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Medicare Advantage 2016 Spotlight: Enrollment Market Update

Issue Brief
  1. The ACA reductions in payments to plans will be fully implemented in 2017.

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  2. G. Jacobson, P. Neuman, and A. Damico. “At Least Half of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006-11,” Health Affairs, vol. 34 no. 1, p. 48-55, January 2015. Also see G. Jacobson, T. Neuman, and A. Damico. “Medigap Enrollment Among New Medicare Beneficiaries: How Many 65-Year Olds Enroll In Plans With First-Dollar Coverage?” Washington DC: Kaiser Family Foundation, April 2015. Available at: http://kff.org/medicare/issue-brief/medigap-enrollment-among-new-medicare-beneficiaries/, Last accessed June 5, 2015.

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  3. F. McArdle, T. Neuman and J. Huang. “Retiree Health Benefits at the Crossroads”. Washington DC: Henry J. Kaiser Family Foundation, April 2014. Available at: http://kff.org/medicare/report/retiree-health-benefits-at-the-crossroads/.

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  4. Sutherly, B. “OPERS Retirees Face Big Changes.” The Columbus Dispatch. November 27, 2015. Available at: http://www.dispatch.com/content/stories/local/2015/11/27/opers-retirees-face-big-changes.html.

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  5. Medicare Payment Advisory Commission “Chapter 13. The Medicare Advantage Program: Status Report” in Report to Congress: Medicare Payment Policy, Washington DC, March 2015. pp 313-343.

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  6. Centers for Medicare and Medicaid Services, “Announcement of Calendar Year (CY) 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter,” April 4, 2016. Available at: https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf.

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  7. In the fall of 2015, we calculated that beneficiaries who were enrolled in Medicare Advantage plans at that time would pay a premium of $41 per month in 2016, compared to $38 per month in 2015, which assumed they remained in the same plan. Among Medicare Advantage enrollees in 2016, the average premium actually paid by enrollees ($37 per month) is slightly lower than the amount estimated in the fall, with the difference in estimates reflecting both changes in beneficiaries enrolled in Medicare Advantage plans from 2015 to 2016 and shifts by enrollees among plans and plan types.

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  8. G. Jacobson, M. Gold, A. Damico, T. Neuman, and G. Casillas. “Medicare Advantage 2016 Data Spotlight: Overview of Plan Changes,” Washington DC: Henry J. Kaiser Family Foundation, December 2015. Available at: http://kff.org/medicare/issue-brief/medicare-advantage-2016-data-spotlight-overview-of-plan-changes/.

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  9. In Minnesota, 69% of private plan enrollment is in cost plans, which have higher average premiums than Medicare Advantage plans.

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  10. Limits were required for regional PPOs since they were first authorized in 2006.

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  11. J. Hoadley, J. Cubanski, and T. Neuman, “Medicare Part D: A First Look At Plan Offerings in 2016” Kaiser Family Foundation, October 2015.

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  12. J. Hoadley, J. Cubanski, and T. Neuman, “Medicare Part D at Ten Years: The 2015 Marketplace and Key Trends, 2006-2015,” Kaiser Family Foundation, October 2015.

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  13. See https://www.anthem.com/health-insurance/about-us/anthem-overview.

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  14. CMS conducted a demonstration between 2012 and 2014 that provided bonus payments to the vast majority of plans. For more information, see G. Jacobson, T. Neuman, A. Damico and J. Huang, “Medicare Advantage Plan Star Ratings and Bonus Payments in 2012,” Kaiser Family Foundation, November 2011. Available at: http://kff.org/medicare/report/medicare-advantage-2012-star-ratings-and-bonuses/.

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  15. G. Jacobson, C. Swoope, M. Perry, and M.C. Slosar. “How are Seniors Choosing and Changing Health Insurance Plans?” Kaiser Family Foundation, May 2014. Available at: http://kff.org/medicare/report/how-are-seniors-choosing-and-changing-health-insurance-plans/.

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  16. T. Neuman, G. Casillas, and G. Jacobson. “Medicare Advantage and Traditional Medicare: Is the Balance Tipping?” Washington DC: Henry J. Kaiser Family Foundation, October 2015. Available at: http://kff.org/report-section/medicare-advantage-and-traditional-medicare-is-the-balance-tipping-issue-brief/.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.