Medicare Advantage 2014 Spotlight: Enrollment Market Update
Introduction
G. Jacobson, T. Neuman, and J. Huang, “Projecting Medicare Advantage Enrollment: Expect the Unexpected?” Kaiser Family Foundation, June 2013. Also see Alliance for Health Reform briefing, “The Future of Medicare Advantage: Are We on the Right Path?” June 2013; available at https://www.kff.org/medicare/event/june-10-briefing-the-future-of-medicare-advantage-are-we-on-the-right-path/
In this document, the ACA refers to the Patient Protection and Affordable Care Act os 2010 (P.L. 111-148; PPACA) as amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152).
Overall Trends in Enrollment
Statistics include cost and demonstration plans even though they are organized under separate authority from Medicare Advantage. Enrollment includes those in Special Needs Plans, as well as regular Medicare Advantage plans and includes those enrolled individual plans and group plans. The analysis is based on publicly available CMS data from the contract/plan/state/county enrollment file. This file excludes enrollment in counties with fewer than 11 people in a plan in a county. County-plan records without a valid FIPS county identifier were also excluded from the analysis. These small exclusions add up to about 242,640 beneficiaries or 1.5 percent of total Medicare Advantage enrollment in March 2014.
M. Gold, G. Jacobson, A. Damico, and T. Neuman. “Medicare Advantage 2014 Data Spotlight: Plan Availability and Premiums,” Washington DC: Henry J. Kaiser Family Foundation, December 2013.
Trends in Enrollment by Plan Type
M. Gold “Medicare’s Private Plans: A Report Card on Medicare Advantage,” Health Affairs Web Exclusive, November 24, 2008.
For more information on PFFS plans, see M. Gold, G. Jacobson, A. Damico, and T. Neuman. “Medicare Advantage 2011 Data Spotlight: Plan Availability and Premiums,” Washington DC: Henry J. Kaiser Family Foundation, October 2010. J. Blum, R. Brown and M. Frieder “An Examination of Medicare Private Fee For Service Plans, Washington DC: Kaiser Family Foundation, March 2007.
M. Gold, “Medicare Advantage in 2008.” (Table 1: PFFS Contracts by Firm and Number of Counties Covered by the Contract, 2006-2008), Kaiser Family Foundation, June 2008.
Specialized Sectors of the Market
F. McArdle, T. Neuman and J. Huang. “Retiree Health Benefits at the Crossroads”. Washington DC: Henry J. Kaiser Family Foundation, April 2014.
Medicare Payment Advisory Commission “Chapter 13. The Medicare Advantage Program: Status Report” in Report to Congress: Medicare Payment Policy, Washington DC, March 2014. pp 323-349.
Kaiser Family Foundation and Health Research and Education Trust, “Section 11. Retiree Health Benefits.” Employer Health Benefits: 2013 Annual Survey. Washington, DC: Kaiser Family Foundation, 2013, pp. 191-199; and P. Fronstein and N. Adams. “Employment Based Retiree Health Benefits: Trends in Access and Coverage: 1997-2010.” EBRI Education and Research Institute, 2012.
Premiums
M. Gold, G. Jacobson, A. Damico, and T. Neuman. “Medicare Advantage 2014 Data Spotlight: Plan Availability and Premiums” Washington DC: Henry J. Kaiser Family Foundation, December 2013.
M. Gold and M. Hudson (2013, op site) and M. Gold, M. Hudson, G. Jacobson and T. Neuman “2010 Data Spotlight: Benefits and Cost Sharing” Washington DC: Henry J. Kaiser Family Foundation, February 2010.
Benefits
Kaiser Family Foundation. “The Medicare Part D Prescription Drug Benefit” Fact Sheet. Washington DC, November 2013.
Firms and Market Structure
M. Gold, “Medicare Advantage in 2008.” Kaiser Family Foundation, June 2008.