Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 1;7(7):e2423733.
doi: 10.1001/jamanetworkopen.2024.23733.

Medicare Advantage Plan and Health System Vertical Integration, 2011-2020

Geronimo Bejarano  1 , Andrew Ryan  1 , Amal Trivedi  1   2 , Kendra Offiaeli  1 , David J Meyers  1
Affiliations

Medicare Advantage Plan and Health System Vertical Integration, 2011-2020

Geronimo Bejarano et al. JAMA Netw Open. .
No abstract available

Plain language summary

This cross-sectional study compares the beneficiary and plan characteristics and trends in enrollment, premiums, star ratings, and benefits of nonintegrated, non–legacy-integrated, and legacy-integrated Medicare Advantage plans between 2011 and 2020.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Trivedi reported receiving grants from the National Institute on Aging during the conduct of the study. No other disclosures were reported.

Figures

Figure.
Figure.. Trends in Enrollment by Integration Status and Race and Ethnicity, 2011-2020
A, Enrollment in non–legacy- and legacy-integrated Medicare Advantage (MA) plans. B, Enrollment in non–legacy-integrated MA plans by race and ethnicity. C, Enrollment in legacy-integrated MA plans by race and ethnicity. Legacy-integrated MA plans are for beneficiaries in Kaiser Permanente, Intermountain Health, or Geisinger. Non–legacy-integrated MA plans are for beneficiaries in all other integrated MA plans. The vertical integration dataset and Medicare Beneficiary Summary File datasets were used to calculate enrollment. The vertical integration dataset and Medicare Beneficiary Summary File datasets were used to calculate enrollment. The RTI International race and ethnicity variable from the Medicare Beneficiary Summary File was used for stratification. aOther includes any other race or ethnicity not included in the options.
See this image and copyright information in PMC

References

    1. Ochieng N, Biniek JF, Freed M, Damico A, Neuman T. Medicare Advantage in 2023: enrollment update and key trends. KFF. August 9, 2023. Accessed November 22, 2023. https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2023-enro...
    1. Johnson G, Lyon ZM, Frakt A. Provider-offered Medicare Advantage plans: recent growth and care quality. Health Aff (Millwood). 2017;36(3):539-547. doi: 10.1377/hlthaff.2016.0722 - DOI - PubMed
    1. Park S, Langellier BA, Meyers DJ. Differences between integrated and non-integrated plans in Medicare Advantage. Health Serv Res. 2023;58(3):560-568. doi: 10.1111/1475-6773.14101 - DOI - PMC - PubMed
    1. Frakt AB, Pizer SD, Feldman R. Plan-provider integration, premiums, and quality in the Medicare Advantage market. Health Serv Res. 2013;48(6, pt 1):1996-2013. doi: 10.1111/1475-6773.12076 - DOI - PMC - PubMed
    1. Welch WP, Sen AP, Bindman AB. Concentration of physician services across insurers and effects on quality: early evidence from Medicare Advantage. Med Care. 2019;57(10):795-800. doi: 10.1097/MLR.0000000000001193 - DOI - PubMed

Publication types