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Thursday, 17th September 2009

Seniors in Medicare Advantage Receive Higher Quality Care, New Reports Show

Seniors in Medicare Advantage Receive Higher Quality Care, New Reports Show
Source: America's Health Insurance Plans

Seniors in Medicare Advantage spent fewer days in a hospital, were subject to fewer hospital re-admissions, and were less likely to have “potentially avoidable” admissions, for common conditions ranging from uncontrolled diabetes to dehydration, according to a new analysis of publicly available AHRQ data released today by America’s Health Insurance Plans (AHIP).

The new study echoes the findings of an earlier analysis of AHIP member data showing that seniors in Medicare health plans can receive higher quality care compared to fee-for-service (FFS) Medicare.
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Instead of focusing almost exclusively on treating beneficiaries when they are sick, Medicare Advantage plans place a strong emphasis on preventive health care services that detect diseases at an early stage and disease management programs for seniors with chronic illnesses to help them keep their conditions under control. These programs are working to help keep patients out of the hospital and avoid potentially harmful complications.

The new study analyzed statewide datasets on hospital admissions in California and Nevada compiled by the Agency for Healthcare Research and Quality (AHRQ). The unique data in these states allows for direct comparisons of utilization rates among enrollees in Medicare Advantage plans and in FFS Medicare. These comparisons were adjusted for health status using the Medicare risk score process for age, sex, and 70 Hierarchical Condition Categories that are used as a basis for Medicare risk adjustment.

+ Reductions in Hospital Days, Re-Admissions, and Potentially Avoidable Admissions Among Medicare Advantage Enrollees in California and Nevada, 2006 (PDF; 904 KB)


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