Hospitals spend less for patients in Medicare Advantage than for patients in fee-for-service Medicare

2009 ◽  
Keyword(s):  
Fee For Service ◽  
Medicare Advantage

scholarly journals The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits

2018 ◽  
Vol 10 (1) ◽  
pp. 153-186 ◽  
Author(s):  
Mark Duggan ◽  
Jonathan Gruber ◽  
Boris Vabson
Keyword(s):  
New York ◽  
Hospital Inpatient ◽  
Fee For Service ◽  
Medicare Advantage ◽  
Exogenous Shocks ◽  
Inpatient Utilization ◽  
Medicare Program ◽  
Considerable Controversy ◽  
Health Care Privatization ◽  
Managed Care Organizations

There is considerable controversy over the use of private insurers to deliver public health insurance benefits. We investigate the consequences of patients enrolling in Medicare Advantage (MA), privately managed care organizations that compete with the traditional fee-for-service Medicare program. We use exogenous shocks to MA enrollment arising from plan exits from New York counties in the early 2000s and utilize unique data that links hospital inpatient utilization to Medicare enrollment records. We find that individuals who were forced out of MA plans due to plan exit saw very large increases in hospital utilization. These increases appear to arise through plans both limiting access to nearby hospitals and reducing elective admissions, yet they are not associated with any measurable reduction in hospital quality or patient mortality. (JEL G22, I11, I12, I13, I18)

scholarly journals Fully-integrated medical home for people with severe and persistent mental illness: A description and outcome analysis of a Medicare Advantage Chronic Special Needs Program

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Robert Myers
Keyword(s):  
Mental Illness ◽  
Special Needs ◽  
Medical Home ◽  
Social Needs ◽  
Community Treatment ◽  
Outcome Analysis ◽  
Fee For Service ◽  
Medicare Advantage ◽  
Persistent Mental Illness ◽  
Management Approaches

People with severe persistent mental illness pose a significant challenge to managed care organizations and society in general. The financial costs are staggering as is the community impact including homelessness and incarceration. This population also has a high incident of chronic comorbid disorders that not only drives up healthcare costs but also significantly shortens longevity. Traditional case management approaches are not always able to provide the intense and direct interventions required to adequately address the psychiatric, medical and social needs of this unique population. This article describes a Medicare Advantage Chronic Special Needs Program that provides a Medical Home, Active Community Treatment, and Integrated Care. A comparison of utilization and patient outcome measures of this program with fee for service Medicare found significant reduction in utilization and costs, as well as increased adherence to the management of chronic medical conditions and preventative services.

A Longitudinal Analysis of Site of Death: The Effects of Continuous Enrollment in Medicare Advantage Versus Conventional Medicare

2016 ◽  
Vol 39 (8) ◽  
pp. 960-986 ◽  
Author(s):  
Elizabeth Edmiston Chen ◽  
Edward Alan Miller
Keyword(s):  
Logistic Regression ◽  
Longitudinal Analysis ◽  
Financial Incentives ◽  
Health And Retirement Study ◽  
Fee For Service ◽  
Medicare Advantage ◽  
Medicare Beneficiaries ◽  
Lower Odds ◽  
Retirement Study

This study assessed the odds of dying in hospital associated with enrollment in Medicare Advantage (M-A) versus conventional Medicare Fee-for-Service (M-FFS). Data were derived from the 2008 and 2010 waves of the Health and Retirement Study ( n = 1,030). The sample consisted of elderly Medicare beneficiaries who died in 2008–2010 (34% died in hospital, and 66% died at home, in long-term senior care, a hospice facility, or other setting). Logistic regression estimated the odds of dying in hospital for those continuously enrolled in M-A from 2008 until death compared to those continuously enrolled in M-FFS and those switching between the two plans. Results indicate that decedents continuously enrolled in M-A had 43% lower odds of dying in hospital compared to those continuously enrolled in M-FFS. Financial incentives in M-A contracts may reduce the odds of dying in hospital.

scholarly journals Likelihood of hospital readmission in Medicare Advantage and Fee‐For‐Service within same hospital

2020 ◽  
Vol 55 (4) ◽  
pp. 587-595
Author(s):  
Daniel H. Jung ◽  
Eva DuGoff ◽  
Maureen Smith ◽  
Mari Palta ◽  
Andrea Gilmore‐Bykovskyi ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Fee For Service ◽  
Medicare Advantage

Trends in Characteristics of Adults Enrolled in Traditional Fee-for-Service Medicare and Medicare Advantage, 2011–2019

Medical Care ◽  
2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
William B. Weeks ◽  
Stacey Y. Cao ◽  
Jeremy Smith ◽  
Huabo Wang ◽  
James N. Weinstein
Keyword(s):  
Fee For Service ◽  
Medicare Advantage

316-OR: Diabetes Care among Older Adults Enrolled in Medicare Advantage vs. Traditional Medicare Fee-for-Service Plans: The Diabetes Collaborative Registry

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 316-OR
Author(s):  
UTIBE ESSIEN ◽  
YUANYUAN TANG ◽  
TERRENCE LITAM ◽  
RAVI PATEL ◽  
RISHI K. WADHERA ◽  
...  
Keyword(s):  
Older Adults ◽  
Diabetes Care ◽  
Fee For Service ◽  
Medicare Advantage
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