The next five years will be critical for Medicare, a program that provides health coverage for more than 60 million Americans, or about one in six people in the United States, including older adults and people with disabilities. The program is a major source of support for medical education and rural providers and a testing ground for innovative payment models. Medicare payment policy often sets a benchmark for the commercial market and the program is often held up as a potential model for universal coverage.
As Medicare adapts to meet the needs of an aging population, a pandemic, and an economic recession, the Commonwealth Fund has launched the Medicare Data Hub to help policymakers, researchers, consumers, and anyone interested find current information and research on the program. The Data Hub is intended to inform and spark discussion about issues that affect health care for Medicare beneficiaries and all Americans.
Medicare beneficiaries are facing numerous challenges, many of which have been amplified by the COVID-19 pandemic. Nearly 11 percent of older workers age 65 and older have experienced COVID-19-related job losses. COVID-19 has disproportionately affected nursing homes and older people receiving home and community based long-term care, laying bare the variable quality of care, unsuccessful payment models, and lack of provider accountability in our long-term-care system. Beneficiaries’ mental health has suffered as a result of social distancing measures implemented to slow the spread of the virus; this has highlighted the gaps in Medicare’s mental health coverage. And while the federal government has modified more than 210 policies to address existing regulations to respond to the pandemic, including expanding the use of telemedicine, the impending insolvency of the Hospital Insurance Trust Fund will require creative solutions to shore up the program’s financial future.
The Data Hub’s analyses on private plans’ costs and benefits provide a window into how beneficiaries are faring during the pandemic, with a wider variety of data to be included in the future. Average Medicare Advantage premiums have decreased by 40 percent since 2010, but some beneficiaries could face higher out-of-pocket costs. In April, the Centers for Medicare and Medicaid Services raised the out-of-pocket limit for Medicare Advantage plans (for the 2020–21 plan year) for the first time since it was mandated — from $6,700 to $7,550 — providing less protection to beneficiaries during a time where many are facing financial challenges and disproportionately suffering from COVID-19 hospitalizations and medical bills.
While the inaugural installment of the Medicare Data Hub focuses on private plans, future updates will feature data and analyses on broader Medicare trends and performance, including benefits, financing, and international comparisons, to provide more information about how the Medicare program and the people it covers are faring. As the COVID-19 pandemic continues to unfold and exacerbate Medicare’s fiscal challenges, timely information will be crucial to identify issues and generate policy solutions for ensuring high-quality, affordable care for all beneficiaries. We hope this new contribution will help to meet that need.
