A comparison of relative resource use and quality in Medicare Advantage health plans versus traditional Medicare.

ABSTRACT:

Objectives

Prior analyses of Medicare health plans have examined either utilization of services or quality of care, but not both jointly. Our objective was to compare utilization and quality for Medicare Advantage (MA) enrollees with diabetes or cardiovascular disease to that for similarly defined traditional Medicare (TM) beneficiaries.

Study design

Cross-sectional matched observational study using data for 2007.

Methods

We obtained individual-level Healthcare Effectiveness Data and Information Set (HEDIS) relative resource use (RRU) and quality data for patients enrolled in MA, and then developed comparable claims-based measures for matched samples of TM beneficiaries.

Main outcome measures

utilization levels for inpatient care, evaluation and management serv

SUBMITTER: Landon BE 

PROVIDER: S-EPMC6365159 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature