Outcome Evidence

• Based on 2016 payments, the Health Care Learning and Payment Action Network found 43% of healthcare dollars were paid through fee-for-service models. source
• A multi-university Health Affairs study in 2017 found that patients with Medicare Advantage, had better outcomes than patients with traditional fee-for-service Medicare. Specifically, Medicare Advantage patients had lower rates of readmission, higher rates of return to the community, and decreased intensity of post-acute care. source
• A multi-university study by the American College of Physicians re-standardized patients and found that Medicare Advantage patients are more likely to be readmitted than traditional Medicare patients. A third study, comparing the two opposite results, concludes that more work must be done to determine whether either finding truly affects patient outcomes. source
• The 2018 landmark Medicare Advantage Checkup report in NEJM highlights that while in the past fee-for-service Medicare might have cost up to 14% more per beneficiary than Medicare Advantage, today the costs per beneficiary between both are equivalent. source
• A 2018 NEJM survey, polling clinical leaders, clinicians, and executives, estimates that 75% of revenue is based on a fee-for-service structure. source
• A 2017 survey of over 2,000 physicians in the AMA database found that a majority believe there is extensive overuse of services in healthcare and fee-for-service is encouraging a lot of it. source

• In Deloitte’s 2016 Survey of US Physicians, 86% of reporting physicians said they are reimbursed via fee-for-service payments. This number was very close to what was found in the 2014 report, acknowledging little shift over the past two years. source