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Medicare Advantage (MA) and traditional Medicare are frequently compared, and those comparisons increasingly shape Medicare policy. Most of them skip a basic question: Do the two programs serve the same kinds of people?
In this session, Christie Teigland, Ph.D., Vice President of Research Science and Advanced Analytics at Inovalon®, shares new research showing that MA enrollees start out sicker and more socially vulnerable. Her team used three years of pre-Medicare health history, neighborhood-level social risk data, and propensity matching to compare members who actually look alike. Once they did, MA’s lead on 30-day readmissions and preventable hospitalizations grew.
Sari Siegel, Ph.D., of AHIP and Fredric Blavin, Ph.D., of the Blue Cross Blue Shield Association, join her to talk through what the findings mean for health plans, policymakers, and quality measurement.
If you own quality performance at a health plan or design real-world evidence studies, this session is for you.
Learn why traditional Medicare's 30-day readmission rate was 126% higher than MA's once members were matched.
See how MA enrollees entered Medicare with more chronic conditions and greater social risk than those who chose traditional Medicare.
Get practical guidance on breaking out quality results by age, sex, chronic conditions, and social drivers of health to see where your programs are working and where targeted support will help most.
Explore the study design, from a three-year look-back to propensity matching, that makes real-world comparisons more defensible.
Medicare Advantage (MA) and traditional Medicare are frequently compared, and those comparisons increasingly shape Medicare policy. Most of them skip a basic question: Do the two programs serve the same kinds of people?
In this session, Christie Teigland, Ph.D., Vice President of Research Science and Advanced Analytics at Inovalon®, shares new research showing that MA enrollees start out sicker and more socially vulnerable. Her team used three years of pre-Medicare health history, neighborhood-level social risk data, and propensity matching to compare members who actually look alike. Once they did, MA’s lead on 30-day readmissions and preventable hospitalizations grew.
Sari Siegel, Ph.D., of AHIP and Fredric Blavin, Ph.D., of the Blue Cross Blue Shield Association, join her to talk through what the findings mean for health plans, policymakers, and quality measurement.
If you own quality performance at a health plan or design real-world evidence studies, this session is for you.
Learn why traditional Medicare's 30-day readmission rate was 126% higher than MA's once members were matched.
See how MA enrollees entered Medicare with more chronic conditions and greater social risk than those who chose traditional Medicare.
Get practical guidance on breaking out quality results by age, sex, chronic conditions, and social drivers of health to see where your programs are working and where targeted support will help most.
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Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
Presenter wrap-up call to action
Vice President, Research Science and Advanced Analytics, Inovalon
Christie has been dedicated to improving the outcomes and economics of healthcare for over 25 years. An economist and research statistician, she works with health plans, providers, and life science organizations to provide actionable, real-world data insights on performance measure development and testing, health disparities/equity, predictive analytics, comparative effectiveness, treatment patterns, and more. She serves as co-chair of the National Quality Forum Scientific Methods Panel and is a member of the Pharmacy Quality Alliance Quality Measure Expert Panel.
Senior Vice President of Research, AHIP
Sari leads AHIP’s Center for Policy Research, where she sets and carries out the organization’s policy research agenda. Before AHIP, Sari ran the Medicare and Medicaid research portfolios at AARP’s Public Policy Institute. She also held leadership roles at Optum Serve (formerly The Lewin Group) and Westat, directing research for health plans and federal clients across the U.S. Department of Health and Human Services. She has written two books on access to care for low-income populations and has published or presented more than 100 peer-reviewed studies.
Associate Vice President, Research and Policy Development, Blue Cross Blue Shield Association
Fred recently joined the Blue Cross Blue Shield Association after nearly 15 years at the Urban Institute, most recently as a senior fellow in its Health Policy Division. A health economist, he has studied private insurance markets, healthcare reform, healthcare spending, provider supply, and Medicaid and Children’s Health Insurance Program policy. Earlier in his career, Fred was an economist at the Office of the National Coordinator for Health Information Technology within the U.S. Department of Health and Human Services. He holds a Ph.D. in managerial science and applied economics from the University of Pennsylvania.
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Vice President, Research Science and Advanced Analytics, Inovalon
Christie has been dedicated to improving the outcomes and economics of healthcare for over 25 years. An economist and research statistician, she works with health plans, providers, and life science organizations to provide actionable, real-world data insights on performance measure development and testing, health disparities/equity, predictive analytics, comparative effectiveness, treatment patterns, and more. She serves as co-chair of the National Quality Forum Scientific Methods Panel and is a member of the Pharmacy Quality Alliance Quality Measure Expert Panel.
Senior Vice President of Research, AHIP
Sari leads AHIP’s Center for Policy Research, where she sets and carries out the organization’s policy research agenda. Before AHIP, Sari ran the Medicare and Medicaid research portfolios at AARP’s Public Policy Institute. She also held leadership roles at Optum Serve (formerly The Lewin Group) and Westat, directing research for health plans and federal clients across the U.S. Department of Health and Human Services. She has written two books on access to care for low-income populations and has published or presented more than 100 peer-reviewed studies.
Associate Vice President, Research and Policy Development, Blue Cross Blue Shield Association
Fred recently joined the Blue Cross Blue Shield Association after nearly 15 years at the Urban Institute, most recently as a senior fellow in its Health Policy Division. A health economist, he has studied private insurance markets, healthcare reform, healthcare spending, provider supply, and Medicaid and Children’s Health Insurance Program policy. Earlier in his career, Fred was an economist at the Office of the National Coordinator for Health Information Technology within the U.S. Department of Health and Human Services. He holds a Ph.D. in managerial science and applied economics from the University of Pennsylvania.
Director of Market Engagement and Growth, National Committee for Quality Assurance
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
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Medical Software Specialist
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Medical Software Specialist