Social Risk Factors Are High Among Low-Income Medicare Beneficiaries Enrolled in Medicare Advantage
Medicare Advantage beneficiaries are Likely to experience social risk factors that negatively impact health
Research has found that social determinants of health (SDOH) can impact as much as 50 percent of an individual’s health outcomes. Negative SDOH are especially hard-hitting for older adults, particularly factors like food insecurity, lack of social supports, and loneliness, and have been exacerbated due to the COVID-19 pandemic. These social risk factors are key drivers of health disparities.
ATI Advisory partnered with Better Medicare Alliance to study the prevalence of social risk factors that negatively impact health among beneficiaries in Traditional FFS and Medicare Advantage. The social risk factors we evaluated include education, language, housing, transportation, and food insecurity.
Previous analysis by ATI Advisory has demonstrated that low- and modest-income beneficiaries are often drawn to Medicare Advantage for its affordability and cost protections, compared to Traditional FFS. This brief builds on past analyses by demonstrating how Medicare Advantage beneficiaries, even when accounting for income, are more likely to experience certain social risk factors that have an adverse impact on health.
The COVID-19 pandemic has brought attention to the need for greater social supports for the Medicare population, especially low-income beneficiaries. New flexibilities in the Medicare Advantage program, in turn, have allowed health plans to meet some of these needs using the Medicare dollar (see our work on how MA plans have used these flexibilities to respond to COVID-19). Alongside the steady growth of Medicare Advantage enrollment, it is critical that Medicare Advantage plans continue to have the flexibility to better integrate medical care and support supports to manage care holistically.