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April 7, 2014

HSR&D Investigators Receive Health Services Research John M. Eisenberg Article-of-the-Year Award

HSR&D investigators Austin Frakt, Ph.D., and Steven Pizer, Ph.D., part of Health Care Financing & Economics (HCFE) located at the VA New England Healthcare System in Boston MA, and their colleague, Roger Feldman, Ph.D., part of the School of Public Health at the University of Minnesota, will receive the Health Services Research (HSR) journal's 2013 John M. Eisenberg Article-of-the-Year Award for their paper titled "Plan Provider Integration, Premiums, and Quality in the Medicare Advantage Market ." The paper assesses the relationship between plan-provider integration (i.e., plans and providers that are owned or controlled by the same entity) and quality, premiums, and benefits. The study is relevant to the developing health industry landscape because the Affordable Care Act includes incentives for plan-provider integration, which is, therefore, expected to become more prevalent. Using data from the Centers for Medicare and Medicaid Services, key findings from the paper include:

  • Medicare Advantage plans that are fully integrated with providers offer higher quality, relative to plans that are not integrated with providers. However, controlling for their quality, such plans charge higher premiums.
  • Integration is associated with an increase of $28 per month in premiums and a monetized increase of just under $8 per month in quality. Consequently, about 70% of the total premium difference between integrated and non-integrated plans is not attributable to quality.
  • Investigators found no evidence that integration is associated with more generous benefits.

HSR established the John M. Eisenberg Article-of-the-Year Award in 2003 to recognize excellent and original research among all articles published in the Journal during the year prior to the award. Awardees are selected by the Co-Editors-in-Chief and the Senior Associate Editors, based on the overall quality of the article and its relevance to policy-relevant areas that Dr. Eisenberg had worked in or promoted during his tenure as Director of the Agency for Healthcare Research and Quality (AHRQ).

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