Innovations in Medicare Advantage to Improve Care for Seriously Ill Patients

Medicare Advantage’s financing structure, combined with recent statutory and regulatory changes that will allow greater flexibility for delivering non-medical services, make it a fertile testing ground for new models of delivering care to patients with serious and advanced illness. To learn more about new approaches that have been piloted in the Medicare Advantage space, we examined three models developed by third party firms that contract with Medicare Advantage plans: Aspire Health, Landmark Health, and Turn-Key Health. These models are designed to improve care quality and reduce emergency department visits and hospitalizations by providing care management and high-touch, non-medical services that are poorly reimbursed in a traditional fee-for-service environment. The design and functions of these models inform key steps that can be taken to accelerate the spread of these approaches throughout the broader health system, including encouraging payment reforms in traditional Medicare; rigorously studying the impact of serious illness models to expand the evidence of their impact on utilization, quality, and cost; and supporting workforce development initiatives to prepare providers for participation in value-based models.