At-Risk Medicare Advantage Plans Showed Better Outcomes For Dual Eligibles Than Traditional Medicare

At-risk Medicare Advantage (MA) plans for members dually eligible for Medicare and Medicaid (dual eligibles) had higher quality and efficiency than traditional Medicare and fee-for-service (FFS) MA plans for dual eligibles. Those enrolled in at-risk MA plans for dual eligibles had significant reductions in avoidable hospital and emergency department visits.

The differences in quality and efficiency among Medicare options for dual eligibles were reported in a cross-sectional study. Unlike most MA plans, an FFS MA plan does not restrict members’ choice of provider organization to a specific network or permit the use of prior authorization . . .