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Understanding the High Need Populations in Medicare Advantage: Evidence to Improve Quality of Care

Grant Details

Grantee Organization
The Board of Regents of the University of Wisconsin System

Principal Investigator
Eva DuGoff, Ph.D., M.P.P.

Term
1/1/17 - 9/1/17

Award Amount
$109,809

Approval Year

Related Program
Advancing Medicare

Topics
Health System Performance and Costs,
Medicare

Grant Details

Grantee Organization
The Board of Regents of the University of Wisconsin System

Principal Investigator
Eva DuGoff, Ph.D., M.P.P.

Term
1/1/17 - 9/1/17

Award Amount
$109,809

Approval Year

Related Program
Advancing Medicare

Topics
Health System Performance and Costs,
Medicare

The project aims to help fill an information gap by examining the prevalence and characteristics of HNHC populations enrolled in MA. Data will come from self-reported information on the Health Outcomes Survey (HOS) from 2013. Three available HNHC frameworks (CMWF, Harvard, Hopkins) will be examined for best fit with the data. An expert clinical panel will examine differences in patient outcomes by each high need segment and assess the appropriateness of MA quality measures for the most common segments. The project team will recommend changes to MA quality measures as appropriate.

• Identification of high need segments in the MA program to help inform policymakers as well as providers and health plans serving MA enrollees.
• Recommend changes to the MA quality bonus program to better reflect high-need enrollees.

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