Mark K Meiselbach, Andrew Anderson, Laura J Samuel, Kali S Thomas
{"title":"医疗保险优势B部分保费回馈和登记。","authors":"Mark K Meiselbach, Andrew Anderson, Laura J Samuel, Kali S Thomas","doi":"10.1001/jamahealthforum.2025.1215","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>In Medicare Advantage (MA), the private component of the Medicare program that enrolls more than half of beneficiaries, an increasing share of plans are offering Part B premium givebacks to pay for part or all of the at least $174.70 Part B monthly premium. Millions of dollars of Medicare expenditures are attributable to this benefit, yet little is known about its association with member enrollment or other plan characteristics.</p><p><strong>Objective: </strong>To document trends and expenditures in MA Part B premium givebacks and examine their association with plan enrollment.</p><p><strong>Design, setting, and participants: </strong>This longitudinal difference-in-differences analysis compared MA plan enrollment before and after the offer of a Part B giveback among plans that offered the giveback vs plans that did not. January MA plan enrollment and characteristics data from 2018 through 2024 were included. Data were analyzed from May 2024 to February 2025.</p><p><strong>Exposure: </strong>Adoption of a Part B giveback.</p><p><strong>Main outcomes and measures: </strong>Total plan enrollment.</p><p><strong>Results: </strong>A sample of 18 627 plan-years representing more than 130 million enrollee-years was included in the analysis. The percentage of MA plans offering a Part B premium giveback increased from 4.3% (93 of 2187) in 2018 to 18.7% (737 of 3940) in 2024. Plans offering Part B premium givebacks had lower median enrollment, belonged to newer, higher rated contracts, had higher cost-sharing, and had lower enrollee risk scores compared with plans that did not offer givebacks. In 2024, the 3.4 million enrollees in plans with Part B givebacks received a mean (SD) of $77 ($42), amounting to as much as approximately $261 million in total monthly expenditures across the MA program. Adoption of a Part B giveback was associated with a 33.3% (95% CI, 9.3-56.9) increase in enrollment, robust to all model specifications. There was a dose-response association between the size of the giveback and enrollment.</p><p><strong>Conclusions and relevance: </strong>In this study, the adoption of Part B premium givebacks among MA plans was associated with a substantial increase in plan enrollment. Further research will be needed to understand the total value to enrollees of Part B givebacks, which confers hundreds of millions of dollars monthly to Medicare beneficiaries.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 6","pages":"e251215"},"PeriodicalIF":9.5000,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144618/pdf/","citationCount":"0","resultStr":"{\"title\":\"Medicare Advantage Part B Premium Givebacks and Enrollment.\",\"authors\":\"Mark K Meiselbach, Andrew Anderson, Laura J Samuel, Kali S Thomas\",\"doi\":\"10.1001/jamahealthforum.2025.1215\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>In Medicare Advantage (MA), the private component of the Medicare program that enrolls more than half of beneficiaries, an increasing share of plans are offering Part B premium givebacks to pay for part or all of the at least $174.70 Part B monthly premium. Millions of dollars of Medicare expenditures are attributable to this benefit, yet little is known about its association with member enrollment or other plan characteristics.</p><p><strong>Objective: </strong>To document trends and expenditures in MA Part B premium givebacks and examine their association with plan enrollment.</p><p><strong>Design, setting, and participants: </strong>This longitudinal difference-in-differences analysis compared MA plan enrollment before and after the offer of a Part B giveback among plans that offered the giveback vs plans that did not. January MA plan enrollment and characteristics data from 2018 through 2024 were included. Data were analyzed from May 2024 to February 2025.</p><p><strong>Exposure: </strong>Adoption of a Part B giveback.</p><p><strong>Main outcomes and measures: </strong>Total plan enrollment.</p><p><strong>Results: </strong>A sample of 18 627 plan-years representing more than 130 million enrollee-years was included in the analysis. The percentage of MA plans offering a Part B premium giveback increased from 4.3% (93 of 2187) in 2018 to 18.7% (737 of 3940) in 2024. Plans offering Part B premium givebacks had lower median enrollment, belonged to newer, higher rated contracts, had higher cost-sharing, and had lower enrollee risk scores compared with plans that did not offer givebacks. In 2024, the 3.4 million enrollees in plans with Part B givebacks received a mean (SD) of $77 ($42), amounting to as much as approximately $261 million in total monthly expenditures across the MA program. Adoption of a Part B giveback was associated with a 33.3% (95% CI, 9.3-56.9) increase in enrollment, robust to all model specifications. There was a dose-response association between the size of the giveback and enrollment.</p><p><strong>Conclusions and relevance: </strong>In this study, the adoption of Part B premium givebacks among MA plans was associated with a substantial increase in plan enrollment. 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Medicare Advantage Part B Premium Givebacks and Enrollment.
Importance: In Medicare Advantage (MA), the private component of the Medicare program that enrolls more than half of beneficiaries, an increasing share of plans are offering Part B premium givebacks to pay for part or all of the at least $174.70 Part B monthly premium. Millions of dollars of Medicare expenditures are attributable to this benefit, yet little is known about its association with member enrollment or other plan characteristics.
Objective: To document trends and expenditures in MA Part B premium givebacks and examine their association with plan enrollment.
Design, setting, and participants: This longitudinal difference-in-differences analysis compared MA plan enrollment before and after the offer of a Part B giveback among plans that offered the giveback vs plans that did not. January MA plan enrollment and characteristics data from 2018 through 2024 were included. Data were analyzed from May 2024 to February 2025.
Exposure: Adoption of a Part B giveback.
Main outcomes and measures: Total plan enrollment.
Results: A sample of 18 627 plan-years representing more than 130 million enrollee-years was included in the analysis. The percentage of MA plans offering a Part B premium giveback increased from 4.3% (93 of 2187) in 2018 to 18.7% (737 of 3940) in 2024. Plans offering Part B premium givebacks had lower median enrollment, belonged to newer, higher rated contracts, had higher cost-sharing, and had lower enrollee risk scores compared with plans that did not offer givebacks. In 2024, the 3.4 million enrollees in plans with Part B givebacks received a mean (SD) of $77 ($42), amounting to as much as approximately $261 million in total monthly expenditures across the MA program. Adoption of a Part B giveback was associated with a 33.3% (95% CI, 9.3-56.9) increase in enrollment, robust to all model specifications. There was a dose-response association between the size of the giveback and enrollment.
Conclusions and relevance: In this study, the adoption of Part B premium givebacks among MA plans was associated with a substantial increase in plan enrollment. Further research will be needed to understand the total value to enrollees of Part B givebacks, which confers hundreds of millions of dollars monthly to Medicare beneficiaries.
期刊介绍：
JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health, and health care. The journal publishes original research, evidence-based reports, and opinion about national and global health policy. It covers innovative approaches to health care delivery and health care economics, access, quality, safety, equity, and reform.
In addition to publishing articles, JAMA Health Forum also features commentary from health policy leaders on the JAMA Forum. It covers news briefs on major reports released by government agencies, foundations, health policy think tanks, and other policy-focused organizations.
JAMA Health Forum is a member of the JAMA Network, which is a consortium of peer-reviewed, general medical and specialty publications. The journal presents curated health policy content from across the JAMA Network, including journals such as JAMA and JAMA Internal Medicine.
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