• Seeking review paper on effects of competition among private Medicare plans (a bleg)

    This is an odd bleg because I know a lot of the literature on the effects of competition* among private Medicare plans (Parts C and/or D). What I’m wondering is if anyone has ever done a comprehensive review article on the subject. It’s hard to prove a negative, but I’m starting to think such a paper is not out there. I’ve done some Google Scholar searches and asked some colleagues and have come up empty. If you know of a relevant paper, please share.

    * By “effects of competition” I mean the consequences for premiums, benefits, provider access, and quality (etc.).

    • I have never seen such a report. On sites where they claim that competition is the key to bringing down costs, I have asked for literature references on MA competition. No literature references were forthcoming.


      • I was involved in the industry when the product was Medicare+Choice and can suggest reasons why there may be no such research. In highly competitive markets (S. Florida, Phoenix, LA), all plans offered “zero premium” plans; i.e., the customer paid no additional premium. Benefits tended to be very similar, low/no copays for MD visits, RX.
        Competition was based on network (the joke was you needed to have Dr. Kahn, not Dr. Khan), especially for specialists and hospitals.
        Some competition was also based on extras: vision, hearing benefits health club memberships.
        We defined quality as “days/K” and readmission rates (hospital) and Rx compliance. Not very sophisticated. Never had anyone ask to study us.

        • There is a lot of research in this area. I’ve written some of the papers and am familiar with many others. My question was if someone had done a literature review article that surveys it all. So far, nobody knows of one.