Value-based models tied to less acute care in Medicare Advantage enrollees, study finds

Becker's Healthcare March 17, 2022
Jakob Emerson

Value-based payment models were “significantly associated with lower acute care use” in Medicare Advantage beneficiaries, according to a study published March 17 by Humana researchers.

The Louisville, Ky.-based payer found that Medicare Advantage beneficiaries under a two-sided risk value-based payment model had lower rates of hospitalizations, observation stays and emergency department visits compared to fee-for-service Medicare beneficiaries.

The study was conducted using data from 489,796 of Humana’s Medicare Advantage beneficiaries. Nearly 17 percent of enrollees were under a fee-for-service plan, 32 percent were under an upside-only risk plan, and 51 percent were under a two-sided risk plan.

Adjusted analyses showed:

• The rate of emergency department visits per 1,000 patients for two-sided risk models was 375.8, compared with 434.1...

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