Study: Medicare Advantage Outperforms FFS Medicare on Some Outcomes for Diabetes Patients

Avalere analysis finds earlier detection, greater utilization of preventive care, and fewer inpatient hospitalizations and emergency room visits among Medicare Advantage beneficiaries with diabetes compared to fee-for-service Medicare beneficiaries with diabetes.

WASHINGTON – With nearly one-third of people aged 65 and older with type 2 diabetes, a new study commissioned by Better Medicare Alliance suggests that Medicare Advantage may provide higher-quality and more cost-effective care to beneficiaries with diabetes compared to fee-for-service (FFS) Medicare.

The study conducted by Avalere Health finds that Medicare Advantage patients with diabetes have better outcomes on certain measures, including higher prescription fill rates, lower rates of inpatient hospitalizations, fewer emergency department visits, and lower total medical spending as compared to similar diabetes patients enrolled in FFS Medicare.

Further, the study found that patients with prediabetes who developed type 2 diabetes received their diagnosis earlier (relative to when they were diagnosed with prediabetes) in Medicare Advantage than FFS Medicare and had a lower diabetes severity score.

Recognizing the link between diabetes and kidney disease, the study also finds that Medicare Advantage beneficiaries with chronic diabetes more frequently received testing for kidney disease and required dialysis less frequently than those enrolled in FFS Medicare.

“With nearly one-third of seniors who have a type 2 diabetes diagnosis, this study shows how Medicare Advantage is already at work engaging the unique needs of this beneficiary population, focusing on earlier detection and greater use of preventive care, resulting in fewer hospitalizations and lower total medical spending, and creating better opportunities to age with vitality and independence for all seniors who live with this condition compared to FFS Medicare,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance. “Policymakers and advocates should look to this report as a reminder of the importance of protecting Medicare Advantage, which enables this care management that is demonstrably improving outcomes for Medicare beneficiaries with diabetes.”

“Medicare Advantage is increasingly popular among Medicare beneficiaries. Given the program’s rising enrollment and the high incidence of diabetes among Medicare beneficiaries, our study focused on how enrollees with diabetes in Medicare Advantage compare to similar enrollees in fee-for-service Medicare. The study finds that several measures indicative of positive management of diabetes were higher for those in Medicare Advantage than those in traditional Medicare. Studies like this one are important to understand beneficiaries’ experiences across the Medicare program,” said Tom Kornfield, Senior Consultant at Avalere Health.

Health policy leaders remarked on the report’s findings, including:

“The prevalence of diabetes across the Medicare population, but most especially in communities of color, cannot be ignored. This truth means that diabetes management is deeply intertwined with the work of advancing health equity,” said Daniel E. Dawes, JD, Senior Vice President and Executive Director at Meharry Medical College and Member of the Better Medicare Alliance Board of Directors. “This research from Better Medicare Alliance demonstrates clearly how Medicare Advantage delivers a better health care experience for all who manage this disease.”

“At the National Black Nurses Association (NBNA), our nurse professionals across the country have witnessed the devastating consequences of diabetes in our communities. However, with education, timely interventions, and planned care management, this condition can be well-managed to increase the quality of life for patients living with the disease,” said Martha A. Dawson, DNP, RN, FACHE, FAAN, President of the National Black Nurses Association. “As this study attests, Medicare Advantage is playing a pivotal role in reducing the severity of diabetes and alleviating its strain on the health care system. We look forward to working with Better Medicare Alliance in communicating these important findings to policymakers and encouraging them to apply the equity-enhancing lessons in Medicare Advantage to their work.”

“Georgia is among the states with the highest prevalence of diabetes in the nation. As is the case throughout the country, Georgians of color are most acutely impacted. Severe diabetes can impact patients’ eyesight, limbs, and ultimately their mortality. In this report, we see a path through Medicare Advantage to greater hope, brighter futures, and healthier lives for communities who have long battled this disease,” said Nacondus G. Gamble, OD, FAAO, Associate Doctor at The South Eastern Eye Center in Pembroke, Georgia.

“We started Podimetrics to bring freedom from the pain of diabetic foot ulcers that lead to lower extremity amputations. A diabetes diagnosis should never mean fear of losing a limb,” said Jon Bloom, MD, CEO and Co-Founder of Podimetrics. “Preventive care, powered by programs such as Medicare Advantage, is critically important for all patients living with costly, debilitating chronic diseases like diabetes. Medicare Advantage is a vital partner in our efforts at Podimetrics to improve outcomes for patients living with complex diabetes.”

Read the full report from Avalere Health HERE.

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