Health Affairs September 1, 2024
Kaylyn E. Swankoski, Amanda Sutherland, Emily Boudreau, Yong Li, Melanie Canterberry, J. Michael McWilliams, Vivek Garg, Brian W. Powers

Abstract

Population-based payment in Medicare Advantage (MA) can foster innovation in care delivery by giving risk-bearing providers flexibility and strong incentives to enhance care and engage patients. This may particularly benefit historically underserved groups for whom payments often exceed costs. In this study, using data from Humana MA plans, we examined “senior-focused” primary care organizations that are supported predominantly by population-based payments in contracts with MA plans. We explored whether such organizations supported by such payment are associated with better care and improved equity compared with other primary care...

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Topics: Insurance, Medicare Advantage, Patient / Consumer, Primary care, Provider
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