New Study: Physician Groups with Medicare Advantage Risk Models Enhance Care for Socially Vulnerable Patients

Research indicates that physician groups accountable for both cost and quality of care can better coordinate services and manage chronic conditions for socially vulnerable patients

A new study from America's Physician Groups  (APG) found that socially vulnerable Medicare beneficiaries experienced significantly better health outcomes when cared for by physician groups operating under two-sided risk arrangements with Medicare Advantage plans. Compared with similar patients in traditional fee-for-service Medicare, these beneficiaries had fewer inpatient admissions, emergency department visits, and use of high-risk medications.

The study, published in the June 2026 edition of Population Health, Equity & Outcomes, is the fifth in a series conducted by APG in collaboration with Optum Translational Research and Care Journey/Arcadia. It analyzed care delivered to 1.7 million Medicare Advantage patients by 16 APG physician groups in 2019 and adds to earlier research involving 5 million patients.

APG said the findings suggest that physician groups taking full accountability for both the cost and quality of care are better equipped to coordinate services, manage chronic conditions, and address the needs of patients facing social determinants of health. The organization plans to continue evaluating more recent data to further assess the impact of value-based Medicare Advantage care models.

About the Author

Pietje Kobus-McAllister

Pietje Kobus-McAllister

Pietje Kobus-McAllister has an international background and experience in content management and editing. She studied journalism in the Netherlands and Communications and Creative Nonfiction in the U.S. Pietje joined Healthcare Innovation in January 2024.

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