LAUSR

Hospitals and health systems are increasingly offering their own insurance products, a type of consolidation known as "vertical integration." The relationship between plan-provider vertical integration and quality of care has not been examined extensively or over time. We created a new data set of all vertically integrated Medicare Advantage contracts operating in the period 2011-15 and tracked their characteristics and quality over time. While the percentage of vertically integrated contracts increased slightly between 2011 and 2015, the percentage of all Medicare Advantage enrollees in them declined from 24.4 percent to 22.0 percent. Vertically integrated contracts generally were of higher quality than other contracts, with the largest differences related to enrollee satisfaction. These findings provide the first detailed, longitudinal look at vertically integrated Medicare Advantage plan enrollment and quality.