![]() ![]() Our findings emphasize the important role that TM plays in the MA market and that TM payment changes could have a spillover effect on MA prices and spending.Īm J Manag Care. Similarity between MA and TM prices appears to be stable over time, despite recent policy changes. This holds even as the generosity of MA plan payment changes. We also find that even as MA benchmarks (relative to local fee-for-service spending) increase, the median price ratio for office visits remains close to 1.00.Ĭonclusions: After analyzing claims for common physician services, we find that employer-sponsored MA plans pay prices that are similar to TM rates. Results: For both services, the estimated median price ratio is close to 1.00. In a subanalysis, we disaggregate the result for office visits by MA benchmark generosity. ![]() We then construct an MA-to-TM price ratio for each MSA and report the median price ratio. For a given service, we identify the prices paid by MA plans and by TM in a metropolitan statistical area (MSA), which is our definition of a market. Methods: We focus on claims for low-complexity office visits with an established patient (Current Procedural Terminology code 99213) and electrocardiograms (CPT code 93000). Study Design: Descriptive analysis of medical claims data from the 2014-2015 MarketScan Medicare Claims Database. Objectives: To compare the prices paid to physicians by employer-sponsored Medicare Advantage (MA) plans with those paid by traditional Medicare (TM) and to determine whether the relationship between MA and TM prices is affected by the generosity of MA benchmarks. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |