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Medicare+Choice: current role and near-term prospects
Kenneth E Thorpe1, Adam Atherly
1Department of Health Policy and Management at Emory University, Atlanta, USA.
Health Affairs (Project Hope)
|April 22, 2003
Summary
Medicare+Choice (M+C) faces enrollment declines, impacting poor and minority beneficiaries. Proposed reforms could stabilize or reduce M+C enrollment, with significant consequences for beneficiaries if eliminated.
Area of Science:
- Health Policy
- Medicare Program Analysis
- Healthcare Economics
Background:
- The Balanced Budget Act of 1997 led to challenges for the Medicare+Choice (M+C) program, including plan withdrawals and decreased enrollment.
- Despite challenges, M+C covers over 12% of Medicare beneficiaries, a population with a higher proportion of low-income and minority individuals.
Purpose of the Study:
- To analyze the impact of current law and proposed reforms on Medicare+Choice (M+C) program enrollment.
- To project the consequences of M+C program elimination for its beneficiaries.
Main Methods:
- Analysis of Medicare+Choice (M+C) program enrollment trends under different legislative scenarios.
- Modeling the potential outcomes for M+C beneficiaries if the program were to be eliminated.
Main Results:
- Current law and Medicare Payment Advisory Commission (MedPAC) reform options project a decline of one million M+C enrollees in three years.
- The Bush administration's proposal is projected to stabilize M+C program enrollment.
- Eliminating M+C could result in one-third of current members transitioning to traditional Medicare without enhanced coverage, and 18% enrolling in Medicaid.
Conclusions:
- Medicare+Choice (M+C) program enrollment is sensitive to legislative changes and reform proposals.
- The elimination of M+C would disproportionately affect vulnerable populations, potentially increasing their reliance on traditional Medicare or Medicaid.