Five Questions With: Momotazur Rahman

Momotazur Rahman, a Brown University economist, has researched disparities in health care access, utilization and outcomes across different demographic and socio-economic groups in the United States.
Momotazur Rahman, a Brown University economist, has researched disparities in health care access, utilization and outcomes across different demographic and socio-economic groups in the United States.

Momotazur Rahman is a Brown University economist interested in the organization and economic performance of the U.S. health care system. His research focuses on disparities in health care access, utilization and outcomes across different demographic and socio-economic groups; the effects of managed care on the health care system; and the effects of regulation on health care markets. He recently authored a study examining the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare.

PBN: Medicare Advantage users abandon the plans and return to public Medicare precisely when their health care costs begin to mount. Why is this?
RAHMAN:
There could be two potential reasons. The first is that Medicare Advantage beneficiaries were more dissatisfied with the service they received. But it’s worth noting that an individual can experience satisfaction or dissatisfaction with care only if she or he uses care. The second is that home health and nursing home care providers might be more comfortable dealing with traditional Medicare and influence patients to switch.

PBN: Is there any cynicism among policy analysts regarding the private sector gaming the system to yield this specific phenomenon?
RAHMAN:
Our study identifies what kind of switching has been occurring and at what rate. It raises many questions about why it’s happening and whether we have effective measures in place to present this. What we need now is further study to answer those questions. As we gather evidence, we’ll be able to formulate ways to effect the changes we want.

PBN: Do your research findings suggest that it is time for Congress to update, or replace, the 2003 law that strove to prevent flight from private Medicare?
RAHMAN:
The law was enacted to reduce adverse selection of plans. Our results show that as patients become more risky for the plans, they become more likely to see a need to leave the plans. If this is because of things the plans are doing, then Congress may conclude that it has not done enough to stem the flow of risk out of Medicare Advantage.

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PBN: What kind of financial hit does the migration represent for public Medicare?
RAHMAN:
Our findings imply net transfer of costly patients from Medicare Advantage to traditional Medicare and that Medicare Advantage plans are not bearing the entire risk of a patient. This implies an overpayment to Medicare Advantage plans.

PBN: Are there specific Medicare Advantage plans that see significantly less dissatisfaction and flight?
RAHMAN:
We are currently studying this.

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