Even with the advent of Accountable Care Organizations (ACOs), for the foreseeable future the Medicare Advantage (MA) program is likely to remain numerically the most important alternative to Traditional Medicare (TM). Although MA currently enrolls over a quarter of Medicare beneficiaries, the reimbursement reductions ushered in by the ACA could diminish the array of supplemental benefits offered to MA beneficiaries, increase premium and cost sharing levels, and decrease the willingness of both beneficiaries and plans to participate. Moreover, many of these changes could also affect selection, the management of care, and prices private MA plans negotiate with health care providers with repercussions for the entire delivery system. Given the prominence of MA in the Medicare program, evaluating these critical aspects of MA in light of these policy changes represents an important opportunity for research. In addition, despite substantial new and important contributions by our team to the understanding of current risk adjustment methods in addressing risk selection, their adequacy in the face of the ACA's payment cuts remains an open question. This project continues our study of the provision of services, selection, and the quality of care under MA and how all of those change over time as new policies are implemented. By continuing the complementary stock and flow comparisons of health risks in the MA and TM populations that we have employed using both administrative and survey data, we will clarify how payment changes affect the performance of MA and TM. Furthermore, through the incorporation of data from Truven MarketScan as well as from several additional health plans that serve this market, we will be able to examine for the first time pricing MA plans obtain from providers and examine how those prices change over time and relate to market-level factors such as provider concentration. In short, in our current Program project we have developed methods to address the salient policy issues that MA poses, we have addressed them at a time when reimbursement was becoming more generous and MA was expanding, and now we can apply our methods to a more austere reimbursement policy in which successful ACOs may nonetheless decide to convert to MA plans.
| Barnett, Michael L; McWilliams, J Michael (2018) Changes in specialty care use and leakage in Medicare accountable care organizations. Am J Manag Care 24:e141-e149 |
| Roberts, Eric T; Hatfield, Laura A; McWilliams, J Michael et al. (2018) Changes In Hospital Utilization Three Years Into Maryland's Global Budget Program For Rural Hospitals. Health Aff (Millwood) 37:644-653 |
| Gilstrap, Lauren G; Huskamp, Haiden A; Stevenson, David G et al. (2018) Changes In End-Of-Life Care In The Medicare Shared Savings Program. Health Aff (Millwood) 37:1693-1700 |
| McWilliams, J Michael; Hatfield, Laura A; Landon, Bruce E et al. (2018) Medicare Spending after 3 Years of the Medicare Shared Savings Program. N Engl J Med 379:1139-1149 |
| Roberts, Eric T; McWilliams, J Michael; Hatfield, Laura A et al. (2018) Changes in Health Care Use Associated With the Introduction of Hospital Global Budgets in Maryland. JAMA Intern Med 178:260-268 |
| Schwartz, Aaron L; Zaslavsky, Alan M; Landon, Bruce E et al. (2018) Low-Value Service Use in Provider Organizations. Health Serv Res 53:87-119 |
| Ganguli, Ishani; Souza, Jeffrey; McWilliams, J Michael et al. (2018) Practices Caring For The Underserved Are Less Likely To Adopt Medicare's Annual Wellness Visit. Health Aff (Millwood) 37:283-291 |
| Chen, Julius L; Hicks, Andrew L; Chernew, Michael E (2018) Prices for physician services in Medicare Advantage versus traditional Medicare. Am J Manag Care 24:341-344 |
| Landon, Bruce E; Zaslavsky, Alan M; Souza, Jeffrey et al. (2018) Trends in Diabetes Treatment and Monitoring among Medicare Beneficiaries. J Gen Intern Med 33:471-480 |
| Roberts, Eric T; Zaslavsky, Alan M; McWilliams, J Michael (2018) The Value-Based Payment Modifier: Program Outcomes and Implications for Disparities. Ann Intern Med 168:255-265 |
Showing the most recent 10 out of 85 publications
