More data is necessary to evaluate the quality of care Medicare Advantage beneficiaries with serious illnesses receive, a group of researchers wrote in the New England Journal of Medicine.
In a piece published May 6, researchers wrote that data is missing on the quality of care in Medicare Advantage and the availability of supplemental benefits, which are often used by beneficiaries with serious illness.
The researchers also said there are issues with CMS' quality bonus program, which rates plan quality and provides bonus payments to high-quality plans. The program undersamples enrollees with serious illnesses like dementia, and there is not enough granular data provided on a plan, rather than contract, level, the researchers said.
In a news release, Claire Ankuda, MD, assistant professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City, and the first author on the piece, said she is worried the quality bonus program does not capture the voices of people with serious illness.
"If the program is not hearing from these adults, or factoring in their experiences, the accuracy of their reporting has a true missing piece," Dr. Ankuda said.
In the future, government agencies could commission more research on care quality in Medicare Advantage, the researchers wrote. For more immediate solutions, more quality data could be added to Medicare's plan finder website, and CMS could require plans to report more data on supplemental benefits.
"With Medicare Advantage growing disproportionately among Black and Latino beneficiaries, there is strong cause for concern that any quality deficiencies in the program will widen and reinforce the racial and ethnic disparities in quality of care that we have been working so hard to address," Dr. Ankuda said.
The viewpoint was authored by researchers at the Icahn School of Medicine at Mount Sinai, Weill Cornell Medical College, and the James J. Peters Veterans Affairs Medical Center in New York City; the Perelman School of Medicine in Philadelphia; Harvard Medical School in Boston; Providence, R.I.-based Brown University School of Public Health; Vanderbilt University and the Veterans Affairs Tennessee Valley Healthcare System in Nashville; and the Arilington, Va.-based RAND Corporation.