Enrollment in Medicare Advantage (MA) has exploded over the past 15 years, a new study shows. However, the researchers warn that payment policy hasn't kept up with the times.

From 2006 to 2022, MA enrollment increased by 337% as enrollment in traditional Medicare declined by 2.9%, according to a study in Health Affairs. Meanwhile, the number of Medicare beneficiaries grew from 41.8 million in 2006 to about 63 million in 2022, the researchers found.

In addition, the study found that while the presence of traditional Medicare across counties has declined, MA’s presence has grown. In 2006, 86% of counties showed less than 15% of MA penetration, and, by 2022, that shrank to 10.6%.

By 2022, 32% of counties had seen MA penetration between 45% to almost 60%, with 10.6% having MA penetration of 60% or more. In addition, MA enrollment for Black, Asian and Hispanic beneficiaries is higher than for white beneficiaries, the study found.

“The dramatic growth in MA penetration during the past two decades indicates that beneficiaries are reforming Medicare with their feet,” the study concluded. “Policy discussions about the future of the Medicare program would be well served by recognizing these trends and accounting for the dramatic shifts in the preferences exercised by Medicare beneficiaries in recent years.”

Researchers gathered data from the Medicare Master Beneficiary Summary Files, which can be accessed through the Centers for Medicare & Medicaid Services’ Virtual Research...

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