Individuals enrolling in Medicare can choose among several managed care and traditional fee-for-service (FFS) plans. Medicare managed care (MMC) is better at delivery of preventive services, whereas traditional Medicare is better in the overall care experience, according to a study supported in part by the Agency for Healthcare Research and Quality (HS09205). The researchers analyzed responses of elderly Medicare beneficiaries in both MMC and traditional plans to the Consumer Assessment of Health Plans (CAHPS®) surveys in 2000 and 2001.
Nationally, FFS Medicare beneficiaries rated experience with care (getting needed care; getting care quickly; communication with clinicians; courtesy and respect of physician's office staff; and paperwork, information, and customer service) higher than MMC beneficiaries. For instance, in overall care ratings (scale of 1-10), FFS enrollees rated care 8.91, and MMC enrollees rated care 8.86 in 2000; in 2001 the corresponding ratings were 8.88 and 8.78. Differences varied across States, however.
MMC enrollees reported significantly fewer problems with paperwork, information, and customer service. They were also more likely to report having received immunizations for influenza and pneumonia in 2000 than FFS enrollees (77 vs. 63 percent), and MMC smokers were more likely to report having received counseling to quit smoking. The tradeoff between the strengths of both programs should be considered when policy decisions are made that affect the availability of choice or influence beneficiaries to choose one model of care over another, suggest the researchers.
See "Comparison of performance of traditional Medicare vs. Medicare managed care," by Bruce E. Landon, M.D., M.B.A., Alan M. Zaslavsky, Ph.D., Sulamit L. Bernard, Ph.D., and others in the April 14, 2004, Journal of the American Medical Association 291(14), pp. 1744-1752.
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