Studies from Humana Have Provided New Data on Medicare and Medicaid (Mortality Differences Between Traditional Medicare and Medicare Advantage: A…

Studies from Humana Have Provided New Data on Medicare and Medicaid (Mortality Differences Between Traditional Medicare and Medicare Advantage: A Risk-Adjusted Assessment Using Claims Data)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Investigators publish new report on Medicare and Medicaid. According to news reporting out of Louisville, Kentucky, by VerticalNews editors, research stated, "Medicare Advantage (MA) has grown rapidly since the Affordable Care Act; nearly one-third of Medicare beneficiaries now choose MA. An assessment of the comparative value of the 2 options is confounded by an apparent selection bias favoring MA, as reflected in mortality differences."

Our news journalists obtained a quote from the research from Humana, "Previous assessments have been hampered by lack of access to claims diagnosis data for the MA population. An indirect comparison of mortality as an outcome variable was conducted by modeling mortality on a traditional fee-for-service (FFS) Medicare data set, applying the model to an MA data set, and then evaluating the ratio of actual-to-predicted mortality in the MA data set. The mortality model adjusted for clinical conditions and demographic factors. Model development considered the effect of potentially greater coding intensity in the MA population. Further analysis calculated ratios for subpopulations. Predicted, risk-adjusted mortality was lower in the MA population than in FFS Medicare. However, the ratio of actual-to-predicted mortality (0.80) suggested that the individuals in the MA data set were less likely to die than would be predicted had those individuals been enrolled in FFS Medicare. Differences between actual and predicted mortality were particularly pronounced in low income (dual eligibility), nonwhite race, high morbidity, and Health Maintenance Organization (HMO) subgroups. After controlling for baseline clinical risk as represented by claims diagnosis data, mortality differences favoring MA over FFS Medicare persisted, particularly in vulnerable subgroups and HMO plans."

According to the news editors, the research concluded: "These findings suggest that differences in morbidity do not fully explain differences in mortality between the 2 programs."

For more information on this research see: Mortality Differences Between Traditional Medicare and Medicare Advantage: A Risk-Adjusted Assessment Using Claims Data. Inquiry-The Journal of Health Care Organization Provision and Financing, 2017;54():1-8. Inquiry-The Journal of Health Care Organization Provision and Financing can be contacted at: Sage Publications Inc, 2455 Teller Rd, Thousand Oaks, CA 91320, USA.

Our news journalists report that additional information may be obtained by contacting S.M. Mendes, Humana Inc, Louisville, KY 40202, United States. Additional authors for this research include R.A. Beveridge, A. Caplan, T.L. Rogstad, V. Olson, M.C. Williams, J.M. McRae and S. Vargas.

Keywords for this news article include: Louisville, Kentucky, United States, North and Central America, Medicare and Medicaid, Health Policy, Medicare, Humana.

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