Immediate release: November 4, 2024
BOSTON, Mass.—Medicare Advantage (MA) plans save billions of federal dollars by enrolling veterans who do not receive Medicare services, according to a new study led by Harvard University’s T.H. Chan School of Public Health. It became clear that he had received it. This study highlights the growing prevalence of advanced VA plans (defined as plans where 20% or more of enrollees are veterans) and their impact on veteran care, and the federal suggests that the increase in veterans’ health care costs is doubling. .
of study Published in Health Affairs on Monday, November 4th.
“As veterans grapple with increasingly complex health care options, our research aims to inform policymakers and stakeholders about the urgent need to optimize the use of federal resources in VA health care. ” said corresponding author Jose Figueroa, associate professor of health policy and management. “This is especially important given the significant budget constraints currently facing the Veterans Affairs system.”
Researchers used a variety of data from the Centers for Medicare and Medicaid Services (CMS) and the Veterans Health Administration (VHA) to examine veterans’ health insurance enrollment and utilization, as well as federal costs. . They found that the number of veterans enrolled in MA plans increased between 2016 and 2022, with a significant increase in the number of senior veterans enrolled in MA plans. Approximately one in five veterans enrolled in these VA plans did not receive any MA-paid Medicare services within a given period of time. This is more than double the rate for veterans in other MA plans and nearly six times the rate for the general MA population. Instead, enrolled veterans were much more likely to receive care at a VHA facility.
In 2020 alone, CMS paid more than $1.32 billion to MA plans to enroll veteran enrollees without Medicare services. This is an increase of nearly 60% from 2016. Almost 20% of that funding was disproportionately directed to veteran MA plans. . According to the researchers, this finding is important given that MA plans pay full capitation payments (a fixed amount per patient, regardless of service use) to cover comprehensive care. They say it raises concerns about the efficiency of federal health spending. Meanwhile, the Veterans Administration is prohibited from billing MA plans for Medicare-covered services.
“Our study has important policy implications for leaders interested in improving the efficiency of federal resources for veteran care,” Figueroa said. “This result highlights the considerable extent to which federal spending on MA plans to enroll veterans without Medicare services is wasteful and duplicative.”
“The growth in veteran MA plans highlights the need to reduce potentially wasteful payments and strengthen health care coordination between CMS and VHA, especially as MA plan enrollment continues to grow. ” added lead author Yanley Ma, a researcher at the Ministry of Health. Policy and Management.
Harvard Chan’s other authors include Jessica Phelan, Thomas Tsai, and Austin Fracht.
“Medicare Advantage Plans for Veterans: Enrollment, Utilization, and Potential Waste” by Yanley Ma, Jessica Phelan, Kathleen Yujin Chung, Thomas C. Tsai, Austin B. Fracht, and Stephen. D. Peiser, Melissa M. Garrido, Alison Dorneo, Jose F. Figueroa, Health Affairs, November 4, 2024, doi: 10.1377/hlthaff.2024.00302
Visit the Harvard Chan School website for the latest news, press releases, and events from our studio.
Photo: iStock/Julio Tamayo
For more information:
maya brownstein
[email protected]
###
The Harvard T.H. Chan School of Public Health brings together passionate experts from many fields to educate a new generation of global health leaders and generate powerful ideas that improve the lives and health of people everywhere. I am. As a community of leading scientists, educators, and students, we work together to bring innovative ideas from the lab into people’s lives, making not only scientific advances, but also personal action, public policy, and innovation. We are also working to change medical practice. Each year, the Harvard Chan School has more than 400 faculty members who teach more than 1,000 full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officials, the school is known as America’s oldest professional training program in public health.
