Research
The Health Care Transformation Hub elevates peer-reviewed and top-tier, reliable research from some of the leading researchers across the health care industry. Explore their findings and insights below.
American Journal of Managed Care
Health Outcomes Under Full-Risk Medicare Advantage vs Traditional Medicare
K. Cohen, B. Vabson, et al. | May 2025
Peer-reviewed study showing Medicare Advantage enrollees whose physicians were under fully accountable models — taking full risk for the costs and quality of their care — have superior outcomes in 16 of 20 measures, including up to 43% fewer hospitalizations for patients with acute chronic conditions and 19% fewer avoidable ED visits.
American Journal of Managed Care
Potential Spillover Effects on Traditional Medicare When Physicians Bear Medicare Advantage Risk
B. Vabson, K. Cohen, et al. | February 2025
This study is the first to demonstrate the advantages of value-based care can extend — or “spill over” — beyond Medicare Advantage patients to other Medicare recipients. These benefits include fewer hospitalizations for chronic illnesses, fewer emergency visits, more wellness visits and better medication adherence.
JAMA Network Open
Medicare Risk Arrangement and Use and Outcomes Among Physician Groups
K. Cohen, B. Vabson, et al. | January 2025
This study compared Medicare Advantage (MA) enrollees who received care in two-sided value-based care arrangements with those who received care in fee-for-service MA. The findings demonstrate MA full-risk value-based care arrangements are associated with higher-quality clinical care and better health results than the traditional MA model.
Health Affairs
Differences In Use Of Services And Quality Of Care In Medicare Advantage And Traditional Medicare, 2010 And 2017
B. Landon, A. Zaslavsky, et al. | April 2023
This analysis compared Medicare Advantage (MA) HMO and PPO data and traditional Medicare data across a range of established quality and utilization measures. The authors found MA plans delivered superior clinical quality, improved patient-reported outcomes and lower utilization of health services compared to traditional Medicare.
Health Affairs
Comparing Medicare Advantage And Traditional Medicare: A Systematic Review
R. Agarwal, J. Connolly, et al. | June 2021
A literature review comparing Medicare Advantage (MA) to traditional Medicare. MA plans outperformed traditional Medicare in almost all areas of analysis, including higher rates of preventive visits, fewer ED visits and higher breast cancer screening rates.
JAMA Network Open
Comparison of Care Quality Metrics in 2-Sided Risk Medicare Advantage vs Fee-for-Service Medicare Programs
K. Cohen, O. Ameli, et al. | December 2022
This study compared Optum patients in fully accountable Medicare Advantage plans with a national random sample of administrative claims data for patients served by traditional Medicare fee-for-service. In every metric examined, the health of patients in Optum’s care model showed statistically significant improvements.
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