New study from Harvard Medical School and Inovalon:
Medicare Advantage Members Have Better Quality Outcomes
(November 11, 2023 – Palm Springs, CA) During the annual Medicare Open Enrollment period – October 15 to December 7 – many people reassess their current Medicare coverage or consider their Medicare options for the first time. Desert Oasis Healthcare (DOHC) contracts with a variety of Medicare Advantage HMO health plans from insurers that many of us already know and trust, such as Anthem Blue Cross, Blue Shield of California, Humana, SCAN, United Healthcare, and WellCare among others.
“This latest study helps to validate what we already felt to be true about Medicare Advantage and why we encourage those who are Medicare-eligible to take the Part C option, better known as Medicare Advantage,” said Marc Hoffing, MD, MPH and Medical Director at DOHC. “The Harvard/Inovalon study found that Medicare Advantage members have better quality outcomes than fee-for-service Medicare patients.”
The study tracked patients from before they turned 65 and were covered by commercial insurance to after they turned 65 and enrolled in Medicare, adjusting for pre-existing differences in the two populations, including demographic, clinical, and social risk factors. Researchers found that Medicare Advantage (MA) beneficiaries had 70% fewer readmissions, 24% fewer preventable hospitalizations, and 59% fewer preventable acute hospitalizations than fee-for-service (FFS) Medicare.
“A key reason why patients appear to be going to the hospital less under Medicare Advantage is because they have fewer complications and don’t need the care, unlike those in FFS,” said Boris Vabson, a health economist at Harvard Medical School and lead researcher of the study. He added that MA plans offer more care management and care coordination services than FFS Medicare, and are financially incentivized to deliver more quality care.
Christie Teigland, vice president of research science and advanced analytics at Inovalon, said, “MA plans provide members with social risk factors – such as inadequate housing, lack of transportation, poor access to healthy food, and other factors known to impact health outcomes – with non-medical benefits to address those social needs. These benefits are generally not available under FFS.”
This is the third study from these researchers comparing differences between Medicare Advantage and fee-for-service Medicare. In future reports, the researchers will examine how Medicare Advantage tackles health inequities, as well as compare differences between different type of MA plans.
Harvard-Inovalon Medicare Study:
Quality Outcomes Under Medicare Advantage vs. Medicare Fee-for-Service
While Medicare Advantage (MA) now covers over half of Medicare beneficiaries, including a disproportionate share of those facing socioeconomic disadvantage and complex care needs, there is a limited understanding of how quality of care under MA compares to Medicare Fee-for-Service (FFS). There is particularly limited understanding on how quality of care differs under MA and FFS for the most disadvantaged or complex populations.
Press Contact
Rob Banchich
Director of Marketing
Desert Oasis Healthcare
About Desert Oasis Healthcare
Formed in 1981 as one of the first medical groups in the desert communities of southern California, Desert Oasis Healthcare (DOHC) continues to advance with changes in the healthcare market. DOHC provides primary and immediate care, home health, palliative care, clinical research studies and other services to more than 60,000 members/patients living in the greater Coachella Valley and the Morongo Basin of Riverside and San Bernardino counties. The multidisciplinary and comprehensive care programs of DOHC are committed to educating individuals on preventive health care in their daily lives, reflected in the DOHC motto, "Your Health. Your Life. Our Passion." For more information, visit www.mydohc.com.
