# Private Medicare Plans and Health Outcomes for Older Adults

> **NIH NIH K01** · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2022 · $121,444

## Abstract

Although enrollment in private Medicare plans has risen from 12.8% in 2004 to 37.5% in 2019, the health
consequences of large numbers of older Americans enrolling in these plans are not clear. This is of
particular concern for high-risk patients, people with selected chronic conditions that place them at
higher risk of adverse outcomes. Private Medicare plans are typically managed care plans that receive a
capitated payment for each plan enrollee and therefore face financial incentives to control costs.
Although high-risk patients could potentially benefit if some private Medicare plans are able to improve
health outcomes through care coordination or by steering patients to high-quality health care providers,
they could also be adversely impacted if some private Medicare plans achieve cost savings by reducing
provision of necessary or preventive care. This Career Development Award proposal, “Private Medicare
Plans and Health Outcomes for Older Adults,” focuses on leveraging new data—from private Medicare
encounter claims, a state all-payer claims database, and the private Medicare risk adjustment system—in
order to better understand how private Medicare plans impact health outcomes for older adults,
particularly among high-risk patients. This work will focus on evaluating the performance of specific
private Medicare plans—as opposed to evaluating private Medicare plans as a whole—something made
possible by the recent availability of comprehensive health care claims data from private Medicare plans.
Examining plan-specific effects will allow for a more complete understanding of whether there are
specialized private Medicare plans that can improve health outcomes for high-risk patients. The research
aims encompass three areas: 1) estimating plan-specific effects of private Medicare plans on quality of
care and patient outcomes, 2) evaluating the performance of private Medicare plans that specialize in
improving health outcomes for high-risk patients, and 3) using prediction methods to quantify the
potential for favorable selection by private Medicare plans. This work will make use of quasi-
experimental methods to estimate whether enrollment in specific private Medicare plans is associated
with better health outcomes; for example, by studying patients who transition from an employer-
sponsored plan to a private Medicare plan, or patients who switch from traditional Medicare to a private
Medicare plan. This award will also support additional training toward three career goals that support
the research aims: 1) developing expertise in measurement of health care quality and improvement of
patient outcomes, 2) acquiring knowledge of clinical management of high-risk patients, and 3) building
skills in statistical methods used for prediction and modeling health outcomes. These goals will be
achieved through coursework, mentorship, seminars, and research, among a highly productive group of
health economics and health policy scholars at a leading instituti...

## Key facts

- **NIH application ID:** 10471307
- **Project number:** 5K01AG073583-02
- **Recipient organization:** HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH
- **Principal Investigator:** Vilsa Eliana Curto
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $121,444
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10471307

## Citation

> US National Institutes of Health, RePORTER application 10471307, Private Medicare Plans and Health Outcomes for Older Adults (5K01AG073583-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10471307. Licensed CC0.

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