AHIP cites Hardesty Partner’s Published Thought Leadership in Congress

Before the House Energy and Commerce Committee’s Subcommittee on Health, America’s Health Insurance Plans (AHIP) has voiced its support for a CMS demonstration project that would allow Medicare Advantage (MA) plans to qualify as Advanced Alternative Payment Models (APMs). In its Statement of Record”, AHIP prominently cited Hardesty Healthcare Solutions Partner, Dr. Aloke K. Mandal.

 

Dr. Mandal’s work, published in the American Journal of Medicine, compared two medical groups contracted by the same Medicare Advantage health plan. In this well-controlled study, one medical group agreed to an alternative payment model, which included full-risk capitation, while a control group continued reimbursement on a fee-for-service schedule. Value-based contracting generated considerable cost efficiencies by intensifying primary care. The effect of this contracting change reduced inpatient hospital admissions and emergency department visits. Most importantly, survival increased by 6%. In other words, if a Medicare Advantage enrollee switched from the fee-for-service group to the capitated group, the risk of dying decreased by 32.8%. This research stemmed from Dr. Mandal’s work while at Optum.

 

In addition to AHIP’s Statement of Record, Dr. Mandal’s seminal research on Medicare payment reform has been cited by:

 

An interview with Dr. Mandal on CMS’s decision to develop such a demonstration project, based on his research can be found in Medicare Advantage News, featured, Nov. 16, 2017. Read the story.