Bitte verwenden Sie diesen Link, um diese Publikation zu zitieren, oder auf sie als Internetquelle zu verweisen: https://hdl.handle.net/10419/336732 
Erscheinungsjahr: 
2026
Schriftenreihe/Nr.: 
GLO Discussion Paper No. 1716
Verlag: 
Global Labor Organization (GLO), Essen
Zusammenfassung: 
Failure to account for the full complexity and costs of high-need populations in the risk-adjusted capitated payment model for Medicare Advantage (MA) plans may create financial disincentives for plans to invest in comprehensive care for affected beneficiaries, potentially exacerbating health disparities. This paper leverages the reinstatement of Alzheimer's Disease and Related Dementias (ADRD) hierarchical condition category (HCC) into the MA risk-adjusted payment model in 2020 as a quasi-natural experiment to study how risk-adjustment model affects access, affordability, and quality of care. Using MA beneficiaries in the Medicare Current Beneficiary Survey (2015-2022), we perform a difference-in-differences analysis by comparing beneficiaries with ADRD with those without ADRD but with similar neurologic conditions. We find that the revised risk-adjusted payment model is associated with a 6.6 percentage-point decrease in reporting any troubles accessing needed care and a 9.2 percentage-point decrease in reporting any medical financial burden among MA beneficiaries with ADRD. Its effects on satisfaction with access to specialists and satisfaction with overall quality of care are not notable. These findings suggest that refining risk adjustment to better capture the costs of chronic and complex conditions can help align MA plan incentives with the needs of vulnerable populations and promote equity in care.
Schlagwörter: 
Medicare Advantage
Risk Adjustment
ADRD
Care Experiences
JEL: 
I13
I12
I18
I14
Dokumentart: 
Working Paper

Datei(en):
Datei
Größe
3.84 MB





Publikationen in EconStor sind urheberrechtlich geschützt.