REPORT: The Medicare Advantage Experience

Alliance: 12/13/12

ATLANTA- The most effective way to slow Medicare spending is to reduce the cases of preventable chronic conditions and incorporate evidence-based care coordination into the traditional Medicare program.

Kenneth E. Thorpe, PhD, professor of Health Policy and Management at Emory’s Rollins School of Public Health along with colleague Daniel Perry, president and CEO of the Alliance for Aging Research, suggest adopting specific initiatives such as transitional and team-based care, comprehensive medication therapy management, and health coaching to slow the growth in spending and improve quality of care. The team will host a teleconference on Thursday, December 13 from 10:30 a.m. – 11 a.m. to discuss these recommendations.

Most spending in the Medicare program is for treatment of chronically ill patients. The high prevalence of chronic disease, such as diabetes, is a key contributor to the growth of Medicare costs.

“Since Medicare and Medicaid account for nearly 40 percent of the projected rise in federal costs over the next decade, slowing the growth in federal health care spending is imperative for reducing the federal budget deficit,” says Thorpe, who also serves as co-chair of the Partnership for the Future of Medicare. “Intentional changes in the Medicare program are necessary and the reform discussion must include ways to incorporate modernized healthcare delivery.”

Despite the primary role of chronic diseases in Medicare spending, the program does not provide care coordination or cover lifestyle-related preventive benefits for most patients. The paper discusses the integration of a team-based healthcare model as the best way to improve patient care and health outcomes. Read More