News-Medical.Net October 8, 2024
New findings from a team of renowned researchers calls for transparency and rigorous oversight of the U.S. Medicare Advantage (MA) program, the United States’ largest healthcare capitation program.
The new research, published in the INFORMS journal Manufacturing & Service Operations Management, finds evidence that some MA health plans conduct strategic cross-subsidization, offering extra benefits in some areas to attract healthier, less costly patients, while providing fewer benefits to sicker patients. Through such strategic cross-subsidization, health plans can unfairly increase their profits resulting in reduced care quality for sicker patients and obvious inequity in care.
Our findings open the black box of Medicare Advantage operations, revealing a previously unknown resource misallocation problem.”
“Our work underscores the urgent need for...
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