Medical Research Institution Selects Inovalon to Empower Novel Analyses of Medicare Program
Analyses Have Potential to Help Policymakers and Administrators Improve Care, Outcomes, and Economics for Tens of Millions of Americans
BOWIE, Md. – September 13, 2022 – Inovalon, a provider of cloud-based software solutions empowering data-driven healthcare, today announced a research collaboration with faculty in the Department of Health Care Policy at Harvard Medical School (HMS) to generate new insights about Medicare effectiveness and help drive improvements throughout the Medicare program. The study will provide a comprehensive, longitudinal view of de-identified members transitioning from commercial insurance to Medicare Fee-for-Service (FFS) or Medicare Advantage (MA) at age 65.
Inovalon’s MORE2 Registry consisting of medical and pharmacy data, including large populations of commercially insured MA beneficiaries across the U.S., will be utilized for this study. This data will be combined with the 100% of Medicare FFS data accessed through a Centers for Medicare and Medicaid Services Data Use Agreement. In addition, the research will incorporate social determinants of health data, such as median household income, education level, race and ethnicity, living alone, English proficiency, and other social risk factors. A series of analyses will be conducted to answer research questions that have not been previously explored due to the limited nature of data sources previously available to academics and policymakers. The findings will provide insights that policymakers and health plans can use to design and deliver more efficient and cost-effective care.
“With the massive cohort of baby boomers aging into Medicare and the move toward value-based care and payment structures, the insights from this research are timely and potentially transformative,” said Christie Teigland, PhD, Vice President of Research Science and Advanced Analytics at Inovalon. “The scale and comprehensive nature of this project and our datasets will enable the research team and additional stakeholders to surface insights that we believe have the potential to impact the healthcare future of tens of millions of Americans.”
Researchers at Inovalon and in the HMS Department of Health Care Policy will compare demographic and clinical characteristics of this transitioning population and identify the types and aggregate demographics of beneficiaries typically enrolling in traditional Medicare FFS versus a managed MA plan. These analyses will consider factors such as previous exposure to managed care and whether that increases likelihood of enrolling in MA. Additionally, analyses will be undertaken to compare healthcare utilization and outcomes under FFS versus MA coverage. By looking at those newly eligible for Medicare, the study will be able to compare individual health and economic outcomes under FFS or MA to what they previously experienced under commercial coverage, enabling comparisons between FFS and MA not previously undertaken. These results, expected to be available in the fall of 2022, will equip policymakers to better manage and allocate program resources, and ultimately to improve beneficiary outcomes and lower healthcare costs in the rapidly growing Medicare population.
“The insights from this collaborative research will provide a tool for policymakers and healthcare administrators to proactively improve the value of both Medicare Advantage and traditional Medicare programs resulting in improved benefits for the rapidly growing population of Medicare beneficiaries,” states Michael Chernew, PhD, health economist and professor helping to oversee the project. “When evaluating potential partners, it was clear that Inovalon’s dataset is uniquely suited to support this critical policy research and we’re excited to join forces to add to the knowledgebase about these populations.”
For more information on Inovalon Data Solutions, visit: https://www.inovalon.com/products/insights/data-solutions/.
Inovalon is a leading provider of cloud-based software solutions empowering data-driven healthcare. The Inovalon ONE® Platform brings together national-scale connectivity, real-time primary source data access, and advanced analytics into a sophisticated cloud-based platform empowering improved outcomes and economics across the healthcare ecosystem. The company’s analytics and capabilities are used by more than 20,000 customers and are informed by the primary source data of more than 71 billion medical events across one million physicians, 622,000 clinical settings, and 359 million unique patients. For more information, visit www.inovalon.com.