Quality of provider-offered Medicare Advantage plans

Lyon, Zoe; Feyman, Yevgeniy; Johnson, Garret; Frakt, Austin B.

doi:10.1136/bmjqs-2017-006882

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…Higher premiums among integrated MA plans may be partly explained by higher quality. Indeed, integrated MA plans had higher quality ratings than non‐integrated MA plans and this was consistently found in prior research 15,16,19 . However, we also found that integrated MA plans still had higher premiums even after accounting for quality ratings.…”

Section: Discussionsupporting

confidence: 88%

“…Indeed, integrated MA plans had higher quality ratings than non-integrated MA plans and this was consistently found in prior research. 15,16,19 However, we also found that integrated MA plans still had higher premiums even after accounting for quality ratings. This also aligns with prior research showing that about 70% of premium differences are not explained by differences in quality ratings.…”

Section: Discussionmentioning

confidence: 57%

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Differences between integrated and non‐integrated plans in Medicare Advantage

Park

Langellier

Meyers

2022

Health Services Research

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Objective: To understand differences in financial performance, quality performance, supplemental benefits provision, and enrollee composition between integrated and non-integrated plans in the Medicare Advantage (MA) program.Data Sources: We used data from the Center for Medicare and Medicaid Services for 2015-2017. We included 156 integrated MA plans (31 unique contracts) and 2096 non-integrated MA plans (392 unique contracts).Study Design: We estimated linear probably models for financial performance, quality performance, supplemental benefits provision, and enrollee composition with state fixed effects and contract random effects. We adjusted for county-level market structure-related factors, cost-related factors, and demand-related factors. Our primary independent variable was an indicator of plan-provider integration.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 57%

Differences between integrated and non‐integrated plans in Medicare Advantage

Park

Langellier

Meyers

2022

Health Services Research

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“…Prior work has found that these vertically aligned plans differ in terms of their overall quality and the outcomes that they deliver for enrollees. 6,7 The MA plan that the authors evaluate is one such aligned plan, which may further explain the differences in spending. Under vertical alignment, health systems receive a fully capitated payment to care for their MA enrollees, which may provide an even stronger…”

mentioning

confidence: 99%

“…There is a growing trend toward vertical integration between plans and health care systems in the MA program with health systems either creating their own plans or partnering with insurers to offer exclusive insurance products. Prior work has found that these vertically aligned plans differ in terms of their overall quality and the outcomes that they deliver for enrollees . The MA plan that the authors evaluate is one such aligned plan, which may further explain the differences in spending.…”

mentioning

confidence: 99%

Comparing Spending in Medicare Advantage and Accountable Care Organizations—Is Plan–Health Care System Integration the Future?

Meyers

2022

JAMA Netw Open

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The Medicare Advantage (MA) program is growing rapidly, now enrolling more than 44% of all Medicare beneficiaries, with that number expected to surpass 50% in the next several years. This growth has occurred during the same period as expansions of value-based alternative payment models in traditional Medicare (TM), such as Accountable Care Organizations (ACOs), most commonly under the Medicare Shared Savings Program (MSSP). With the growth of these different models of payment and care delivery, its it imperative to better understand how these programs compare with one another. The study by Parikh and colleagues 1 begins to address these questions.

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