Potential Spillover Effects on Traditional Medicare When Physicians Bear Medicare Advantage Risk
Our study is the first to examine the association between providers' exposure to MA risk payments and the outcomes they achieve beyond MA, specifically for their TM patients. We found that quality and efficiency outcomes for TM patients were higher under physician groups with high MA risk exposure. Although our study is not causal in nature, to the extent that such a relationship exists, it suggests that the benefits of MA risk payment arrangements extend beyond MA. Consequently, if more MA lives become subject to risk payment arrangements, the magnitude of potential benefits to the TM program could further increase.
Authors
- Kierstin Catlett
- Omid Ameli (ORCID: https://orcid.org/0000-0001-7878-0551)
- Samuel A. Skootsky (ORCID: https://orcid.org/0000-0002-9995-436X)
- Kenneth J. Cohen (ORCID: https://orcid.org/0000-0001-9193-9344)
- Susan Dentzer
- Nathan J. Smith (ORCID: https://orcid.org/0000-0002-5443-9962)
- Boris Vabson
- Jennifer Podulka
- Megan S. Jarvis
- Jane Sullivan (ORCID: https://orcid.org/0000-0002-5273-2997)
Institutions
- Optum (United States) (US)
Publication Details
- Journal
- The American Journal of Managed Care
- Published
- 2025-02-20
- DOI
- https://doi.org/10.37765/ajmc.2025.89686
- Citations
- 2
- Primary Topic
- Healthcare Policy and Management
- Type
- article
- Field-Weighted Citation Impact
- 6.26