Optum patients who are in a two-sided risk Medicare Advantage plan have better health outcomes than patients enrolled in traditional Medicare, according to a study published in JAMA Network Open.
The study was published Dec. 12 and compared claims data from MA patients under the financial and clinical responsibility of Optum to claims data from FFS Medicare patients.
The claims data was from Jan. 1, 2018, to Dec. 31, 2019, from more than 316,000 beneficiaries across six states who were enrolled in a two-sided risk MA model or in a FFS Medicare program. The data was analyzed from Feb. 1 to June 15, 2022.
Physicians operating within Optum's two-sided risk MA model provided higher care quality and efficiency across eight metrics compared to physicians practicing under FFS.
The MA enrollees had 18 percent lower odds of inpatient admission, 6 percent lower inpatient admission rates through the emergency department, 11 percent fewer ED visits, 14 percent fewer avoidable ED visits, a 9 percent lower 30-day inpatient readmission rate, 10 percent lower odds of admission for stroke or myocardial infarction, and a 44 percent less chance of hospitalization for chronic obstructive pulmonary disease or asthma exacerbation.