Medicaid Managed Care - U.S. Senate Special Committee on Aging

Medicaid Managed Care - U.S. Senate Special Committee on Aging Medicaid Managed Care - U.S. Senate Special Committee on Aging

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29.07.2013 Views

154 INTERPRETATION OF RESULTS * Equivalent health outcomes for average HMO and FFS patient do not hold for Medicare or poverty groups * Previous studies that followed Medicare patients for only one year may have been too brief POLICY IMPLICATIONS * Favorable overall HMO experience to date may not generalize to chronically ill elderly and poor * ong>Medicaidong> coverage did not explain worse outcomes for poor in HMOs * Health outcomes should be reported on a planby-plan basis sen71597.ppt p.

44-098 97 - 6 155 NCQA "HEALTH OF SENIORS" MEASURE (HEDIS 3.0) INCORPORATES LATEST MOS ADVANCES * Summarizes SF-36 physical and mental health outcomes * Two-year follow-up of 1 000/plan * Uses standardized risk adjustment * Reports plan-level results publicly sen71597.pptp. 11

154<br />

INTERPRETATION OF RESULTS<br />

* Equivalent health outcomes for average HMO and<br />

FFS patient do not hold for Medicare or poverty<br />

groups<br />

* Previous studies that followed Medicare patients<br />

for <strong>on</strong>ly <strong>on</strong>e year may have been too brief<br />

POLICY IMPLICATIONS<br />

* Favorable overall HMO experience to date may<br />

not generalize to chr<strong>on</strong>ically ill elderly and poor<br />

* <str<strong>on</strong>g>Medicaid</str<strong>on</strong>g> coverage did not explain worse<br />

outcomes for poor in HMOs<br />

* Health outcomes should be reported <strong>on</strong> a planby-plan<br />

basis<br />

sen71597.ppt p.

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