Better Diabetes Care for Medicare Advantage Beneficiaries Compared to Fee-for-Service Medicare
A recent study by Avalere Health has shown that Medicare Advantage is more effective in managing diabetes compared to traditional Medicare. The study compared diabetes management between enrollees in Medicare Advantage and those in fee-for-service Medicare. The results showed that Medicare Advantage enrollees had higher rates of positive diabetes management than those in traditional Medicare. The study was conducted using Medicare Part A and Part B fee-for-service claims and enrollment data, as well as Medicare Advantage data from the MORE Registry and data from two major payers in the Medicare Advantage sector.
The study analyzed over 198,500 Medicare Advantage members and an equal number of fee-for-service Medicare beneficiaries in the pre-diabetes cohort, with 162,500 Medicare Advantage enrollees and the same number of fee-for-service beneficiaries in the incident type 2 diabetes cohort, and over 1.1 million Medicare Advantage enrollees and an equal number of fee-for-service beneficiaries in the chronic type 2 diabetes cohort.
Over a 42-month period for participants with diabetes and 30-month period for participants with pre-diabetes, 20 outcome measures were evaluated, including disease detection and severity, primary care visits, prescriptions and tests, healthcare spending, and acute care utilization. The results showed that pre-index, Medicare Advantage beneficiaries with pre-diabetes had 10% lower average healthcare spending compared to fee-for-service Medicare patients. In the first one to two years post-index, Medicare Advantage patients’ healthcare spending was 13% lower, while Medicare Advantage beneficiaries in the incident diabetes cohort and chronic diabetes cohort had lower healthcare spending of 20% and 13%, respectively.
The study also found that Medicare Advantage patients were diagnosed with type 2 diabetes more quickly and had more primary care visits, as well as more frequent testing and prescription use. These results demonstrate that Medicare Advantage is an effective tool in managing diabetes for beneficiaries and can lead to better health outcomes and lower healthcare spending.