The Role of Medicare Advantage - JAMA slideshow

1. Exhibit 0
Traditional
Fee-for-service
Medicare
70%
HMO 64%
Local PPO 23%
Regional PPO 8%
PFFS 2%
Other 3%
Medicare
Advantage
30%
NOTE: PFFS is Private Fee-for-Service plans, PPOs are preferred provider organizations, and HMOs are Health Maintenance Organizations. Other includes MSAs, cost plans, and demonstration plans. Includes enrollees in Special Needs Plans as well as other Medicare Advantage plans.
SOURCE: MPR / KFF analysis of the Centers for Medicare and Medicaid Services (CMS) Medicare Advantage enrollment files, 2014.
Three in 10 Medicare beneficiaries are enrolled in Medicare Advantage plans, most of whom are in HMOs
Total Medicare Advantage Enrollment, 2014 = 15.7 Million
Distribution of Enrollment in Medicare Advantage Plans, by Plan Type, 2014

2. Exhibit 1
NOTE: Includes cost plans, MSAs, demonstrations, and Special Needs Plans, as well as other Medicare Advantage Plans.
SOURCE: KFF analysis of the Centers for Medicare and Medicaid Services (CMS) Medicare Advantage enrollment files, 2005-2014, and Congressional Budget Office, “Medicare Baseline,” April 2014.
Medicare Advantage enrollment has increased rapidly and is projected to continue to rise
25
24
23
22
22
21
20
19
18
17
15.7
14.4
13.1
11.9
11.1
10.5
9.7
8.4
6.8
5.6
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
Actual Enrollment
Projected Enrollment
Medicare Advantage Enrollment (in millions), 2005-2024

3. Exhibit 2
NOTE: Includes cost plans, MSAs, demonstrations, and Special Needs Plans, as well as other Medicare Advantage Plans.
SOURCE: KFF analysis of the Centers for Medicare and Medicaid Services (CMS) Medicare Advantage enrollment files, 2014.
The share of Medicare beneficiaries in Medicare Advantage plans varies greatly across the country
U.S. Average Medicare Advantage Penetration= 30%
Louisville, 27%
Portland, 56%
Idaho Falls, 21%
Anchorage, 0%
Los Angeles, 43%
Topeka, 7%
Austin, 23%
Miami, 59%
Milwaukee, 34%
Baltimore, 10%
Portland, 24%
Tucson, 48%
Manhattan, 32%
Honolulu, 48%
0%-20%
21%-40%
>41%

4. Exhibit 3
112%
112%
113%
114%
109%
110%
107%
104%
106%
101%
2006
2007
2008
2009
2010
2011
2012
2013
2014
2017
SOURCE: Medicare Payment Advisory Commission (MedPAC) Report to Congress, 2006-2014.
Medicare has been paying more for beneficiaries in Medicare Advantage plans than for those in traditional Medicare
Traditional
Medicare
Spending
Actual
Projected
Average Medicare Advantage Payments as a Percentage of Traditional Medicare Spending

5. Exhibit 4
UnitedHealthCare 20%
Humana 17%
BCBS 17%
Kaiser
Permanente 8%
Aetna 7%
Cigna 3%
Other national insurers 5%
All other
insurers 23%
NOTE: Other includes firms with less than 3% of total enrollment. BCBS are BlueCross BlueShield affiliates and includes Wellpoint BCBS plans that comprise 4% of all enrollment (approximately 600,000 enrollees) in Medicare Advantage plans. Other national insurers includes approximately 428,000 enrollees across the following firms: Wellcare, HealthNet, Universal American, Munich American Holding Corporation, and Wellpoint non-BCBS plans . Accounts for merger between Coventry and Aetna in 2013; Medicare Advantage plans offered by Coventry covered 306,000 beneficiaries and Aetna plans covered 615,000 in 2013. Percentages may not sum to 100% due to rounding.
SOURCE: MPR/Kaiser Family Foundation analysis of CMS Enrollment files, 2014.
Medicare Advantage enrollment is concentrated within a small number of firms and affiliates, 2014
Total Medicare Advantage Enrollment, 2014 = 15.7 Million
Kaiser
Permanente 8%
Aetna 7%
Other National
Insurers 5%
Cigna 3%