Growth in the number of Medicare Advantage beneficiaries will likely overtake that for traditional Medicare in 2025, according to new estimates from the U.S. Centers for Medicare & Medicaid Services (CMS).
The agency projects that total MA enrollment will reach 35.7 million people following the open enrollment period slated to begin later this month, representing 51% of all Medicare beneficiaries. This is up from 34.3 million as of September 2024.
“This implies expected low-to-mid single digit MA market growth relative to current enrollment. Importantly, the MA market should still likely grow as fast (or faster) than the overall Medicare market even as products and footprints are adjusted to reflect ongoing MA margin pressures,” Scott Fidel, analyst for Stephens, indicated in a research note.
Medicare Advantage currently does not reimburse for hospice care outside of the value-based insurance design model (VBID) demonstration. The hospice component of VBID is slated to end on Dec. 31. However, many providers rely on MA to support other business lines such as palliative care or Programs for All-Inclusive Care of the Elderly (PACE).
Medicare Advantage (MA) beneficiaries are also less likely to receive intensive treatments or burdensome transfers during the last six months of life compared to those in traditional Medicare, according to research published in JAMA Health Forum.
Researchers examined Medicare claims data for more than 1 million patients who died between 2016 and 2018. Results indicated that MA beneficiaries were 1.6% less likely than those in traditional Medicare to receive aggressive treatment during the last six months of life and were 3.3% less likely to die in a hospital. MA enrollees were also 5.2% less likely to go to a skilled nursing facility post-discharge.
MA enrollment also correlated to a small degree with higher rates of hospice utilization. However, overall hospice election during the last 30 days before death hovered around 16%.
“In 2025, average premiums and benefits for Medicare Advantage and the Medicare Part D prescription drug program are expected to remain stable, and Medicare enrollees will have access to a wide range of affordable Medicare coverage options,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “We encourage all people with Medicare to review their health care coverage during open enrollment.”
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