‘Two-sided risk’ Medicare Advantage plans improve patient outcomes

America’s well being system is buckling underneath the load of a number of converging pressures: an growing older inhabitants, excessive charges of power illness, a scarcity of clinicians, and rising prices. The response to those challenges will decide the way forward for care on this nation — and new proof suggests the answer is rooted in how we ship and pay for care.

A peer-reviewed research printed within the American Journal of Managed Care by America’s Doctor Teams (APG), CareJourney, and Optum checked out whether or not well being outcomes for dual-eligible Medicare and Medicaid sufferers (individuals who qualify for each Medicare and Medicaid) fluctuate relying on the cost mannequin they’re handled underneath.  

We examined well being outcomes information underneath three totally different Medicare cost fashions: at-risk, or “two-sided danger” Medicare Benefit plans (the place doctor teams take full monetary danger for affected person care); fee-for-service (FFS) Medicare Benefit (the place suppliers are paid per service by the Medicare Benefit plan insurer); and conventional Medicare (the place suppliers are paid per service by the federal government).