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Effects Of Medicare Advantage On Health Care Use And Outcomes Among Retired State Employees In 5 States
Peter J Huckfeldt1, Tyler Boese2, Victoria Shier3
1Peter J. Huckfeldt (huckfeld@umn.edu), University of Minnesota, Minneapolis, Minnesota.
Health Affairs (Project Hope)
|August 3, 2026
Summary
Medicare Advantage (MA) plans may improve efficiency by increasing outpatient services and reducing hospital admissions for state retirees. This study examined a natural experiment showing shifts in healthcare utilization without affecting mortality.
Area of Science:
- Health Services Research
- Public Health Policy
- Gerontology
Background:
- Medicare Advantage (MA) plans utilize capitated payments, potentially enhancing efficiency over traditional Medicare.
- Existing research on MA plan impacts is limited by cross-sectional designs and potential selection bias.
- Understanding MA plan effects on healthcare utilization and outcomes is crucial for policy and beneficiaries.
Purpose of the Study:
- To evaluate the impact of a large-scale shift to Medicare Advantage (MA) plans on healthcare utilization and mortality among retired state employees.
- To leverage a natural experiment involving five states transitioning retiree health benefits to MA plans.
- To address limitations of previous research by analyzing a quasi-experimental design.
Main Methods:
- Quasi-experimental study design examining a natural experiment involving health benefit transitions for state retirees.
- Analysis of healthcare utilization and mortality data for over 220,000 state retirees across five states (2017-2019).
- Comparison of outcomes before and after the shift from traditional Medicare supplemental plans to MA plans.
Main Results:
- Increased utilization of outpatient services, including annual wellness visits and home evaluation/management visits.
- Higher rates of observation stays observed post-transition to MA plans.
- Significant reductions in hospital admissions and post-acute care admissions were identified.
Conclusions:
- The transition to Medicare Advantage plans was associated with shifts in healthcare utilization patterns, including increased outpatient care and reduced hospitalizations.
- No significant impact was observed on days spent at home or in the community, nor on mortality rates.
- Findings suggest MA plans may influence service delivery and care coordination for retiree populations.
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