Health-related Quality of Life and Quality of Care in Specialized Medicare-managed Care Plans

Published In: Journal of Ambulatory Care Management, v. 36, no. 1, Jan.-Mar. 2013, p. 72-84

Posted on RAND.org on January 01, 2013

by Susan C. Grace, Marc N. Elliott, Laura Giordano, James N. Burroughs, Rochelle L. Malinoff

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Special needs plans (SNPs) were created under the Medicare Modernization Act of 2003 to focus on Medicare beneficiaries who required more coordination of care than most beneficiaries served through the Medicare Advantage program. This research indicates that beneficiaries in 3 types of SNPs show evidence of worse health-related quality of life. Special needs plans demonstrated worse plan performance on the HEDIS osteoporosis testing in older women measure compared with non-SNP Medicare Advantage beneficiaries, but better plan performance on the HEDIS fall risk management measure. Future research should consider broader measures of plan performance, quality of care, and cost.

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