Medicare Beneficiary Care Differences by Practice Ownership

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Summary

Avalere released a white paper analyzing spending and utilization among Medicare beneficiaries receiving care from independent physician practices and hospital-owned physician practices in Ohio.

The 2018–2019 analysis in the white paper showed that:

  • Average Medicare Parts A and B spending per beneficiary was lower among beneficiaries associated with independent physicians in 3 of the 5 markets
  • The percentage of admissions that had a readmission differed between beneficiaries attributed to independent practices and hospital-owned physician practices
  • The percentage of beneficiaries with a wellness visit in both 2018 and 2019 was higher among beneficiaries attributed to independent physicians
  • The average number of evaluation and management visits to primary care providers was higher among beneficiaries attributed to independent physicians in all markets
Webinar | A Closer Look at Patient Support On June 6 at 2 PM ET, Avalere experts will explore how potential implications of the Inflation Reduction Act (IRA)’s out-of-pocket cap, in addition to other key regulatory and policy activities shaping benefit design and patient cost-share (e.g., EHB), could impact patient commercial and foundation assistance. Learn More
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