MA Plans Outperform Medicare
A study by Niall Brennan, acting director of the Office of Policy at the Centers for Medicare and Medicaid Services (CMS), and Mark Shepard, a Harvard University Ph.D. candidate in economics shows that Medicare Advantage (MA) plans outperform Medicare fee for service (FFS) in offering higher quality care. For eight of the 11 measures, MA performed substantially better than FFS, and it performed slightly better on a ninth.
A study by America’s Health Insurance Plans finds that:
- For diabetes patients, all of the MA plans had fewer inpatient days and readmissions than FFS.
- The vast majority of the MA plans had fewer emergency room visits, fewer admissions overall, and fewer potentially avoidable admissions.
- Though somewhat less consistent, heart disease patients followed these same trends.
Interesting and important.
Im not surprised by this.
If the Medicare Advantage plans have higher quality than FFS Medicare, then they should be rewarded with higher payments. On the other hand, if the payments to MA plans are ratcheted down, Medicare costs may increase, because some of the quality measures used in the analysis are measures that affect costs — such as rehospitalization rates, etc.
The reason liberals, progressives and public health advocates love traditional Medicare is because it represents a single-payer system of socialized medicine for seniors. They love the idea of free health care; they love the idea of the government funding health care with progressive taxation. They also love the idea that seniors are a natural ally because seniors will do anything to protect the Medicare gravy train that is worth hundreds of thousands of dollars upon retirement. But what critics of the private Medicare Advantage plans fail to appreciate is that traditional Medicare (which they love) manages nothing. The doctors that treat Medicare patients coordinate nothing. Utilization is not managed and care is not coordinated because nobody is being paid to do so.
A very important study.
Don’t Medicare Advantage plans control hospital admissions? If so, how is it that fewer readmissions is an exogenous variable?
Has anyone looked at admissions that should have happened but didn’t?