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.

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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
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article

Potential Spillover Effects on Traditional Medicare When Physicians Bear Medicare Advantage Risk

Kierstin Catlett, Omid Ameli, Samuel A. Skootsky, Kenneth J. Cohen et al.
2 citations
The American Journal of Managed Care
Healthcare Policy and Management
6.26
article

Potential Spillover Effects on Traditional Medicare When Physicians Bear Medicare Advantage Risk

Kierstin Catlett, Omid Ameli, Samuel A. Skootsky, Kenneth J. Cohen, Susan Dentzer, Nathan J. Smith, Boris Vabson, Jennifer Podulka, Megan S. Jarvis, Jane Sullivan
article en
2 citations

Abstract

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.

The American Journal of Managed CareVol. 31(8)
Optum (United States) (US)
Zero hunger
Openalex Percentile: Top 5%
Healthcare Policy and Management
6.26
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