Research indicates Medicare Advantage plans may not be equipped to take care of sicker patients, according to Austin Frakt, PhD, health economist and founder of the blog "The Incidental Economist."
Writing for The New York Times, Dr. Frakt pointed to a number of studies, both new and old, that together suggest the "managed care" aspect of MA — that the plans often require pre-approval or a physician's referral to access certain services — and the narrower networks associated with the plans can actually worsen outcomes for sicker patients, even though they generally make the plans more efficient and higher quality.
Many of the studies cited by Dr. Frakt indicate MA plans make care more difficult to access, and for many sick patients, these restrictions can be significant. For example, one study he refers to shows that MA beneficiaries with depression had more difficulty accessing services and drugs they needed than those in traditional Medicare. Another study shows lower-income seniors were three to six times more likely to switch to traditional Medicare from MA, rather than the other way around, according to the report.
Dr. Frakt concludes that even though MA plans reduce fraud and wasteful spending, traditional Medicare is the best option for sicker patients. Read the full article here.
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