{"678356":{"#nid":"678356","#data":{"type":"news","title":"New Research by ISyE Professor Turgay Ayer Calls for Transparency in Medicare Advantage Operations","body":[{"value":"\u003Cp\u003EIndustrial and Systems Engineering (ISyE) Professor \u003Ca href=\u0022https:\/\/www.isye.gatech.edu\/users\/turgay-ayer\u0022\u003E\u003Cstrong\u003ETurgay Ayer\u003C\/strong\u003E\u003C\/a\u003E, was recognized with a team of renowned researchers for their work titled \u003Ca href=\u0022https:\/\/pubsonline.informs.org\/doi\/10.1287\/msom.2023.0637\u0022\u003E\u201cStrategic Cross Subsidization in Healthcare Capitation Programs: Evidence from Medicare Advantage\u201d\u003C\/a\u003E.\u003C\/p\u003E\u003Cp\u003ERecently published in the \u003Cem\u003EINFORMS Journal Manufacturing \u0026amp; Service Operations Management,\u0026nbsp;\u003C\/em\u003Etheir research calls for transparency in the Medicare Advantage (MA) program.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003ETheir \u003Ca href=\u0022https:\/\/www.informs.org\/News-Room\/INFORMS-Releases\/News-Releases\/New-Research-Calls-for-Transparency-in-Medicare-Advantage-Operations\u0022\u003Efindings\u003C\/a\u003E share that Medicare Advantage Plans adjust and reallocate funds inappropriately by implementing strategic cross-subsidization, which directly shifts the quality of care between high-risk and low-risk patients.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EWith MA Plans supporting over $2 million enrollees, they\u2019ve provided the first empirical evidence of strategic cross-subsidization happening within a large commercial insurance database.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EAyer collaborated with faculty researchers, Zhaowei She (Singapore Management University), Bilal Gokpinar (University College London), and Danny Hughes (Arizona State University), to study and address the need for Medicare reform and regulating ongoing health equities.\u003C\/p\u003E\u003Cp\u003E\u0022This study underscores the urgent need for enhanced transparency in Medicare Advantage. The practice of strategic cross-subsidization we\u0027ve uncovered could exacerbate socio-economic inequalities in healthcare access and outcomes, highlighting the critical importance of rigorous oversight in capitation payment models.\u0022\u003C\/p\u003E\u003Cp\u003EExamples of this can be seen when individuals become ill or considered high-risk, however the healthcare plan may suggest spending less resources on the patient. These specific findings have the potential to alert policymakers and encourage enforcers to revisit the structure behind MA Plans.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EBy revealing this unknown issue of resource misallocation, these types of solutions may have the ability to impact millions of beneficiaries across the entire Medicare Advantage system.\u003C\/p\u003E\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003ETo learn more about their research and the full story,\u003C\/strong\u003E read \u003Ca href=\u0022https:\/\/www.informs.org\/News-Room\/INFORMS-Releases\/News-Releases\/New-Research-Calls-for-Transparency-in-Medicare-Advantage-Operations\u0022\u003Ehere\u003C\/a\u003E.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003ETo read their published paper:\u003C\/strong\u003E https:\/\/pubsonline.informs.org\/doi\/10.1287\/msom.2023.0637\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EAbout INFORMS and\u0026nbsp;\u003C\/strong\u003E\u003Cem\u003E\u003Cstrong\u003EManufacturing \u0026amp; Service Operations Management\u003C\/strong\u003E\u003C\/em\u003E\u003Cstrong\u003E\u0026nbsp;\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EINFORMS is the leading international association for data and decision science professionals.\u0026nbsp;\u003Cem\u003EManufacturing \u0026amp; Service Operations Management\u003C\/em\u003E, one of 17 journals published by INFORMS, is a premier academic journal that covers the production and operations management of goods and services including technology management, productivity and quality management, product development, cross-functional coordination, and practice-based research. More information is available at\u0026nbsp;www.informs.org\u0026nbsp;or\u0026nbsp;@informs.\u003C\/p\u003E\u003Cp\u003ETurgay Ayer co-authored the study with his former PhD student, Zhaowei She (now on the faculty at Singapore Management University), as well as Bilal Gokpinar (University College London) and Danny Hughes (Arizona State University).\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E_____\u003C\/p\u003E\u003Cp\u003ECamille Carpenter, Communications Manager\u003C\/p\u003E","summary":"","format":"limited_html"}],"field_subtitle":"","field_summary":[{"value":"\u003Cdiv\u003E\u003Cp\u003EIndustrial and Systems Engineering (ISyE) Professor Turgay Ayer, was recognized with a team of renowned researchers for their work titled \u201cStrategic Cross Subsidization in Healthcare Capitation Programs: Evidence from Medicare Advantage\u201d.\u0026nbsp;\u003C\/p\u003E\u003C\/div\u003E","format":"limited_html"}],"field_summary_sentence":[{"value":"Accepted to the INFORMS journal Manufacturing \u0026 Service Operations Management, this study reveals a resource misallocation issue in Medicare Advantage"}],"uid":"36284","created_gmt":"2024-11-12 16:39:59","changed_gmt":"2024-11-26 15:55:45","author":"chenriquez8","boilerplate_text":"","field_publication":"","field_article_url":"","location":"Atlanta, GA","dateline":{"date":"2024-11-01T00:00:00-04:00","iso_date":"2024-11-01T00:00:00-04:00","tz":"America\/New_York"},"extras":[],"hg_media":{"675591":{"id":"675591","type":"image","title":"Turgay Ayer","body":null,"created":"1731429655","gmt_created":"2024-11-12 16:40:55","changed":"1731429655","gmt_changed":"2024-11-12 16:40:55","alt":"Turgay Ayer","file":{"fid":"259231","name":"Turgay Ayer copy 22.jpg","image_path":"\/sites\/default\/files\/2024\/11\/12\/Turgay%20Ayer%20copy%2022.jpg","image_full_path":"http:\/\/hg.gatech.edu\/\/sites\/default\/files\/2024\/11\/12\/Turgay%20Ayer%20copy%2022.jpg","mime":"image\/jpeg","size":2757803,"path_740":"http:\/\/hg.gatech.edu\/sites\/default\/files\/styles\/740xx_scale\/public\/2024\/11\/12\/Turgay%20Ayer%20copy%2022.jpg?itok=TzCuFqUi"}}},"media_ids":["675591"],"related_links":[{"url":"https:\/\/www.isye.gatech.edu\/users\/turgay-ayer","title":"Turgay Ayer, Virginia C. and Joseph C. Mello Chair Professor"}],"groups":[{"id":"1250","name":"Center for Health and Humanitarian Systems (CHHS)"},{"id":"1242","name":"School of Industrial and Systems Engineering (ISYE)"},{"id":"1243","name":"The Supply Chain and Logistics Institute (SCL)"}],"categories":[{"id":"135","name":"Research"}],"keywords":[{"id":"187915","name":"go-researchnews"}],"core_research_areas":[{"id":"39511","name":"Public Service, Leadership, and Policy"},{"id":"39541","name":"Systems"}],"news_room_topics":[],"event_categories":[],"invited_audience":[],"affiliations":[],"classification":[],"areas_of_expertise":[],"news_and_recent_appearances":[],"phone":[],"contact":[],"email":[],"slides":[],"orientation":[],"userdata":""}}}