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Managing care and competition
Date:12/4/2012

ns that cover less healthy, more expensive patients will be used in the health care exchanges and in other aspects of health care reform that will be implemented under the Affordable Care Act, there is reason to be optimistic about how well these reforms will function, the researchers said.

"Ideally, we would want health plans to compete on the basis of costs and quality," said McWilliams. "Together, these three papers attempt to gauge if Medicare Advantage is heading in theright direction. Examining utilization of services addresses whether MA plans can create more efficiency and value. Examining selection addresses whether plans might be competing on another basis, by selecting favorable health risks and profiting from the difference between the payments and the costs for healthier patients."

All three papers were produced under the umbrella of a large program project grant from the National Institute on Aging that supports a comprehensive evaluation of different aspects of Medicare Advantage, including ongoing work on the quality of care provided under the system and that Newhouse directs. "There are tremendous synergies across the individual papers that come out of this work," said Landon.

More research remains to be done to fully understand the workings of MA, the researchers said, not least because the program will undergo another series of reforms as the Affordable Care Act is fully implemented.

"It will be important to continue to monitor all of these factors during implementation to make sure that the system is delivering the highest quality and highest value care we can provide," said Landon.


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Contact: David Cameron
david_cameron@hms.harvard.edu
617-432-0441
Harvard Medical School
Source:Eurekalert

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