Medicare Advantage plan providers have long been accused of cherry picking healthier patients in an effort to reduce costs. A study published in the Journal of the American Geriatrics Society and led by Northern Arizona University researcher Amit Kumar echoes that idea among a particular group of patients: older Mexican Americans.
The number of Americans enrolled in a Medicare Advantage plan has nearly doubled over the last decade reaching 22 million enrollees in 2019, according to the Kaiser Family Foundation, a nonprofit health information organization.
Older Mexican Americans are a particularly vulnerable population when it comes to getting adequate health care. Kumar said older Hispanic and Mexican Americans tend to have a higher rate of chronic conditions than other populations in their age range in the United States.
Mexican Americans had the highest prevalence of diabetes among Hispanics according to the American Diabetes Association. According to a 2017 brief from the CDC’s National Center for Health Statistics, the prevalence of obesity among Hispanics was higher than any other group in the country, putting them at higher risk for many chronic illnesses such as cardiovascular disease.
Because of the increasing amount of Medicare recipients who are choosing to enroll in Medicare Advantage plans, and because Hispanics were the fastest growing subgroup, Kumar and his team studied how the changes were affecting older Mexican Americans.
States in the Southwest tend to have above average Medicare Advantage enrollment rates. In 2018, 42% of the total Medicare population in Maricopa County was enrolled in a Medicare Advantage plan, according to data analysis completed by the Kaiser Family Foundation. Medicare Advantage enrollment for the state of Arizona was four percent higher than the national average.
The study found that older Mexican Americans in traditional fee for service plans were more likely to be socioeconomically disadvantaged and less healthy than those in Medicare Advantage plans.
The researchers also found that Mexican Americans who were younger and more financially well off were the ones most likely to switch from a fee for service plan to a Medicare Advantage plan. The study also suggests the majority of Medicare enrollees opt not to examine their current plan when open enrollment begins in the winter months, as enrollees are likely overwhelmed and confused by the myriad of choices on the market.
While Kumar said the findings were in line with previous studies that looked at the health of Medicare Advantage populations, more research had to be performed in order to understand why Medicare Advantage plans tended to have healthier enrollees.