title: Comparing quality of care in the Medicare program.
abstract: OBJECTIVE
  To compare the clinical quality of care between Medicare fee-for-service (FFS) and Medicare Advantage (MA) programs.
  
  
  METHODS
  We compared 11 Healthcare Effectiveness Data and Information Set (HEDIS) quality measures nationwide for MA managed care plans and the FFS program in 2006 and 2007. We adjusted FFS measures to match the geographic distribution of MA.
  
  
  RESULTS
  Medicare Advantage plans scored substantially better (4-16 percentage points; median, 7.8 percentage points) on 8 measures, slightly better (1.5 percentage points) on 1 measure, and worse than FFS (2-5 percentage points; median, 4.1 percentage points) on 2 measures. The 8 measures on which MA scored substantially better were well established in the HEDIS measure set (introduced in the 1990s), whereas the other 3 were all newer (introduced in 2004-2005 data). Data and program differences complicated the comparison, but it is unlikely that they were large enough to explain the sizable MA-FFS gaps observed.
  
  
  CONCLUSIONS
  Quality measures showed large, though mixed, differences between MA and FFS. The dichotomy between older and newer measures in MA suggests a learning effect, with plans improving measurement and quality over time as measures become more familiar.
authors.affiliation: The Brookings Institution, Washington, DC, USA. niall.brennan@cms.hhs.gov
authors.forename: Niall
authors.initials: N
authors.lastname: Brennan
authors.forename: Mark
authors.initials: M
authors.lastname: Shepard
mesh_terms: D019985:Benchmarking; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D007345:Insurance Claim Review; D006278:Medicare / Q000706:statistics & numerical data*; D015397:Program Evaluation / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D016903:Drug Monitoring