Medicare Advantage outperforms traditional with diabetes outcomes, study finds

Medicare Advantage patients may receive high-quality and more effective diabetes care compared to fee-for-service (FFS) enrollees, according to a new study from Avalere Health and the Better Medicare Alliance, a pro-MA advocacy group.

The study was released Jan. 10 and included data from nearly 400,000 MA and FFS enrollees with prediabetes, over 320,000 MA and FFS enrollees with incident diabetes, and over 2.2 million MA and FFS enrollees with chronic diabetes.

Prediabetes is when a patient has a prediabetes diagnosis, incident diabetes is a type 2 diagnosis, and chronic diabetes is having type 2 for more than one year.

Five key takeaways:

  • For MA patients with prediabetes that later developed into type 2, they received a diagnosis quicker than FFS (401 days vs. 543 days) and had a lower severity score at diagnosis.

  • MA patients with incident diabetes were more likely than FFS patients to fill diabetes treatment prescriptions in their first year of diagnosis.

  • MA patients with chronic diabetes were more likely than FFS patients to receive preventive care and were less likely to require dialysis. Primary care visits were about the same.

  • MA patients with prediabetes and diabetes saw fewer emergency department visits and hospital admissions compared to FFS patients.

  • MA patients had lower total medical spending than FFS patients, but MA patients with diabetes had higher diabetes-related spending.


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