Avalere Health compared 30-day all-cause hospital readmission rates between California dual eligibles in traditional Medicare and those enrolled in SCAN Health Plan, the fourth largest not-for-profit Medicare Advantage plan. The study found that SCAN’s dual eligible members had a hospital readmission rate that was 25 percent lower than those in fee-for-service. It also found that SCAN performed 14 percent better than Medicare fee-for-service on the “prevention quality indicator overall composite,” which measures how hospitals keep patients out of hospitals from the get-go.
Based on the results of a matched cohort analysis, SCAN’s program could lead to 1,320 fewer hospitalizations and 1,773 fewer readmissions for California fee-for-service dual eligibles. This would result in approximately $50 million in annual cost savings to Medicare fee-for-service in California. This research suggests integrated and coordinated care for dual eligibles may help improve quality while reducing healthcare costs.
Related Articles on Readmissions:
California Hospitals, County Partner for New Advanced Care Transitions Model
UnitedHealthcare, Dovetail Health Launch Readmission Initiative in New Jersey
