Industrial Organization Medicaid/Medicare Medicare Advantage

Are Integrated Medicare Advantage Plans better?

That is the question Park, Langellier, and Meyers (2022) aim to estimate in their recent Health Services Research publication. The authors use 2015-2017 data from the Centers for Medicare and Medicaid services and control for other differences between integrated and non-integrated Medicare Advantage (MA) plans using state fixed effects and contract random effects. Using this approach, they find:

Integrated MA plans were associated with $19.4 (95% CI: 9.2, 29.7) and $16.6 (95% CI: 10.3, 22.9) higher Part C and Part D monthly premiums, but were associated with higher star quality ratings…Integrated MA plans were associated with $40.5 (95% CI: -54.0, -26.9) lower non-claims costs than non-integrated MA plans. There was limited evidence that integrated MA plans provided more generous supplemental benefits than non-integrated MA plans. Enrollment rates in integrated MA plans were particularly low among socially marginalized groups [3.4 (95% CI: -5.9, -1.0), 4.7 (95% CI: -8.5, -0.9), and 4.4 (95% CI: -6.4, -2.4) percentage points lower among non-Hispanic Black, Medicare-Medicaid dual eligible, and the disabled].

Integrated MA plans may improve efficiency and quality, but these benefits accrue disproportionately to more socially advantaged Medicare beneficiaries due to enrollment trends.

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