One of the most important takeaways from the COVID-19 pandemic is the importance of health equity—that is, the idea that everyone deserves an equal opportunity to achieve their optimal health through access to high-quality, comprehensive, and affordable health care. The pandemic laid bare the many challenges the Badger State has when it comes to ensuring all Wisconsinites are able to equitably access the care they need. And unfortunately, for many minority and historically marginalized communities in Wisconsin, there remain a number of barriers to care that lead to poorer health care outcomes.
Our job as policymakers should be to provide solutions that help low-income, minority, and otherwise disenfranchised patients and communities access the essential services and programs that expand access to care and deliver on the promise of health equity. That is why lawmakers in Washington, D.C., must continue to strengthen and improve the popular Medicare Advantage program.
Medicare Advantage has already been invaluable in the effort to expand health care access by serving an increasing number of lower-income and minority communities. Today, more than one-third of Medicare Advantage patients identify as a racial or ethnic minority, compared to just 16% of beneficiaries in fee-for-service (FFS) Medicare. In the last decade, enrollment in Medicare Advantage has grown by 111% among minority beneficiaries and 125% among dually eligible ones—those whose incomes qualify them for both Medicare and Medicaid.
Medicare Advantage is not only helping expand access to care to some of our most vulnerable community members, it is also delivering better health care outcomes for beneficiaries living with diabetes—which itself has an outsized impact on communities of color due to a range of socioeconomic factors, including food insecurity.
For our minority communities, a diabetes diagnosis can be a death sentence. According to a 2019 study by the Medical College of Wisconsin, while diabetes affects nearly 10% of Americans, African Americans suffer a much higher rate than white Americans, at a rate of nearly 60%. An analysis from the Wisconsin Department of Health Services of the Hispanic communities in Wisconsin found that there is a higher rate of death from diabetes compared to the total Wisconsin population. Much of this disparity has to do with the fact that African Americans and Hispanics are more likely to experience food insecurity or lack of access to affordable health care.
Now, a more recent study conducted by Avalere Health demonstrates the positive impact Medicare Advantage has on beneficiaries living with this disease. The study compared type 2 diabetes patients at three stages of the disease (prediabetes, incident diabetes, and chronic diabetes) in both FFS Medicare and Medicare Advantage. The findings of this study speak for themselves.
Among patients with prediabetes who later developed type 2 diabetes, those in Medicare Advantage both received their diagnosis earlier—relative to the date of their prediabetes diagnosis—and had a lower diabetes severity score at diagnosis than those in FFS Medicare. At the same time, Medicare Advantage patients in their first year of a type 2 diabetes diagnosis were also more likely than FFS Medicare patients to fill prescriptions for medications to treat the disease and related conditions.
Both early detection and patient adherence to prescribed medications are critical factors in treating diabetes, giving Medicare Advantage patients a leg up over their FFS Medicare counterparts. Additionally, the study also found that among chronic diabetes patients, those in Medicare Advantage were more likely to receive preventative care, including diabetes-related office visits and testing for kidney disease, and were less likely to require dialysis than those in FFS Medicare.
One of the most compelling findings of the study was the cost savings diabetic Medicare Advantage beneficiaries have over those enrolled in FFS Medicare. Across all diabetic beneficiary groups, total medical spending was lower for Medicare advantage patients. This aligns with other studies that found that Medicare Advantage beneficiaries save, on average, nearly $2,000 every year compared to FFS Medicare beneficiaries. These cost savings are critical for the members of our community on a fixed income – especially in the face of rising household costs.
Moving forward, policymakers in Washington—including our own Senator Tammy Baldwin—should continue working to protect and strengthen Medicare Advantage to ensure it can continue to grow along with enrollment in order to deliver better outcomes for patients with diabetes while also expanding access to care for traditionally underserved patients. Ultimately, that will help improve the health and quality of life in communities throughout Wisconsin and across the country.