Physician Reimbursement in Medicare Advantage Compared With Traditional Medicare and Commercial Health Insurance.

ABSTRACT:

Importance

Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear.

Objective

To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans.

Design, setting, and participants

Retrospective analysis of claims data evaluating MA prices paid to physicians and for laboratory services and durable medical equipment between 2007 and 2012 in 348 US core-based statistical areas. The study population included all

SUBMITTER: Trish E 

PROVIDER: S-EPMC5710575 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature