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Medicare and Medicare Advantage Enrollment.ppt

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Medicare and Medicare Advantage Enrollment.ppt Powered By Docstoc
					Compendium of Key Issues in National Health Care Policy




Medicare and Medicare Advantage
          Enrollment




                                                          1
                                Medicare Enrollment, 1966-2010
                                                        Nonelderly Disabled (Under Age 65)
                                                        Elderly (Age 65 and Older)
                                                                                                                       47.0
                                                                                                        44.0 45.4 46.1
Number in millions:                                                                           42.5 43.3                 8.0
                                                                                    39.6                     7.5 7.67.3
                                                                          37.6                  6.7       7.0
                                                                34.2 4.4             5.4
                                                      31.1 3.3
                                            28.5 2.9
                                25.0         3.0
                       20.5 2.2
            19.1                                                                                                             37.9      38.5      39.0
                                                                                               35.8      36.3      37.0
                                                                           33.2      34.3
                                                                 31.0
                                                      28.2
                                            25.5
                                  22.8
              19.1      20.5




             1966       1970      1975      1980      1985      1990      1995      2000      2005      2006       2007      2008      2009      2010

NOTES: Numbers may not sum to total due to rounding. People with disabilities under age 65 were not eligible for Medicare prior to 1972.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Enrollment: Hospital Insurance and/or Supplemental Medical Insurance Programs for Total,     2
Fee-for-Service and Managed Care Enrollees as of July 1, 2008: Selected Calendar Years 1966-2008; 2009-2010, HHS Budget in Brief, FY2011.
                         Medicare Enrollment Projections, 2010-2050
                                                                     (Millions)

     100
                                                                                                                            90,300,000
      90                                                                                           86,100,000
                                                                        78,600,000,
      80

      70
                                             62, 000,000
      60

      50           46,700,000

      40

      30

      20

      10

        0
                      2010                       2020                       2030                       2040                   2050




Source: Trapp, Doug, “Latest Medicare Projections Renew Alarm on Long-term Sustainability.” Amednews.com, April 14, 2008.
http://www.ama-assn.org/amednews/2008/04/14/gvl10414.htm#s1
                                                                                                                                         3
                                        Medicare Population by Age, 2009
 50,000,000

 45,000,000                                                                                                   43,436,200

 40,000,000

 35,000,000

 30,000,000

 25,000,000

 20,000,000                                19,052,200

 15,000,000                                                       12,600,900

 10,000,000
                   6,764,000
                                                                                         4,448,400
  5,000,000

           0




                                                                                                                     Total
                         Adults 19-64




                                                                                                Elderly 85+
                                                                         Elderly 75-84
                                                  Elderly 65-74




Source: Kaiser Family Foundation, State Health Facts.
http://www.statehealthfacts.org/comparebar.jsp?typ=2&ind=294&cat=6&sub=75&cha=434&o=a
                                                                                                                             4
 Medicare Beneficiaries as a Percent of State Population, 2010

                                                              National Average, 2010 = 15%

                                                                                                                         18%
                      14%                                                                                                          20%
                                             17%               17%                                                                           16%
                                                                             15%
                     16%                                                                                                                     16%
                                                                                                                         15%
                                                                                       16%                                                  17%
                                 14%                           17%                                 16%
                                               14%                                                                                    16%
                                                                                                                    18%              15%
                                                                               17%
                                                                 15%                                     16%                          16%
                        13%                                                              14%     15%                                14%
                                     10%           12%                                                         21% 14%
                                                                    15%            17%                                                 DC 13%
                13%                                                                                  17%
                                                                                                                     16%
                                                                                                  16%
                                   14%           15%                   16%         18%                             17%
                                                                                                             12%                9%-14% (14 states and DC)
                                                                                           17%     18%
                                                                                                                                15% (8 states)
                                                                   12%             15%
                                                                                                                                16% (12 states)
                9%                                                                                                              17%-21% (16 states)
                                                                                                                    18%


                                                     16%



NOTES: Percent enrollment calculated using U.S. Census Bureau July 2009 population estimates.
SOURCE: Centers for Medicare & Medicaid Services (CMS) Management Information Integrated Repository (MIIR), February 16, 2010. Medicare beneficiaries as a   5
share of state population estimates are based on July 1, 2009 state-level population estimates from the U.S. Census Bureau.
                          Characteristics of the Medicare Population
                                               Percent of total Medicare population:

                   Income <200% FPL
                    ($21,660 in 2010)                                                                                                                47%

              3+ Chronic Conditions                                                                                                             45%
   Cognitive/Mental Impairment
                                                                                                               29%

                      Fair/Poor Health                                                                       28%

                   Under-65 Disabled                                                  17%

                   2+ ADL Limitations                                             15%

                                  Age 85+                                  12%

Long-term Care Facility Resident                           4%


NOTE: ADL is activity of daily living.
SOURCE: Income data for 2009 from U.S. Census Bureau, Current Population Survey, 2009 Annual Social and Economic Supplement. All other data from Kaiser   6
Family Foundation analysis of the Centers for Medicare & Medicaid Services Medicare Current Beneficiary 2008 Access to Care file.
    Medicare Advantage enrollment continued to grow in 2010
Almost 11 .4 million beneficiaries (24%) were enrolled in a Medicare Advantage (MA) plan in
November 2010, a one-year increase of 5%. Enrollment grew about 7% in rural and 4% in urban
areas. Enrollment in Private Fee-for-Service (PFFS) plans shrunk by 33%.
                                November MA Enrollment (millions)
                                         2009                            2010                          Change     MA Enrollment/
                                                                                                                  Total Medicare


Total                                     10.9                           11.4                              5%          24%
        Rural                              1.3                            1.4                              7%          15%
        Urban                              9.6                           10.0                              4%          26%
Plan type
        HMO                                7.0                            7.4                              6%          16%
        Local PPO                          0.1                            1.4                              40%         3%
        Regional                           0.4                            0.9                              104%        2%
        PPO
        PFFS                               2.4                            1.6                              -33%        3%
Note: PFFS – Private Fee-for-Service                                                                                          7
                                Source: MedPAC, Presentation to MedPAC Commissioners, December 11, 2009,
  Percentage of Medicare beneficiaries with an MA plan available,
                           2005-2011
 In 2010, all Medicare beneficiaries had access to MA plans and most had a choice among all of
 the types of MA plans.

Type of Plan                2005            2006            2007         2008     2009   2010   2011

Local CCP                    67%             80%            82%          85%      88%    91%    92%

Regional PPO                 N/A              87             87          87        91    86%    86

PFFS                          45              80             100         100       100   100%   63
Any MA                        84             100             100         100       100   100%   100
Zero-premium                 N/A              73             86          88        94     85    90
plan with drugs
Average                        5              12             20          35        34     21    12
number of
choices


CCP: coordinated care plans; PFFS (private fee-for-service)
Zero premium plan is a plan with no enrollee premium beyond Medicare Part D premium.

Source: MedPAC, Presentation to MedPAC Commissioners, November 4, 2010                                 8
                      Medicare Advantage enrollment by state, 2010
                               For state-by-state analysis please click the link above




Source: Kaiser Family Foundation, Kaiser State Health Facts

                                                                                         9

				
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