Medicare Advantage linked with fewer hospitalizations than traditional Medicare

In areas of the U.S. both large and small, patients enrolled in Medicare Advantage tend to experience fewer overall hospitalizations and avoidable hospitalizations than those enrolled in traditional fee-for-service Medicare, according to a new study.

The study was conducted by the Robert Graham Center and is titled "Understanding the Impact of Medicare Advantage on Hospitalization Rates." It includes data from the Healthcare Cost and Utilization Project for 12 states.

Ultimately, the study revealed Medicare Advantage enrollees were considerably less likely than traditional Medicare beneficiaries to experience an avoidable hospitalization, with a 10 percent decrease in the rate of such hospitalizations, regardless of age, gender, race/ethnicity or region.

Additionally, rates of referral-sensitive hospitalizations, which are frequently used to evaluate outpatient care, are slightly higher among Medicare Advantage enrollees than traditional Medicare beneficiaries.

"Further study is needed to definitively explain this effect and determine if it is the product of payment incentives that promote efficiency, coordination and primary care in the treatment of [Medicare Advantage] enrollees," the study concluded.

 

 

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