Personalized preventive care reduces healthcare expenditures among Medicare Advantage beneficiaries

• Published in: The American journal of managed care Vol. 20; no. 8; pp. 613 - 620
• Main Authors: Musich, Shirley, Klemes, Andrea, Kubica, Michael A, Wang, Sara, Hawkins, Kevin
• Format: Journal Article
• Language: English
• Published: United States MultiMedia Healthcare Inc 01.08.2014
• Subjects: Aged; Aged, 80 and over; Beneficiaries; Cost Savings - statistics & numerical data; Female; Health administration; Health care expenditures; Health Expenditures - statistics & numerical data; Health services; Humans; Male; Medicare; Medicare Part C - economics; Medicare Part C - statistics & numerical data; Middle Aged; Physician patient relationships; Precision Medicine - economics; Precision Medicine - statistics & numerical data; Preventive medicine; Preventive Medicine - economics; Preventive Medicine - statistics & numerical data; Primary care; Socioeconomic factors; Trends; United States; United States
• ISSN: 1088-0224; 1936-2692

To investigate the impact on healthcare expenditure and utilization trends of a personalized preventive care program designed to deliver individualized care focused on disease preventionamong Medicare Advantage beneficiaries. MD-Value in Prevention (MDVIP) consists of a network of affiliated primary care physicians who utilize a model of healthcare delivery based on an augmented physician-patient relationship and focused on personalized preventive healthcare. The cost-effectiveness of the program was estimated using medical and pharmacy claims data relative to nonmembers. Multivariate modeling was used to control for demographic, socioeconomic, supply of healthcare services, and health status differences between members and nonmembers. Healthcare expenditure and utilization trends for members and nonmembers were tracked from the pre-period prior to member enrollment for a period of 2 years post enrollment. MDVIP members experienced significantly reduced utilization rates for emergency department visits and inpatient admissions. Reduced medical utilization resulted in program savings of $86.68 per member per month (PMPM) in year 1 and $47.03 PMPM in year 2 compared with nonmembers. A primary care model based on an augmented physician-patient relationship and focused on personalized preventive medicine can reduce Medicare Advantage healthcare spending.