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.
Heidenreich PA. Observational Outcomes or Use of Guideline Recommended Treatments? Which Demonstrates Better Care? JAMA Cardiol. Published online February 20, 20194(3):271–272. doi:10.1001/jamacardio.2019.0050
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