Measuring Value-Added Quality in Medicare Advantage Contracts

• Activity Number: 174 - Statistical Methods to Assess the Performance of Health Providers
• Type: Contributed
• Date/Time: Monday, July 29, 2019 : 10:30 AM to 12:20 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Matthew Brault* and Alan M. Zaslavsky and Bruce E. Landon
• Companies: Harvard University and Harvard Medical School and Harvard University Medical School
• Keywords: Medicare Advantage; Value-added; Quality; CAHPS

Abstract

Since the passage of the Affordable Care Act, Medicare Advantage (MA) quality measures have helped determine the per-beneficiary payment to plans, with high-quality ones receiving a bonus percentage. Plan quality, however, can reflect the underlying health care system of the areas in which contracts are offered and so existing methods may unfairly reward plans. This paper attempts to measure value-added quality in MA contracts; that is, how MA quality scores differ from how one might expect an average plan to perform in the same contract area. Using Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data from MA plans and Fee-for-service (FFS) beneficiaries, we examine the geographic variation in quality scores and propose several measures of value-addedness. We then assess correlations between the new measures and their relationships with other health information.