ArticleHealth affairs (Project Hope)2019
Adjusted Mortality Rates Are Lower For Medicare Advantage Than Traditional Medicare, But The Rates Converge Over Time.
Article in Health affairs (Project Hope), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed.
- Advancing the measurement of favorable selection in Medicare Advantage: evidence from encounter data.Health affairs scholar · 2026Article
- U.S. adults with diagnosed diabetes enrolled in Medicare by age and insurance type.Preventive medicine reports · 2025Article
- Examining Trends in Medicare Advantage Plan Disenrollment Associated With Expanded Supplemental Benefit Adoption.Health services research · 2025Article
- Coding intensity variation in Medicare Advantage.Health affairs scholar · 2025Article
- Frailty in Medicare Advantage Beneficiaries and Traditional Medicare Beneficiaries.JAMA network open · 2024Article
- Health Care Spending, Use, and Financial Hardship Among Traditional Medicare and Medicare Advantage Enrollees With Mental Health Symptoms.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2024Article
- Postacute Care for Medicare Advantage Enrollees Who Switched to Traditional Medicare Compared With Those Who Remained in Medicare Advantage.JAMA health forum · 2024Article
- Association of 7-Day Follow-Up With 6-Month Suicide Mortality Following Hospitalization for Suicidal Thoughts or Behaviors Among Older Adults.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2024Article
- Dental Services Use: Medicare Beneficiaries Experience Immediate And Long-Term Reductions After Enrollment.Health affairs (Project Hope) · 2023Article
- Completeness of cohort-linked U.S. Medicare data: An example from the Agricultural Health Study (1999-2016).Preventive medicine reports · 2022Article
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- Article
- Commentary on: The effects of coding intensity in Medicare advantage on plan benefits and finances.Health services research · 2021Article
- Trends in Use of Low-Value Care in Traditional Fee-for-Service Medicare and Medicare Advantage.JAMA network open · 2021Article
- Article
- Health Care Utilization, Care Satisfaction, and Health Status for Medicare Advantage and Traditional Medicare Beneficiaries With and Without Alzheimer Disease and Related Dementias.JAMA network open · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Overall mortality rates, adjusted for age, sex, and Medicaid status, in Medicare Advantage have been below those in traditional Medicare for many years. Much attention has been paid to the resulting issue of favorable selection in Medicare Advantage. The common study design used to estimate causal effects of Medicare Advantage on utilization and outcomes compares new Medicare Advantage beneficiaries immediately before and after enrollment in Medicare Advantage with beneficiaries who choose to remain in traditional Medicare. What has not been studied is the mortality experience of a cohort that initially chooses enrollment in Medicare Advantage versus one that chooses traditional Medicare. In this study we found that the adjusted mortality rate of a cohort newly enrolled in Medicare Advantage was initially well below that of a cohort newly enrolled in traditional Medicare, but the difference markedly decreased after five years. As a result, the common study design is flawed because it assumes that any initial difference in mortality risk remains constant after enrollment in Medicare Advantage. In other words, those initially choosing Medicare Advantage become sicker relative to traditional Medicare beneficiaries over five years. Whether the mortality rates would fully converge if a period longer than five years were observed is a topic for further research.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.