AJMC® Research Roundup: September 2019

Hi, I’m Christina Mattina for The American Journal of Managed Care^®. Here are 5 findings from research published in the September issue.

Did Medicare Advantage Payment Cuts Affect Beneficiary Access and Affordability?

1. Payment cuts to Medicare Advantage under the Affordable Care Act did not appear to make the program less attractive to plans or enrollees. Not only did enrollment in MA grow between 2009 and 2017, but access and affordability remained stable for beneficiaries.

VA Geriatric Scholars Program’s Impact on Prescribing Potentially Inappropriate Medications

2. Participation in the Veterans Affairs Geriatric Scholars Program course, which teaches providers about best practices on appropriate prescribing, was associated with reduced prescribing of potentially dangerous or inappropriate medications for older veterans in VA primary care.

Changes in Ambulatory Utilization After Switching From Medicaid Fee-for-Service to Managed Care

3. After some New York Medicaid beneficiaries switched from fee-for-service to managed care, those who switched had larger decreases in ambulatory visits and providers than those who were continuously enrolled in either fee-for-service or managed care. The patterns were mainly driven by changes among beneficiaries with 5 or more chronic conditions.

Managed Care for Long-Stay Nursing Home Residents: An Evaluation of Institutional Special Needs Plans

4. Compared with Medicare fee-for-service beneficiaries, nursing home residents in MA Institutional Special Needs Plans had different patterns of healthcare use across various settings, including lower emergency department use and hospital admissions and readmissions, but higher use of skilled nursing facilities.

Multi-Payer Advanced Primary Care Practice Demonstration on Quality of Care

5. The Multi-Payer Advanced Primary Care Practice Demonstration was intended to improve care by facilitating the transformation to a patient-centered medical home, but a study of claims and enrollment data found few significant improvements in quality after the demonstration period across 8 participating states.

To read all of these studies and more, visit AJMC.com.