Marc N. Elliott, PhD

Medicare Advantage customer service supports a less healthy, higher-need population, indicating that it should be designed and staffed to effectively serve complex, high-need patients.

This article examines how CMS’ adjustment for social risk factors affects the Medicare Advantage Star Ratings and the type of contracts affected by the adjustment.

Health plans use data to decide on quality improvement initiatives. Having a dashboard that characterizes how equitably plans are serving their enrollees would promote health equity.

Efforts are needed to ensure that Medicare beneficiaries with poor mental health receive regular routine care, which may be facilitated by having a personal doctor.

Only low-income male Medicare beneficiaries had worse patient experience than their female counterparts. The authors discuss opportunities to improve experiences for all patients.

Practices undertake many care delivery changes and quality improvement practices to become patient-centered medical homes (PCMHs), and these differ by years of PCMH recognition.

We describe an easy-to-interpret, patient-reported Functional Limitations Index that can be used to monitor care of patients along the disability continuum.

CMS implemented the Categorical Adjustment Index as part of the Medicare Advantage and Part D Star Rating Program in 2017. These analyses informed its development. Check out our website’s new table/figure pop-up feature! Click on the name of a table or figure in the text to see it in your browser.

Patient ratings of plans and care were lower among beneficiaries filing complaints or reporting denied care. Appeals did not further predict ratings, but successful complaint resolution did.

This study examines disparities in important patient-reported functional outcomes not routinely assessed among diverse racial/ethnic groups in Medicare managed care.