medicare; seniors in their first few years on Medicare (in their late sixties) switched from traditional Medicare to Medicare Advantage at higher than average rates;
- In each year between 2006 and 2011, fewer than 5 percent of traditional Medicare beneficiaries switched to Medicare Advantage, and a similar percentage of Medicare Advantage enrollees switched to traditional Medicare, suggesting that initial coverage decisions made by Medicare beneficiaries have long-lasting effects;
- People dually eligible for Medicare and Medicaid (“dual eligibles”) and Medicare beneficiaries under age 65 and disabled disenrolled from Medicare Advantage at higher than average rates.
Understanding Medicare Advantage enrollment preferences and trends is of growing importance to Congress as well as private insurers and plan sponsors as the Obama Administration – long hostile to Medicare Advantage plans – is expected to continue to try to curb the growth of Medicare Advantage enrollment, cut Medicare Advantage expenditures and tighten regulations and enforcement against these private sector alternatives to traditional Medicare implemented as part of Republican-lead health care reforms during the Bush Administration.
For Advice, Training & Other Resources
If you need assistance resolving past Form 5500 or other filing exposures, or monitoring and responding to these and other regulatory policy, enforcement, litigation or other developments, or to review or respond to these or other workforce, benefits and compensation, performance and risk management, compliance, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.
Board Certified in Labor & Employment Law, Past Chair of the ABA RPTE Employee Benefit & Other Compensation Arrangements Group, Co-Chair and Past Chair of the ABA RPTE Welfare Plan Committee, Vice Chair of the ABA TIPS Employee Benefit Plans Committee, an ABA Joint Committee On Employee Benefits Council representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section, a Fellow in the American College of Employee Benefit Counsel, ABA, and State Bar of Texas, Ms. Stamer has more than 25 years’ experience advising health plan and employee benefit, insurance, financial services, employer and health industry clients about these and other matters. Ms. Stamer has extensive experience advising and assisting health plans and insurers about ACA, and a wide range of other plan design, administration, data security and privacy and other compliance risk management policies. Ms. Stamer also regularly represents clients and works with Congress and state legislatures, EBSA, IRS, EEOC, OCR and other HHS agencies, state insurance and other regulators, and others. She also publishes and speaks extensively on health and other employee benefit plan and insurance, staffing and human resources, compensation and benefits, technology, public policy, privacy, regulatory and public policy and other operations and risk management concerns. Her publications and insights appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.
You can review other recent human resources, employee benefits and internal controls publications and resources and additional information about the employment, employee benefits and other experience of the Cynthia Marcotte Stamer, PC here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile www.cynthiastamer.com or by registering to participate in the distribution of these and other updates on our HR & Employee Benefits Update distributions here including:
- Advance Copies Of 2014 Form 5500s Reminder To Avoid Penalties By Confirming Compliance
- Out-Of-Date, Unpatched Software Triggers HIPAA Security Sanction
- 2015 Tax Standard Mileage Rates Announced
- 12/5 Deadline For Insurers, Certain Self-Insured Health Plans To Submit 2014 Transitional Reinsurance Program Contribution Data
- OIG Report Pressures EBSA To Finalize ERISA Fiduciary Investment Advice Rule & Repeal or Restrict Small Scope Audit Rule
- TEGE Counsel To Assume Responsibility For Employee Plans, Exempt Orgs & IRA Technical Guidance in 2015
- Private Exchanges: Employer Health Program Panacea or Problem? Consider Carefully!
- Tell Senate To Pass Fix To ACA’s Full-Time Employee Definition
- Check Out Updated Kaiser Calculator For 2015 Zip Code-Specific Premium and Tax Credit Estimates for Health Marketplace Coverage Coverage
- Ebola Scare & New OCR Privacy Guidance Reminder To Prepare For Pandemic & Other Emergencies
- Stamer Kicks Off Dallas HR 2015 Monthly Lunch Series With 2015 Federal Legislative, Regulatory & Enforcement Update
- New DOL, IRS & HHS FAQ Confirms Employers Can’t Pay, Use HRAs to Reimburse Employees For Individual Policy Premiums
- Review Health Plans With Reference-Based Reimbursement Designs Under New Agency FAQ Guidance
- IRS Raises Health FSA Contribution Limit For 2015
- IRS Guidance Raises Concerns For Many Employers Offering “Skinny” & Other Limited Coverage Health Plans
- Supreme Court Delays Deciding Availabilities of ACA Subsidies For Coverage Purchased On Federal Exchange
- HHS Delays Enforcement Of HIPAA HPID Requirements
- Plan’s Purchase of Company Stock Triggers $6.48 Million Award Against ESOP Sponsor, Shareholder, Board Members & Trustees
- Government Contractors Get More Time To Comment On Burdens Of OFCCP Proposed Compensation Transparency Disclosure Regs
- IRS Announces Employee Plan Cost-Of-Living Adjustments
- Encourage Workers To Review Withholding As Part Of Annual Enrollment
- OFCCP FAQs On Veteran Hiring & Telework Rules
- Encourage Workers To Review Withholding As Part Of Annual Enrollment
- HHS Claims Average $69/Month Cost for Subsidized Coverage Shows ACA Success Challenged
- HIPAA Compliance & Breach Data Shares Helpful Lessons For Health Plans, Providers and Business Associates
- Making Wellness Work On A Shoestring Budget
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©2014 Cynthia Marcotte Stamer. Limited, non-exclusive right to republished granted to Solutions Law Press, Inc. All other rights reserved.