Thursday, June 09, 2016

Two types of Medicare users

A third of Medicare enrollees get their coverage through plans run by insurance companies, not the 80-20 deal of straight Medicare.

But it has been pointed out that the groups are not the same. Writing in JAMA Internal Medicine, a group at the University of Michigan found, among other things, that the groups differed in coverage use in the last six months of life.

The ones in Advantage Plans--operated by insurance companies--were younger and healthier than those in the traditional "fee for service" Medicare.

These users also were more likely to be black, live in cities, and not qualify for Medicaid.

Yet, health policy decisions are made by looking at data from traditional Medicare. It's easier to get that information.

This could mean policy makers are overestimating the severity of illness for Medicare patients in general.

The study team looked at data from 9,285 participants between 1998 and 2012. A fourth of that sample had Advantage.

The upshot is we should not base decisions on 3/4s of the users. Or as it pertains overall--2/3s of the users.

When, oh when, will someone get all this right?

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