Study Throws Shade at Fee-for-Service in Medicare Advantage

MedPage Today September 26, 2025
Shannon Firth

All clinical quality outcomes tested favored value-based payment models

Key Takeaways

• Among more than 3 million Medicare Advantage enrollees, value-based payment models outperformed fee-for-service models for all 15 clinical quality outcomes.
• The mean score differences for blood glucose control and blood pressure control indicated “markedly better performance” with value-based payment models.
• Clinical quality performance consistently improved as financial arrangements moved toward 2-sided risk sharing.

Value-based payment models beat fee-for-service models in clinical quality outcomes among Medicare Advantage (MA) members, especially with 2-sided risk sharing, according to a retrospective cross-sectional study.

Among more than 3 million MA enrollees, value-based payment models outperformed fee-for-service models for all 15 clinical quality outcomes, with a mean score difference of +6.7% (all P<0.001),...

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