Medicare is one of America’s largest health programs. It provides health insurance for people 65 and older and people with disabilities. As of October 2023, over 66 million people in the United States were enrolled.

Just over half of all Medicare beneficiaries choose to get their coverage through Medicare Advantage, a popular alternative to traditional fee-for-service Medicare. With Medicare Advantage, beneficiaries choose a private health plan that provides their Medicare benefits.

Kaiser Permanente is one of Medicare Advantage’s largest participants. We provide coverage to more than 1.8 million Medicare members.

We participate in Medicare Advantage because it aligns with our integrated care and coverage model and our commitment to advancing health equity. Our model prioritizes high-quality, high-value care with a strong emphasis on effective care coordination, which is crucial for addressing health disparities.

Benefits of Medicare Advantage

A key to Medicare Advantage’s success is its value-based payment model.

Medicare Advantage pays health plans a monthly rate per enrollee instead of paying health care professionals or health care organizations based on the quantity and type of services delivered. This payment model incentivizes participating health plans to keep beneficiaries healthy.

The payment model also aligns with our focus on preventive care and total health. It complements our global budgeting approach, which uses prepayments to handle all health care costs. The result is more efficient and high-quality care.

In addition, Medicare Advantage plans are rewarded for performance under the Medicare star-ratings quality measurement program.

Medicare Advantage plans are popular among older adults because they often offer prescription drug coverage (Medicare Part D) and additional benefits, such as hearing, vision, and dental coverage. These options help keep people healthy.

Plans may also include health-related services. For example, people may be able to get meal deliveries after being discharged from the hospital.

We’re committed to strengthening the Medicare program and ensuring people who are enrolled receive high-quality care, maintain high levels of satisfaction, and have manageable costs.

Medicare policies we support

We believe Medicare policies should:

• Incentivize improvements in health care quality and Medicare beneficiary satisfaction
• Encourage care delivery innovations
• Ensure the effective use of federal funds and that beneficiaries' costs are manageable
• Support Medicare beneficiaries’ understanding of their care and coverage options and support their involvement in their care decisions
• Ensure a level playing field for a variety of care and coverage models participating in Medicare, including integrated care delivery and payment models like the kind Kaiser Permanente offers

To support these beliefs, we continue to advocate for policies that:

• Expand access to clinically appropriate, high-quality telehealth services for people enrolled in Medicare plans
• Promote strong quality measurement processes and quality performance incentives within Medicare
• Modernize Medicare Advantage network adequacy rules to ensure care is accessible and keeping pace with care delivery innovation

¹ United States Census Bureau, 2023
² Medicare Payment Advisory Committee, 2023
³ KFF, 2023