Latest research provides insights to policy makers and health plans to maximize and tailor benefits to meet the needs of socio-economically disadvantaged populations
BOWIE, Md., April 8, 2024 (GLOBE NEWSWIRE) — Innovaron, a leading provider of cloud-based software solutions that power data-driven healthcare, today announced in collaboration with Harvard Medical School that Medicare Advantage (M.A. ) announced the results of a new study analyzing the planning methods of Fiscal generosity and coverage design influence enrollment, socioeconomic-related health disparities, and utilization outcomes. Results show that zero-premium MA plans significantly attract more socioeconomically disadvantaged populations than non-zero-premium MA plans and traditional Medicare fee-for-service (FFS), and health maintenance organizations ( HMO) plans have been shown to have significantly lower utilization than their preferred provider. Organization (PPO) and FFS plans.
The findings, published in the white paper “The Importance of Plan Design in Medicare Advantage,” are the result of a study conducted by Innovaron and others to understand the underlying factors that influence enrollment, quality outcomes, and utilization in MA vs. FFS Medicare. This is the fourth joint research between Harvard Medical School. . Previous research has found that MA achieves superior quality outcomes and utilization reductions compared with his FFS Medicare, even after adjusting for enrollment differences. However, until now, there has been limited data on differences within MA and how specific MA plan design and features influence outcomes.
Notable findings include:
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Demographic and socioeconomic characteristics differ significantly between participants in zero-premium MA plans and higher-premium options.
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Enrollees in zero-premium plans are three times more likely to be nonwhite and more likely to live in urban areas than enrollees in other MA and FFS
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The net worth of zero-premium MA registrants is 90% of the net worth of other MA registrants, but the net worth of FFS registrants is only 70%.
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Compared to participants in other MA or FFS plans, zero-premium participants are more likely to have a high school education or less, less likely to own a home or car, and more likely to be married. lower and more likely to have difficulty speaking English.
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MA HMO plan enrollees are more socioeconomically disadvantaged and have lower health care utilization rates than MA PPO enrollees.
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MA HMO enrollees are three times more likely to be nonwhite than MA PPO plan enrollees.
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Utilization under an MA HMO is 29% lower compared to the equivalent population in an MA PPO, which equates to $2,460 lower per capita utilization per year.
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“Our study challenges the misconception that Medicare Advantage is monolithic and reveals significant differences in plan design and features and how these variables affect enrollment and outcomes. ,” said study co-author Dr. Boris Vavson, a health economist at Harvard Medical School. Principal investigator of the project. “Medicare Advantage” By understanding the populations that plans attract, policy makers and health plans can work together to incentivize and deliver better cost-effective outcomes for all Medicare enrollees. Masu.”
Due to limited data, previous studies are unable to analyze how different plan types and features, such as copays and coverage design, influence enrollment decisions and outcomes. was. This study fills the gap by leveraging his MORE from Inovalon, the nation's largest longitudinal primary source medical dataset.2 The Registry® covers 100% of public Medicare life and 30% of private insurance life.
“Our analysis will help Medicare Advantage and other health plans more effectively serve their member populations by offering customized designs and features,” Innovaron research said. said Kristi Teigland, Ph.D., vice president of science and advanced analysis and co-principal investigator. “Using these insights, health plans can forecast expected enrollment, evaluate the performance of their capabilities against industry benchmarks, and identify opportunities to address health disparities and drive optimal outcomes. can.”
To download the white paper and learn more about the research, visit www.inovalon.com/harvard-inovalon-medicare-research-collaboration/. Also, join the principal investigators behind the research collaboration for a webinar on April 22, 2024. Reserve your seat by filling out the registration form available here.
About Innovalon
Inovalon is a leading provider of cloud-based software solutions that power data-driven healthcare. The Inovalon ONE® platform brings together nation-wide connectivity, real-time primary source data access, and advanced analytics in a sophisticated cloud-based platform to drive improved outcomes and economics across the healthcare ecosystem . The company's analytics and capabilities are used by approximately 20,000 customers supporting more than 50,000 clinical sites, with 81 billion patients across 1.1 million physicians, 661,000 clinical sites, and 380 million unique lives. Informed by primary source data for over 10,000 medical events. For more information, please visit www.inovalon.com.
contact:
Tom Paolella
Senior Director of Press and Analyst Relations, Inovalon
Thomas.Paolella@inovalon.com
