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September 27, 2025JAMA Health ForumOpen Access

Clinical Quality Performance of Value-Based and Fee-for-Service Models for Medicare Advantage

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Authors

EBEleanor M. BeltzKCKelly Jean Thomas CraigXWXin Wei

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Overview

Quality improvement study compares clinical quality scores and risk-sharing in two reimbursement models.

Key Points

  • The comparison revealed differing clinical quality scores between value-based and fee-for-service models, emphasizing their impact.
  • Mean clinical quality scores demonstrated a significant difference in performance linked to risk-sharing levels, specifically in Medicare Advantage.
  • The study utilized a comparison framework to analyze clinical quality within two distinct reimbursement models for Medicare Advantage.
  • Findings suggest implications for future healthcare policies regarding reimbursement strategies in Medicare Advantage programs.

Cite This Study

Beltz et al. (2025) studied this question.

synapsesocial.com/papers/68d7cc6aeebfec0fc5238d32https://doi.org/10.1001/jamahealthforum.2025.4002
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