About

Amal N Trivedi is a Professor of Health Services, Policy and Practice, and a Professor of Medicine. He is a general internist and health services researcher whose work focuses on quality of care and healthcare disparities, with particular emphasis on the impact of patient and provider incentives on quality and equity of care. His research has been published in prominent journals such as the New England Journal of Medicine, the Journal of the American Medical Association, and Health Affairs. Dr. Trivedi teaches on health policy issues to medical students and residents and offers a course on Quality Measurement and Improvement for graduate students.

Research topics

• Sociology
• Medicine
• Economics
• Economic growth
• Gerontology
• Political Science
• Gender studies
• Environmental health
• Business
• Internal medicine
• Family medicine
• Demography

Selected publications

• Medication Use by Indigenous and Non-Indigenous Australians After a Pharmaceutical Co-Payment Subsidy

  JAMA Health Forum · 2026-03-27

  articleOpen accessSenior author

  This cohort study examines prescription medication use and out-of-pocket spending among Indigenous and non-Indigenous Australians after a governmental program to reduce prescription drug co-payments.

  PublisherDOI

• Rapid Disenrollment Rates Tripled For Medicare Advantage Beneficiaries, 2017–22

  Health Affairs · 2026-03-01

  article

  Rapid disenrollment, when a beneficiary disenrolls from a new Medicare Advantage (MA) plan within the first three months of the calendar year, could signal enrollees' immediate dissatisfaction with their plan. The proportion of MA enrollees who rapidly disenrolled tripled from 3.5 percent in 2017 to 12.2 percent in 2022. We report on trends in rapid disenrollment to guide future actions.

  PublisherDOI

• Trends in Broker Enrollment and Spending in Medicare Advantage

  JAMA Internal Medicine · 2026-05-18

  articleOpen accessSenior author

  This cross-sectional study estimates the proportion of beneficiaries enrolled in Medicare Advantage by brokers and the associated broker fees in the US.

  PublisherOA PDFDOI

• Increased Payments to Medicare Advantage Plans for Dually Eligible Beneficiaries

  The American Journal of Managed Care · 2026-02-01

  articleSenior author

  OBJECTIVE: To address concerns about payment adequacy in Medicare Advantage (MA) plans, a 2017 federal policy change increased risk scores and associated capitated payments for community-dwelling dually eligible beneficiaries with full Medicaid benefits. This study examined whether this payment change was associated with changes in health care utilization or mortality for dually eligible beneficiaries. STUDY DESIGN: Difference-in-differences analysis comparing dually eligible beneficiaries who qualified for risk score increases (full Medicaid enrollees) vs those who did not (partial Medicaid enrollees). METHODS: CMS plan payment files for 2014-2022 provided plan-level information on mean risk scores. We linked 2013-2019 Medicare data and Minimum Data Set nursing home assessments to analyze inpatient use, nursing home use, and mortality for community-dwelling dually eligible beneficiaries. We also investigated hospital readmissions, stays lasting longer than 100 days, and mortality within 365 days among dually eligible beneficiaries with skilled nursing facility (SNF) use. RESULTS: Among plans in which more than half of members had full Medicaid, plan-level risk scores increased 8.9% from 2014-2016 to 2017-2022 relative to the change observed in other plans. The payment change was associated with small declines in mortality, inpatient use, and nursing home use among beneficiaries 65 years and older, but these findings were not clinically significant or robust in sensitivity analyses. No significant changes were observed for dually eligible beneficiaries younger than 65 years or among SNF users in either age group. CONCLUSIONS: These results raise questions about whether payment increases to MA plans led to meaningful improvements in quality of care for dually eligible members. As MA participation increases among dually eligible beneficiaries, policy makers should pay attention to whether higher MA payment levels for these beneficiaries translate to improved outcomes.

  PublisherDOI

• Untangling Dialysis Received in a Nursing Home from Home Hemodialysis in the Community

  Journal of the American Society of Nephrology · 2026-04-02 · 1 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Private Equity Acquisition in Primary Care and Avoidable Hospitalizations

  JAMA Health Forum · 2026-05-08

  articleOpen access

  Importance: Private equity (PE) is one form of corporate investment that has rapidly expanded into primary care, with more than 2400 primary care physicians becoming PE-affiliated since 2019. There are concerns that profit incentives associated with PE investment might be detrimental to care quality and patient outcomes. Objective: To examine changes in patient outcomes for the traditional Medicare (TM) population after primary care practices are acquired by PE firms and to identify any changes in patient composition. Design, Setting, and Participants: This economic evaluation used a stacked difference-in-differences analysis with a 20% Medicare Part B sample from 2016 to 2022. Medicare beneficiaries with PE-acquired primary care physicians were matched to control patients based on age, risk score, sex, race and ethnicity, state of residence, and dual-eligibility status. Statistical analysis was performed from November 2024 to February 2026. Exposure: Primary care practice acquisition by a PE firm, identified using PitchBook data. Main Outcomes and Measures: Primary outcomes at the patient-quarter level include number of all-cause hospitalizations, number of potentially avoidable hospitalizations for ambulatory-sensitive conditions, and number of emergency department (ED) visits. Secondary outcomes include measures of patient composition, including patient age, sex, race and ethnicity, and hierarchical condition category score. Results: The analysis included 24 397 beneficiaries with PE-acquired primary care physicians, matched to 121 939 control patients. The mean (SD) age was 74 (10) years, and 56% of patients were female. After PE acquisition, the number of all-cause ED visits decreased by 1.36% (95% CI, -2.72% to -0.14%) per patient-quarter relative to baseline. Considering various sensitivity tests, there were no significant changes to the probability of or number of potentially preventable hospitalizations or all-cause hospitalizations. Patient composition remained unchanged. Conclusions and Relevance: In this national study of traditional Medicare beneficiaries, PE acquisitions of primary care practices were not associated with meaningful short-term changes in acute care outcomes. Overall, findings contribute to policy discourse on understanding the role of PE investments in shaping care quality, suggesting heterogeneity in outcomes across health care settings.

  PublisherDOI

• Assessing The Inclusion Of Federally Qualified Health Centers In Medicare Advantage Networks

  Health Affairs · 2026-02-01

  articleSenior author

  Medicare Advantage (MA) disproportionately enrolls low-income and racial and ethnic minority populations that may benefit from access to federally qualified health centers (FQHCs). Using 2022 FQHC provider and MA network data, we examined the inclusion of FQHCs in MA provider networks. On average, these networks included 57 percent of FQHCs in their service areas, but 30 percent of contracts had narrow FQHC networks, defined as including fewer than one-quarter of available FQHCs. Asian/Pacific Islander, Hispanic, and Black beneficiaries were more likely to be enrolled in a narrow-network contract than White beneficiaries by 26, 20, and 5 percentage points, respectively, which appears to have been driven by area-specific factors. Contracts lacking a star rating, operating in a single state, or enrolling fewer disabled or rural beneficiaries were more likely to have narrow networks. As MA enrollment grows, efforts to monitor in-network access to community-based safety-net providers are important.

  PublisherDOI

• End-Stage Renal Disease Treatment Choices Model and Use of Home Dialysis and Kidney Transplant

  JAMA Health Forum · 2026-04-24

  articleOpen accessSenior authorCorresponding

  Importance: To increase the use of home dialysis and kidney transplant, the Centers for Medicare & Medicaid Services launched the End-Stage Renal Disease Treatment Choices (ETC) model, a mandatory, randomized pay-for-performance program applied to 30% of US hospital referral regions. Its impact after 4 years of implementation is uncertain. Objective: To assess the ETC model's impact on home dialysis, kidney transplant, and transplant waitlist, as well as measure the rate of financial penalties. Design, Setting, and Participants: This retrospective cross-sectional study used traditional Medicare claims and enrollment data for beneficiaries with kidney failure linked to concurrent transplant data from the United Network for Organ Sharing from January 1, 2017 (4 years before model implementation), to September 30, 2024 (3.75 years postimplementation). Exposures: Receiving dialysis treatment in a region randomly assigned to the ETC model. Main Outcomes and Measures: Primary outcomes were rates of home dialysis, kidney transplant, and transplant waitlist, as well as facility-level financial penalization. Facility-level financial penalties were assessed using Centers for Medicare & Medicaid Services-published performance data. Results: The study population included 795 232 persons with kidney failure (mean [SD] age, 61.8 [14.4] years; 41.5% female), reflecting 20 729 696 person-months from January 1, 2017, to September 30, 2024. The rate of home dialysis increased from 12.8% to 16.7% of attributed patient-months in ETC regions (change of 3.9 percentage points [pp]) and from 13.7% to 17.3% in control regions (change of 3.7 pp), yielding an adjusted differences-in-differences of -0.1 pp (95% CI, -0.6 to 0.5 pp). The number of kidney transplants per 1000 patient-months increased from 3.3 to 4.5 in ETC regions (change of 1.2) and from 3.4 to 4.4 in control regions (change of 1.0), resulting in a differences-in-differences of 0.2 pp (95% CI, -0.1 to 0.4 pp). The percentage of patients per month on the transplant waitlist decreased from 16.1% to 15.5% in ETC regions (change of -0.5 pp) and from 17.7% to 16.7% in control regions (change of -1.0 pp). The adjusted differences-in-differences for transplant waitlist was 0.6 pp (95% CI, -0.3 to 1.6 pp). The proportion of ETC facilities receiving financial penalties increased from 13.8% in 2021 to 25.1% in 2023. Subgroup analyses showed no meaningful differential effects of the model. Conclusions and Relevance: This cross-sectional study shows that after nearly 4 years, the ETC model was not associated with meaningful increases in home dialysis, kidney transplant, or transplant waitlist, while the proportion of facilities receiving financial penalties increased. Future value-based payment models may need to move beyond narrowly targeted financial incentives to address the broader structural and patient-level barriers that influence access to complex specialty care.

  PublisherOA PDFDOI

• Double Bonuses Increased MA Spending In Puerto Rico By $865 Million But Did Not Achieve Plan Improvement Goals

  Health Affairs · 2026-04-01

  articleOpen accessSenior author

  In 2024, more than 90 percent of Medicare beneficiaries in Puerto Rico were enrolled in Medicare Advantage (MA) plans. MA plans receive capitated payments as well as quality-based bonuses, with MA plans operating in so-called double-bonus counties earning twice the usual bonus payments. Puerto Rico was excluded from the double-bonus payment program until 2018, when the double-bonus policy was extended to the territory. Applying a difference-in-differences approach to Centers for Medicare and Medicaid (CMS) data from the period 2012-22, we found that implementation of MA double bonuses in Puerto Rico was not associated with improvements in plan quality or changes in premiums or cost sharing, although it was associated with an increase in the number of plans offered. The findings imply that the additional payments from double bonuses primarily benefited MA plans rather than enrollees. We estimated that the policy resulted in at least $865 million in excess Medicare spending during its first five years. Together with prior evidence questioning the effectiveness of the double-bonus program, these results underscore the need for CMS to reconsider or eliminate MA double bonuses.

  PublisherDOI

• Private Equity Acquisitions In Primary Care: Changes In Utilization, Spending, And Workforce

  Health Affairs · 2026-05-20

  article

  Primary care is essential to advancing population health, yet it has faced underinvestment and workforce shortages in the US. Private equity (PE) investments could expand access by facilitating participation in value-based contracts and enhancing information technology capacity. However, PE's emphasis on short-term profitability may impose productivity pressures on physicians, with uncertain implications for patient care. Using a stacked difference-in-differences design and national Medicare claims data, we examined 225 PE acquisitions of primary care practices during the period 2016-22. PE acquisition increased the number of services billed and patients seen by primary care physicians by 30 percent and 11 percent, respectively. Patients in PE-acquired practices received 12.9 percent more additional services, driven by laboratory testing and the Medicare annual wellness visit. PE acquisitions also increased the total number of primary care physicians and advanced practice providers, with the latter growing at a faster rate. Taken together, our results suggest that PE investments have the potential to increase the use of primary care services, in part through greater reliance on advanced practice providers.

  PublisherDOI

Recent grants

• NIH Grant R01AG04437401

  NIH · $372k · 2016

• NIH Grant RC1AG036158

  NIH · $968k · 2012

• Risk-Adjusting Hospital Outcomes for Veteran's Socioeconomic Status

  NIH · 2017–2020

• Medicaid Expansion, Coverage Loss, and Disparities in Kidney Health in the COVID-19 Era

  NIH · $2.2M · 2017–2026

• NIH Grant I01HX000626

  NIH · 2015

Frequent coauthors

• Vincent Mor

  Providence College

  375 shared

• Shailender Swaminathan

  154 shared

• David J. Meyers

  Brown University

  152 shared

• Maricruz Rivera‐Hernandez

  Providence College

  117 shared

• Momotazur Rahman

  Brown University

  112 shared

• Daeho Kim

  John Brown University

  93 shared

• Rebecca Thorsness

  VA Boston Healthcare System

  92 shared

• Kevin H. Nguyen

  Cole Engineering Services (United States)

  86 shared