Treatment Burdens in Traditional Medicare and Medicare Advantage

Objectives: To examine the treatment burdens from managing health care among Medicare beneficiaries in traditional Medicare (TM) and Medicare Advantage (MA).

Study Design: Cross-sectional analysis of the 2022 Health and Retirement Study Treatment Burden Questionnaire module.

Methods: We analyzed survey responses from 1024 Medicare beneficiaries 65 years and older, comprising 513 TM enrollees and 511 MA enrollees. We examined treatment burdens from doctor visits and appointments (frequency and time spent on these visits), administrative burden (paperwork and claims to obtain care or reimbursement), difficulty in relationships with providers (listening and responsiveness), and financial burden (out-of-pocket costs).

Results: Although most respondents reported no treatment burden, 8.6% of Medicare beneficiaries reported having high administrative burdens, and 6.9% reported high financial burdens. Treatment burden increased with the number of chronic diseases. Among those with 6 or more chronic diseases, 24.3% of MA enrollees and 15.0% of TM beneficiaries reported high administrative burdens, and similarly, 27.7% of MA enrollees and 15.0% of TM beneficiaries reported high financial burdens.

Conclusions: Although the overall treatment burden is low, for those with 6 or more chronic diseases, approximately 1 in 4 MA enrollees and 1 in 6 TM beneficiaries experienced high administrative and financial burdens. These findings suggest that managed care techniques, such as prior authorizations, may exacerbate burdens. Study findings also underscore the need for strengthened regulatory oversight to reduce administrative and cost complexities for vulnerable beneficiaries.