The Impact of the Affordable Care Act on Medicare Advantage Plan Availability and Enrollment
Article first published online: 11 MAY 2012
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 6, pages 2339–2352, December 2012
How to Cite
Afendulis, C. C., Landrum, M. B. and Chernew, M. E. (2012), The Impact of the Affordable Care Act on Medicare Advantage Plan Availability and Enrollment. Health Services Research, 47: 2339–2352. doi: 10.1111/j.1475-6773.2012.01426.x
- Issue published online: 12 NOV 2012
- Article first published online: 11 MAY 2012
- National Institute on Aging. Grant Number: P01 AG032952
- managed care;
- payment policy
To assess the impact of the Patient Protection and Affordable Care Act's (ACA) changes in Medicare Advantage (MA) payment rates on the availability of and enrollment in MA plans.
Secondary data on MA plan offerings, contract offerings, and enrollment by state and county, in 2010–2011.
We estimated regression models of the change in the number of plans, the number of contracts, and enrollment as a function of quartiles of FFS spending and pre-ACA MA payment generosity. Counties in the lowest quartile of spending are treated most generously by the ACA.
Relative to counties in the highest quartile of spending, the number of plans in counties in the first, second, and third quartiles rose by 12 percent, 7.6 percent, and 5.4 percent, respectively. Counties with more generous MA payment rates before the ACA lost significantly more plans. We did not find a similar impact on the change in contracts or enrollment.
The ACA-induced MA payment changes reduced the number of plan choices available for Medicare beneficiaries, but they have yet affected enrollment patterns.