Medicare Advantage Plans have Fewer Cardiovascular Procedures: Study

Medicare Advantage Plans have Fewer Cardiovascular Procedures: StudyAccording to a study, Medicare Advantage plans tallied for fewer cardiovascular procedures than those that pay per-service. Medicare Advantage plans pay for per patient.

The study showed that there were 36% fewer angiographies and 30% fewer percutaneous coronary intervention procedures for Capitated Medicare Advantage patients in comparison to those enrolled in traditional Medicare fee-for-service plans after adjusting for age, sex, race, and income. Daniel Matlock, MD, MPH, of the University of Colorado Denver, and colleagues revealed the figures.

The findings were reported in the July 10 issue of the Journal of the American Medical Association by the researchers. Similar rates were found between plans for coronary artery bypass graft surgery and urgent procedures.

Capitated plans in the Medicare Advantage program covers nearly a quarter of Medicare beneficiaries nationwide. The group wrote, "Capitation in various forms is anticipated to be an effective means of reducing future healthcare cost growth, particularly cost growth resulting from unnecessary care".

The researchers said that capitation alone can't be sought as a reason for reductions in the wide variations seen in use of cardiovascular procedures.

Harlan Krumholz is an MD of Yale University School of Medicine, cautioned in an accompanying editorial. Harlan said that fewer procedures do not always mean better care because it also indicates availability of fewer appropriate procedures.