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Invited Commentary
February 20, 2019

Observational Outcomes or Use of Guideline Recommended Treatments?Which Demonstrates Better Care?

Author Affiliations
  • 1Veterans Affairs Palo Alto Health Care System, Palo Alto, California
JAMA Cardiol. 2019;4(3):271-272. doi:10.1001/jamacardio.2019.0050

As new models of care delivery are developed, particularly when the model is designed to reduce costs, it is imperative to examine any effects on the quality of care. An example is Medicare Advantage, Medicare’s expanding managed care model that pays a lump sum per month for treating a Medicare patient. One study calculated that Medicare pays 8% less for patients in Medicare Advantage than for similar patients in fee-for-service (FFS; traditional) Medicare,1 although this was not the conclusion of the Medicare Payment Advisory Commission.2 The quality of care differences between Medicare Advantage and FFS Medicare are also unclear.

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