Researchers find reason for cautious optimism in the first longitudinal study of vertically integrated Medicare Advantage programs.
The number of healthcare systems seeking to sponsor their own insurance plans has seen a recent resurgence, as systems seek efficiencies through more coordinated, better-streamlined care.
The first longitudinal study of such models tracks vertically integrated Medicare Advantage contracts operating between 2011 and 2015. The results, published in Health Affairs, suggest that vertical integration is at least as effective as other models in terms of care quality and enrollee satisfaction.
Their findings showed vertically integrated contracts outperform others most significantly in areas related to enrollee satisfaction. However, the authors are “are unable to assert that vertical integration itself causes higher quality.”
Real-world evidence for the rosiest scenarios remains mixed, and the authors note that their data tracked a decreasing effect during the study period. The number of vertically integrated plans, while growing, still is not high, limiting the amount of data available. Other studies have found provider-led plans lose money, though industry analysts still see growth opportunities in the model.
The study’s authors conclude that the future of vertically integrated plans will likely hinge on whether they deliver enough of an improvement in care quality to justify their costs, particularly as they grow and consolidate their power within the marketplace.