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Is Medicare Advantage Worthless?
A new study from the Journal of the American Medical Association found that between 2009 and 2018, there was no statistically significant difference between the mortality rates of patients with acute myocardial infarctions (heart attacks) enrolled in Medicare Advantage compared to traditional Medicare.
JIM KAHN; JGKahn@ucsf.edu
Kahn is a professor of health policy, epidemiology and global health at the UCSF School of Medicine and the co-founder of Health Justice Monitor.
Kahn wrote on Health Justice Monitor: “Clinical outcomes for heart attacks appear similar for MA [Medicare Advantage] and TM [traditional Medicare] overall, by 2018. Thus, MA is not providing meaningful health advantages for this clinical situation.” Kahn also discussed how the management of electronic health records can create a bias that favors MA even in the JAMA study. “MA plans aggressively upcode certain diagnoses to increase capitation rates… As a result, hospitalization summaries may list the added diagnoses as comorbidities. The TM patient doesn’t have this upcoding.” Thus, “small differences in hospital comorbidities due to diagnostic upcoding may make MA care look better than it is.”
Kahn also argues that beneficiaries are not privy to the “significant variation across MA plans,” giving them “no way to determine which plans provide better care. It’s a crap shoot.”
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