Traditional Medicare has been an important proving ground for U.S. healthcare for decades, and Medicare reimbursement has been used to support rural healthcare and medical education. In an opinion piece published by JAMA, Gretchen Jacobson and David Blumenthal of The Commonwealth Fund discuss some of the pitfalls of shrinking enrollment in traditional Medicare as the proportion of beneficiaries in Medicare Advantage plans grows.
About 46% of people eligible for Medicare are enrolled in Medicare Advantage (MA) plan and in the next few years the balance is likely to tip so that more than half of beneficiaries will be in MA plans.
MA has grown for several reasons, some of which can be traced back to the generous payments to the plans and the extras they can offer beneficiaries. The plans say they bring efficiency and coordination to beneficiaries’ health care.
Regardless of the reasons, the shift to MA plans has serious implications for Medicare and overall U.S. healthcare system, Gretchen Jacobson, Ph.D., and David Blumenthal, M.D., M.P.P., argue in an opinion piece published online by JAMA this week.
Here are four of the points they make:
Developments in healthcare often take policy makers by surprise, observe Jacobson and Blumenthal. But the migration of an increasing proportion of Medicare beneficiaries into MA plans is a long-term trend.
“While meeting the challenge created by the decline in enrollment in traditional Medicare will raise important issues about roles of regulation and competition in Medicare Advantage,” wrote Jacobson and Blumenthal, “it would be better to confront and resolve those issues now, before traditional Medicare can no longer function to effectively inform the management of the healthcare system.”