What Do We Know About Health Care Access and Quality in Medicare Advantage Versus the Traditional Medicare Program?

Works Cited

AHIP Center for Policy and Research. “Reductions in Hospital Days, Re-Admissions, and Potentially Avoidable Admissions among Medicare Advantage Enrollees in California and Nevada.” Washington: America’s Health Insurance Plans, (Revised) October 2009.[endnote 133466-1111]

AHIP Center for Policy and Research. “Using AHRQ’s ‘Revisit’ Data to Estimate 30-Day Readmission Rates in Medicare Advantage and the Traditional Fee-for-Service Program.” Washington: America’s Health Insurance Plans, October 2010.[endnote 133466-1112]

Anderson G. “The Benefits of Care Coordination: A Comparison of Medicare Fee-for-Service and Medicare Advantage.” Report prepared for the Alliance of Community Health Plans. September 2009.

Ayanian J et al. “Medicare Beneficiaries More Likely to Receive Appropriate Ambulatory Services in HMOs than in Traditional Medicare.” Health Affairs. 32(2013a): 1228-1235.

Ayanian J, Landon B, Zaslavsky A. Newhouse J. “Racial and Ethnic Differences in Use of Mammography Between Medicare Advantage and Traditional Medicare.” Journal of the National Cancer Institute. 105(2013b): 1891-1896.

Balsa AI, Cao Z, McGuire TG. “Does managed health care reduced health care disparities Between minorities and Whites?” Journal of Health Economics. 26(2007): 101-121.

Barnett MJ, Perry PJ, Langstaff JD, Kaboli PJ. “Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector Medicare HMOs.” Journal of Managed Care Pharmacy. 12(2006): 362-370.

Basu J. “Medicare Managed Care and Primary Care Quality: Examining Racial and Ethnic Effects across States.” Health Care Management Science. 15(2012): 15-28.

Basu J, Friedman B. “Adverse Events for Hospitalized Medicare Patients: Is There a Difference Between HMO and FFS Enrollees?” Social Work Public Health. 28(2013): 639-51.

Basu J, Mobley LR. “Do HMOs Reduce Preventable Hospitalizations for Medicare Beneficiaries?” Medical Care Research and Review. 64(2007): 544-567.

Beatty P, Dhont K. “Medicare Health Maintenance Organizations and Traditional Coverage: Perceptions of Health Care among Beneficiaries with Disabilities.” Archives of Physical Medicine and Rehabilitation. 82(2001): 1009-1017.

Bian J, Dow WH, Matchar DB. “Medicare HMO Penetration and Mortality Outcomes of Ischemic Stroke.” American Journal of Managed Care. 12(2006): 58-64.

Brennan N, Shephard M. “Comparing Quality of Care in the Medicare Program.” American Journal of Managed Care. 16(2010): 841-848.

Cohen R, Lemieux J, Schoenborn J, Mulligan T. “Medicare Advantage Chronic Special Needs Plan Boosted Primary Care, Reduced Hospital Use among Diabetes Patients.” Health Affairs. 31(2012): 110-119.

Dhanani N, O’Leary JF, Keeler E, Bamezai A, Melnick G. “The Effects of HMOs on the Inpatient Utilization of Medicare Beneficiaries.” Health Services Research. 39(2004): 1607-1627.

Dowd B, Maciejewski ML, O’Connor H, Riley G, Geng Y. “Health Plan Enrollment and Mortality in the Medicare Program.” Health Economics. 20(2011): 645-659.

Elliott MN, Haviland AM, Orr N, Hambarsoomian K, Cleary PD. “How Do the Experiences of Medicare Beneficiary Subgroups Differ Between Managed Care and Original Medicare?” Health Services Research. 46(2011): 1039-1058.

Erickson LC, Torchiana DF, Schneider EC, Newburger JW, Hannan EL. “The Relationship Between Managed Care Insurance and Use of Lower-Mortality Hospitals for CABG Surgery.” Journal of the American Medical Association. 283(2000): 1976-1982.

Farley DO, Elliott MN, Haviland AM, Slaughter ME, Heller A. “Understanding Variations in Medicare Consumer Assessment of Health Care Providers and Systems Scores: California as an Example.” Health Services Research. 46(2011): 1646-1662.

Friedman B, Jiang HJ. “Do Medicare Advantage Enrollees Tend to be Admitted to Hospitals with Better or Worse Outcomes Compared with Fee-for-Service Enrollees?” International Journal of Health Care Finance and Economics. 10(2010): 171-185.

Friedman B, Jiang HJ, Russo CA. “Medicare Hospital Stays: Comparisons Between the Fee-for-Service Plan and Alternative Plans, 2006.” Health Cost and Utilization Project (HCUP) Statistical Brief #66. January 2009.

Friedman B, Jiang HJ, Steiner CA, Bott J. “Likelihood of Hospital Readmission after First Discharge: Medicare Advantage vs. Fee-for-Service Patients.” INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 49(2012): 202-213.

Huesch M. “Managing Care? Medicare Managed Care and Patient Use of Cardiologists.” Health Services Research. 45(2010): 329-354.

Keating N, Landrum MB, Meara E, Ganz PA, Guadagnoli E. “Do Increases in the Market Share of Managed Care Influence Quality of Cancer Care in the Fee-for-Service Sector?” Journal of the National Cancer Institute. 97(2005): 257-264.

Keenan PS, Elliott MN, Cleary PD, Zaslavsky AM, Landon BE. “Quality Assessments by Sick and Healthy Beneficiaries in Traditional Medicare and Medicare Managed Care. Medical Care. 47(2009): 882-888.

Keenan PS et al. “Geographic Area Variations in the Medicare Health Plan Era. Medical Care. 48(2010): 260-266.

Keyhani S et al. “Use of Preventive Care by Elderly Male Veterans Receiving Care Through the Veterans Health Administration, Medicare Fee-for-Service, and Medicare HMO Plans.” American Journal of Public Health. 97(2007): 2179-2185.

Kirsner RS, Wilkinson JD, Ma F, Pacheco H, Federman DG. “The Association of Medicare Health Care Delivery Systems with Stage at Diagnosis and Survival for Patients with Melanoma.” (Reprinted) Archives of Dermatology. 141(2005): 753-757.

Kulkarni VT et al. “Regional Associations Between Medicare Advantage Penetration and Administrative Claims-based Measures of Hospital Outcomes.” Medical Care. 50(2012): 406-409.

Landon BE, Zaslavsky AM, Bernard SL, Cioffi MJ, Cleary PD. “Comparison of Performance of Traditional Medicare vs Medicare Managed Care. Journal of the American Medical Association. 291(2004): 1744-1752.

Landon BE et al. “Analysis of Medicare Advantage HMOs Compared with Traditional Medicare Shows Lower Use of Many Services During 2003-09. Health Affairs. 31(2012): 2609-2617.

Lee-Feldstein A, Feldstein PJ, Buchmueller T. “Health Care Factors Related to Stage at Diagnosis and Survival among Medicare Patients with Colorectal Cancer.” Medical Care. 40(2002): 362-374.

Lemieux J, Sennett C, Wang R, Mulligan T, Bumbaugh, J. “Hospital Readmission Rates in Medicare Advantage Plans.” American Journal of Managed Care. 18(2012): 96-104.

Luft HS. “Variations in Patterns of Care and Outcomes after Acute Myocardial Infarction for Medicare Beneficiaries in Fee-for-Service and HMO Settings.” Health Services Research. 38(2003): 1065-1079.

Matlock DD et al. “Geographic Variation in Cardiovascular Procedure Use among Medicare Fee-for-Service vs Medicare Advantage Beneficiaries.” Journal of the American Medical Association. 310(2013): 155-162.

Medicare Payment Advisory Commission (MedPAC) Report to the Congress: Medicare Payment Policy. Chapter 13. “The Medicare Advantage Program: Status Report.” Washington: Medicare Payment Advisory Commission, March 2014.

Mello MM, Stearns SC, Norton EC. “Do Medicare HMOs Still Reduce Health Services Use after Controlling for Selection Bias?” Health Economics. 11(2002): 323-340.

Mittler JN, Landon BE, Fisher ES, Cleary PD, Zaslavsky AM. “Market Variations in Intensity of Medicare Service Use and Beneficiary Experiences with Care.” Health Services Research. 45(2010): 647-669.

National Committee for Quality Assurance (NCQA). “Improving Quality and Patient Experience: The State of Health Care Quality 2013.” Washington: National Committee for Quality Assurance, October 2013.

Newhouse JP, McGuire TG. “How Successful is Medicare Advantage?” Milbank Quarterly. 92(2014): 351−394.[endnote 133466-1113]

Nicholas LH. “Better Quality of Care or Healthier Patients? Hospital Utilization by Medicare Advantage and Fee-for-Service Enrollees.” Forum for Health Economics and Policy. 16(2013): 137-161.

Porell FW, Miltiades HB. “Disability Outcomes of Older Medicare HMO Enrollees and Fee-for-Service Medicare Beneficiaries.” Journal of the American Geriatrics Society. 49(2001): 615-631.

Pourat N, Kagawa-Singer M, Wallace SP. “Are Managed Care Medicare Beneficiaries with Chronic Conditions Satisfied with their Care?” Journal of Aging and Health. 18(2006): 70-90.

Riley GF et al. “Comparison of Cancer Diagnosis and Treatment in Medicare Fee-for-Service and Managed Care Plans.” Medical Care. 46(2008): 1108-1115.

Sadetsky N et al. “Prostate Cancer Outcomes among Older Men: Insurance Status Comparisons Results from CaPSURE Database.” Prostate Cancer and Prostatic Diseases. 11(2008): 280-287.

Safran DG, Wilson IB, Rogers WH, Montgomery JE, Chang H. “Primary Care Quality in the Medicare Program: Comparing the Performance of Medicare Health Maintenance Organizations and Traditional Fee-for-Service Medicare.” (Reprinted) Archives of Internal Medicine. 162(2002): 757-765.

Schneider EC, Zaslavsky AM, Epstein AM. “Use of High-Cost Operative Procedures by Medicare Beneficiaries Enrolled in For-Profit and Not-for-Profit Health Plans. New England Journal of Medicine. 350(2004): 143-150.

Schneider EC, Zaslavsky AM, Epstein AM. “Quality of Care in For-Profit and Not-for-Profit Health Plans Enrolling Medicare Beneficiaries.” American Journal of Medicine. 118(2005): 1392-1400.

Selim A et al. “Risk-Adjusted Mortality as an Indicator of Outcomes: Comparison of the Medicare Advantage Program with the Veterans Health Administration.” Medical Care. 44(2006): 359-365.

Selim A et al. “Change in Health Status and Mortality as Indicators of Outcomes: Comparison Between the Medicare Advantage Program and the Veterans Health Administration.” Quality of Life Research. 16(2007): 1179-1191.

Selim A et al. “Comparison of Health Outcomes for Male Seniors in the Veterans Health Administration and Medicare Advantage Plans.” Health Services Research. 45(2010): 376-396.

Smith MA, Frytak JR, Liou J, Finch MD. “Rehospitalization and Survival for Stroke Patients in Managed Care and Traditional Medicare Plans.” Medical Care. 43(2005): 902-910.

Stevenson DG, Ayanian JZ, Zaslavsky AM, Newhouse JP, Landon BE. “Service Use at the End-of-Life in Medicare Advantage Versus Traditional Medicare.” Medical Care. 51(2013): 931-937.

Trivedi AN, Grebla RC. “Quality and Equity of Care in the Veterans Affairs Health-Care System and in Medicare Advantage Health Plans.” Medical Care. 49(2011): 560-568.

Trivedi AN, Zaslavsky AM, Schneider EC, Ayanian JZ. “Trends in the Quality of Care and Racial Disparities in Medicare Managed Care.” New England Journal of Medicine. 353(2005): 692-700.

Ward EM, Fedewa SA, Cokkinides V, Virgo K. “The Association of Insurance and Stage of Diagnosis among Patients Aged 55 to 74 Years in the National Cancer Database.” Cancer Journal. 16(2010): 614­-621.

Zeng F et al. “The Effect of Medicare Health Maintenance Organizations on Hospitalization Rates for Ambulatory Care-Sensitive Conditions.” Medical Care. 44(2006): 900-907.