Steps To Reduce Favorable Risk Selection In Medicare Advantage Largely Succeeded, Boding Well For Health Insurance Exchanges.

Within Medicare, the Medicare Advantage program has historically attracted better risks-healthier, lower-cost patients-than has traditional Medicare. The disproportionate enrollment of lower-cost patients and avoidance of higher-cost ones during the 1990s-known as favorable selection--resulted in Me...

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Publicado en:Health Affairs Vol. 31; no. 12; pp. 2618 - 2629
Autores principales: Newhouse, Joseph P., Price, Mary, Huang, Jie, Mcwilliams, J. Michael, Hsu, John
Formato: Journal Article
Publicado: Health Affairs Publishing, LLC Dec2012
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Steps To Reduce Favorable Risk Selection In Medicare Advantage Largely Succeeded, Boding Well For Health Insurance Exchanges.
      aug:
        au:
          Newhouse, Joseph P.
          Price, Mary
          Huang, Jie
          Mcwilliams, J. Michael
          Hsu, John
        affil: John D. MacArthur Professor of Health Policy and Management, director, Division of Health Policy Research and Education, chair, Committee on Higher Degrees in Health Policy, and director, Interfaculty Initiative in Health Policy, Harvard University, Boston, Massachusetts
      sug:
        subj:
          Managed Competition Methods
          Medicare Statistics and Numerical Data
          Selection Bias Trends
          Managed Care Programs Classification
          Risk Management Methods
          Organizational Policies
          Human
          United States
          Eligibility Determination
          Fee for Service Plans
          Comparative Studies
          Administrative Research
          Predictive Validity
          Health Care Costs
          Mortality
          Case Mix
          Diagnosis-Related Groups
          Prospective Payment System Methods
          Prospective Studies United States
          Billing and Claims Statistics and Numerical Data
          Geographic Factors
          Models, Statistical Utilization
          Confidence Intervals
          Decision Making, Patient
          Funding Source
      ab: Within Medicare, the Medicare Advantage program has historically attracted better risks-healthier, lower-cost patients-than has traditional Medicare. The disproportionate enrollment of lower-cost patients and avoidance of higher-cost ones during the 1990s-known as favorable selection--resulted in Medicare's spending more per beneficiary who enrolled in Medicare Advantage than if the enrollee had remained in traditional Medicare. We looked at two measures that can indicate whether favorable selection is taking place--predicted spending on beneficiaries and mortality--and studied whether policies that Medicare implemented in the past decade succeeded in reducing favorable selection in Medicare Advantage. We found that these policies--an improved risk adjustment formula and a prohibition on monthly disenrollment by beneficiaries--largely succeeded. Differences in predicted spending between those switching from traditional Medicare to Medicare Advantage relative to those who remained in traditional Medicare markedly narrowed, as did adjusted mortality rates. Because insurance exchanges set up under the Affordable Care Act will employ similar policies to combat risk selection, our results give reason for optimism about managing competition among health plans.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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