What the Elevance Study Found
A major new study from the Elevance Health Public Policy Institute suggests that Medicare Advantage enrollment growth has saved the broader Medicare program an estimated $111 billion over nearly a decade. Published on March 23 in INQUIRY: The Journal of Health Care Organization, Provision, and Financing, the research covers the period from 2012 to 2021.
The study compared actual Medicare spending during that period against a projected baseline — specifically, what spending would have looked like if Medicare Advantage penetration had stayed frozen at 2011 levels. The result: substantial, program-wide savings driven by the steady rise of MA enrollment.
This research adds significant weight to ongoing policy debates about Medicare Advantage’s role in the broader healthcare system. Rather than looking at MA in isolation, the Elevance team analyzed spending trends across fee-for-service Medicare, Medicare Advantage, and Medicare Part D together.
How MA Growth Reduces Medicare Spending
The Core Finding: 1.5% Savings Per 10-Point Penetration Increase
At the heart of the study is a single, powerful relationship. Researchers found that every 10-percentage-point increase in MA market penetration corresponds to a 1.5% reduction in total Medicare spending per capita. This association held consistently across the nearly 10-year study window.
Jennifer Kowalski, Vice President of the Elevance Health Public Policy Institute, explained the significance of this finding. “Our study identified a strong association between MA enrollment growth and Medicare spending,” she told Becker’s. “If this relationship is even in part causal, then MA growth looks to have moderated Medicare spending over the last 15 years.”
Spillover Effects Play a Major Role
One of the most striking aspects of the findings involves spillover effects. Traditional Medicare — or fee-for-service (FFS) Medicare — also appears to benefit when MA enrollment grows. Researchers attribute approximately 52% of the total savings to lower FFS spending. The likely mechanism is behavioral change among providers. As MA enrollment grows in a given market, providers increasingly adopt the care coordination practices and cost-efficiency standards required by MA plans — and they apply those same practices to their traditional Medicare patients.
This insight challenges the assumption that MA savings only benefit MA enrollees. Instead, higher MA penetration appears to reshape how providers deliver care across the board.
Breaking Down the $111 Billion in Savings
Where the Savings Come From
The Elevance researchers calculated the $111 billion figure by applying their core finding — the 1.5% spending reduction per 10-point penetration increase — to actual MA enrollment trends over the study period. The savings break down across three categories:
- Lower FFS spending due to spillover effects — approximately 52% of total savings
- Lower MA plan payments for enrolled members — roughly 38% of savings
- Part D payment reductions for all beneficiaries — about 6% of savings
Together, these three channels show that MA growth benefits extend far beyond the enrolled population. Furthermore, Part D savings apply to all Medicare beneficiaries, not just those in MA plans.
A Decade of Enrollment Expansion
Between 2012 and 2021, Medicare Advantage enrollment expanded dramatically. This growth directly drove the savings the study captures. More recently, MA enrollment has continued its upward trajectory. By 2026, more than half of all Medicare-eligible beneficiaries — over 34 million people — are enrolled in an MA plan, according to the Kaiser Family Foundation.
The Coding Intensity Debate
Not all researchers accept the $111 billion figure without qualification. One key source of dispute is coding intensity — the tendency of MA plans to document diagnoses more thoroughly than traditional Medicare, which can inflate risk scores and affect payment calculations.
The Medicare Payment Advisory Commission (MedPAC) has raised concerns about coding intensity for years. When the Elevance researchers applied MedPAC’s coding intensity adjustment to their model, the per-point savings dropped from 1.5% to 1.1% per 10-percentage-point increase in penetration. Under that adjusted assumption, the estimated savings fall from $111 billion to $83 billion over the same time period.
Even so, $83 billion remains a significant figure. Both estimates point in the same direction: MA growth is associated with meaningful Medicare-wide spending moderation.
Why MedPAC Sees It Differently
Different Methods, Different Conclusions
MedPAC has consistently presented a more skeptical view of Medicare Advantage’s fiscal impact. Kowalski acknowledged these differences in methodology. She noted that MedPAC sometimes relies on projections and forward-looking estimates, while the Elevance study used historical data from the study period itself.
Moreover, MedPAC’s March 2026 report confirmed that MA payments will be 14% higher than traditional Medicare this year, translating to an additional $76 billion in federal spending. Critics point to this overpayment as evidence that MA costs the government more, not less.
You Cannot Look at MA in a Vacuum
Kowalski pushed back against analyses that separate MA from the rest of Medicare. “Medicare Advantage has an influence on the whole Medicare program,” she said. “I don’t think you can look at one or the other in a vacuum. You really need to look at them together.”
This integrated view is central to the Elevance study’s design. By examining FFS Medicare, MA, and Part D simultaneously, researchers captured the full scope of how MA enrollment shapes Medicare spending across the system.
What This Means for Medicare’s Future
A Program at a Crossroads
Medicare Advantage faces growing scrutiny in 2026, even as enrollment continues to break records. Policymakers are weighing the program’s demonstrated cost-association benefits against concerns about overpayments, coding intensity, and the long-term fiscal sustainability of federal health spending.
The Elevance study does not claim that MA growth causes lower Medicare spending. Instead, it establishes a strong and consistent association — one that policymakers, insurers, and healthcare leaders should factor into any comprehensive review of Medicare’s financial trajectory.
Evidence That Supports Continued MA Expansion
For advocates of Medicare Advantage, the research provides meaningful evidence that MA’s growth has delivered value to the broader Medicare program. Consequently, calls to restrict or roll back MA enrollment may carry real fiscal risk — not just for enrolled beneficiaries, but for the entire Medicare system.
As the debate continues, studies like this one will be central to shaping the policy conversation. The question is no longer simply whether MA saves money for its enrollees. Additionally, the question is whether the program’s growth benefits everyone in Medicare — and the Elevance research suggests the answer may well be yes.
