Is Less Choice Actually Better for Seniors in MA?

By James Gutman - August 19, 2011

When is having a lot of choices in health plans a bad thing? The answer, according to researchers in a Health Affairs website article released Aug. 18, is when it's seniors trying to choose among a plethora of Medicare Advantage plans. The authors contend, based on fairly old CMS data (running from 2004 to 2007), that too many choices confuse and overwhelm seniors, especially those with "cognitive deficits," and make beneficiaries less likely to enroll in MA plans. The findings could give added fuel to ongoing CMS efforts to make sure there are "meaningful differences" among MA product offerings of individual sponsors and to eliminate low-enrollment plans. But one of the major contributors to the rise in the mean number of MA options between 2004 and 2007 was the proliferation of private-fee-for-service plans, and they have been in retreat in the past two years because of the CMS-mandated end of PFFS network "deeming" in most counties at the close of 2010.

PFFS plans were cited in the study as a big factor in the growth of MA options, but there was no real discussion of what has happened to PFFS plans since 2007. The authors instead used the old data to find that having more options caused increased MA enrollment when beneficiaries were offered fewer than 15 plans, and that MA enrollment actually remained steady or declined "when beneficiaries had to choose from 15 to 30 or more than 30 plans." Moreover, the study conducted by Harvard Medical School professors found that "elderly respondents with low cognitive function were less responsive to the generosity of available benefits when choosing between traditional Medicare and Medicare Advantage."