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Fixed payments not a barrier to quality of care in HMOs, study finds
Date:7/8/2013

ients enroll in HMOs, policy makers have wondered how these two structures affect patient care.

To answer this question, Ayanian and Harvard Medical School health care policy colleagues Joseph Newhouse, Bruce Landon, Alan Zaslavskyas well as experts from the National Committee for Quality Assurance and the law firm Stevens and Leeanalyzed data on the use of these recommended preventive services submitted by Medicare health plans as compared with performance in traditional fee-for-service Medicare using Medicare claims data. All told, the investigators studied data for approximately 2 million beneficiaries in 2009 representing both HMOs and traditional Medicare.

The researchers matched the demographic profiles of enrollees in both parts of Medicare as closely as possible so that regional variations and differences in age, sex and economic status would not confound the data.

Looking specifically at mammograms, diabetes exams and cholesterol testing for cardiovascular disease, patients in HMOs were more likely to receive appropriate services than patients in traditional plans. What's more, the differences remained consistent over the six-year period.

The researchers also looked at vaccination rates for flu and pneumonia, and satisfaction with physicians. The researchers found that in 2003 HMO patients were more likely, by a slight margin, to receive these vaccines, but by 2009 the differences were nearly eliminated. In 2003, patients in traditional Medicare tended to have a slightly higher rate of satisfaction with their primary care doctors and also gave a faint edge to specialists. By 2009, those numbers flipped for primary care doctors, but remained consistent for specialists.

Landon, who is a professor of health care policy, found these latter findings particularly noteworthy. "Back in 2003, there was a tradeoff between higher quality of preventive care seen in HMOs and better experiences, seen in traditional Medicare,"
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Contact: Katie DuBoff
katie_duboff@hms.harvard.edu
617-432-3038
Harvard Medical School
Source:Eurekalert

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