August 26, 2022
Payers
  • A study published in JAMA Open Network found spending discrepancies between Medicare Advantage (MA) enrollees and those enrolled in a Medicare Shared Savings Program (MSSP). Based on an evaluation of 15,763 patients at Ochsner Health System, the authors found that spending for MSSP recipients was 22 percent to 26 percent higher compared to MA beneficiaries. They suggested that the cost disparity could be due to the program’s design differences – for example, at the time of the study the MSSP program included post-acute care in primary care services and because MA has more “levers” it can use to control costs. The authors also pointed out that health system participation in MA may also be more favorable than MSSP because of an inability to manage nonclinical risk factors. (Study here)