Avalere Study: Medicare Advantage plans achieve better outcomes than traditional Medicare
The study conducted by the consulting firm Avalere Health looked at MA encounter data and a sample of Medicare Parts A and B claims data as well as Part D drug event data from 2015 through 2017. The study population was 1.4 million MA beneficiaries and 7.9 million traditional Medicare beneficiaries. Other key findings of the report include:
- Better rates of eye exams for diabetics that are 14 to 56% higher in MA compared with traditional Medicare.
- 66% more MA frail elderly beneficiaries get outpatient visits.
- Rates for depression screenings were 18 to 27% higher for MA beneficiaries and rates of pneumonia vaccinations were 50 to 52% higher.
- Inpatient hospital costs were nine to 23% lower among high-need, high-cost populations in MA relative to fee-for-service Medicare.
- Part D drug costs were 38 to 44% lower.
The report links the better results to key features of the MA program such as risk-adjusted capitation payments and strong value-based care performance incentives to “enable plans to offer care management interventions that help meet the complex care needs of vulnerable beneficiaries in ways that achieve positive health outcomes.”
