Differences Between Medicare Advantage and Fee-for-Service Enrollment

This white paper presents a detailed analysis of the differences between Medicare Advantage (MA) enrollees and those in traditional Medicare Fee-for-Service (FFS) at the critical point of initial enrollment at age 65. The study, conducted by researchers from Harvard and Inovalon, aims to identify demographic, socioeconomic, and health characteristics that distinguish these two groups. It highlights that nearly half of Medicare beneficiaries are now enrolled in MA, yet little is known about the distinct profiles of these enrollees compared to FFS participants. The research utilizes a unique dataset that tracks individuals transitioning from commercial insurance to Medicare, providing insights into the social determinants of health that affect enrollment decisions. The findings indicate that MA enrollees are more socioeconomically disadvantaged and more likely to be non-white compared to FFS enrollees. This foundational research sets the stage for future studies on healthcare utilization and outcomes associated with different Medicare coverage types.