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UnknownDifferences In Use Of Services And Quality Of Care In Medicare Advantage And Traditional Medicare, 2010 And 2017.
Medicare Advantage (MA) enrollment growth could make it difficult for MA plans to maintain their track record of limiting discretionary utilization while delivering higher-quality care than traditional Medicare. We compared quality and utilization measures in Medicare Advantage and traditional Medic...
S-EPMC10171780 | biostudies-literature
UnknownPrimary Care Physicians In Medicare Advantage Were Less Costly, Provided Similar Quality Versus Regional Average.
The use of many services is lower in Medicare Advantage (MA) compared with traditional Medicare, generating cost savings for insurers, whereas the quality of ambulatory services is higher. This study examined the role of selective contracting with providers in achieving these outcomes, focusing on p...
S-EPMC11040031 | biostudies-literature
UnknownMedicare Advantage Plan Double Bonuses Drive Racial Disparity In Payments, Yield No Quality Or Enrollment Improvements.
Under the Medicare Advantage (MA) quality bonus payment program, initiated in 2012, MA plans with relatively high quality performance that are located in "double bonus"-eligible counties-metropolitan areas with high MA enrollment and low fee-for-service Medicare spending-receive quality bonuses twic...
S-EPMC9278554 | biostudies-literature
UnknownThe Medicare Advantage Quality Bonus Program Has Not Improved Plan Quality.
In 2012 Medicare introduced the quality bonus program, linking financial bonuses to commercial insurers' quality performance in Medicare Advantage (MA). Despite large investments in the program, evidence of its effectiveness is limited. We analyzed insurance claims from the period 2009-2018 from the...
S-EPMC9098184 | biostudies-literature
UnknownRisk Adjustment In Medicare ACO Program Deters Coding Increases But May Lead ACOs To Drop High-Risk Beneficiaries.
The Medicare Shared Savings Program (MSSP) adjusts savings benchmarks by beneficiaries' baseline risk scores. To discourage increased coding intensity, the benchmark is not adjusted upward if beneficiaries' risk scores rise while in the MSSP. As a result, accountable care organizations (ACOs) have a...
S-EPMC6394223 | biostudies-literature
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