OCTOBER 20, 2020
Updated data corrects past reporting discrepancy
Washington,
D.C. – Better Medicare Alliance (BMA), the leading research and advocacy
organization supporting Medicare Advantage, responded to new data from the Centers for Medicare & Medicaid
Services (CMS) showing that Medicare Advantage penetration has exceeded a
milestone of 40% of the total Medicare-eligible population nationwide.
The
findings were released in CMS’s October 2020 “MA State/County Penetration”
monthly report. The report shows 25,389,561 Medicare Advantage beneficiaries
nationwide for the month of October out of a Medicare-eligible population of
62,462,094 individuals. This results in a Medicare Advantage penetration rate
reached an all-time high of 40.6%.
Earlier
releases of the Medicare Advantage penetration data, including in the month
prior, indicate a Medicare Advantage penetration rate of 36.2%. The change in
the numbers was the result of Better Medicare Alliance having identified
discrepancies in the data and requesting a CMS review to address these possible
inaccuracies in the numbers and resulting percentage of penetration. CMS was
responsive and made corrections to the data file, leading to a significant
increase in the penetration rate for Medicare Advantage due to an overcounting
of Medicare beneficiaries since 2017.
“With Medicare Advantage set to enroll nearly 27 million Americans
this fall, we’ve long known that seniors are increasingly making an active
choice for the lower costs, better care coordination, and improved health
outcomes uniquely found in Medicare Advantage. These updated CMS figures –
reflecting a key correction first requested by Better Medicare Alliance – paint
a clear picture of the progress made in Medicare Advantage meeting the
preferences and needs of Medicare beneficiaries. We now know that Medicare
Advantage has officially exceeded 40% of the total Medicare population, and
likely met this milestone benchmark some time ago,” said Allyson Y. Schwartz, President and CEO of the Better Medicare
Alliance. “We thank CMS for their swift
review and correction to the data following BMA’s initial outreach and want to
acknowledge the significance of these new numbers, as they indicate the growth
in enrollment and the meaningful role of Medicare Advantage for the millions of
beneficiaries it serves. With more than 40% penetration nationwide, Medicare
Advantage continues to earn the trust of older Americans and cement its place
in the Medicare success story.”
Background:
Each
month, CMS publishes data files detailing enrollment numbers and service areas
for Medicare Advantage and Prescription Drug Plans. One of the files published,
“MA State/County Penetration” provides data on the share of Medicare
beneficiaries that are enrolled in Medicare Advantage at the state and county
level.
This
year, as Better Medicare Alliance was updating BMA’s Medicare Advantage Enrollment Map for
2020, discrepancies were identified with the Medicare Advantage penetration
rates compared to similar figures published by the CMS Office of the Actuary
and the CMS Enrollment Dashboard. Specifically, the number of total Medicare
beneficiaries was much higher in the “MA State/County Penetration” file than in
the other sources, while the total MA enrollment was similar. The result of
these differences was a lower estimated rate of Medicare Advantage penetration
using the CMS “MA State/County Penetration” file compared to other sources.
For
example, earlier this year, the “MA State/County Penetration” file indicated
there were 67.8 million beneficiaries eligible for Medicare, while the other
sources indicated 61.2 million beneficiaries. This discrepancy results in a
difference in penetration rates of 36.6 percent when using the “MA State/County
Penetration” file and 40.0 percent when using other sources. Upon further
evaluation, we discovered that this discrepancy first started in 2017.
In
June, BMA engaged CMS staff to share our findings and ask the Agency to
investigate the discrepancy. Following our discussion, CMS reviewed their
enrollment data, acknowledged an error, and indicated that the Agency would
update the “MA State/County Penetration” file to ensure the data was accurate.
On
October 19, 2020, CMS published the October “MA State/County Penetration” file
with a note of explanation that an issue was identified in previous files in
which the number of beneficiaries with multiple addresses was being counted
twice. CMS has also committed to correcting the files going back to 2017.
View the CMS October 2020 MA State/County Penetration
file HERE.
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