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Friday, 11th June 2010

Medicare Advantage is Reducing Preventable Hospital Readmissions for Seniors

Medicare Advantage is Reducing Preventable Hospital Readmissions for Seniors
Source: America's Health Insurance Plans

A new analysis of federal and state government data provides further evidence that seniors in Medicare Advantage have lower risk-adjusted hospital readmission rates than patients in Medicare’s traditional fee-for-service (FFS) program, according to a report released today by America’s Health Insurance Plans (AHIP). The study analyzed data from nine states and found reductions in risk-adjusted hospital readmission rates averaging 14-29 percent among seniors in Medicare Advantage compared with Medicare FFS enrollees.

Preventing avoidable hospital admissions and readmissions protects patients from the risks associated with inpatient settings, such as infection, and is an indication that patients are getting the care and services they need on an outpatient basis to stay healthy and avoid complications that can lead to hospital readmissions.

According to a study published in the New England Journal of Medicine, nearly one-fifth (19.6 percent) of Medicare fee-for-service beneficiaries who had been discharged from a hospital were rehospitalized within 30 days, and 34 percent were rehospitalized within 90 days. Moreover, half of patients who were rehospitalized within 30 days did not have a physician visit between the time of discharge and rehospitalization – suggesting that one of the reasons patients ended up back in the hospital was lack of needed follow-up care.

+ Using State Hospital Discharge Data to Compare Readmission Rates in Medicare Advantage and Medicare’s Traditional Fee-for-Service Program
+ Innovations in Reducing Preventable Hospital Admissions, Readmissions, and Emergency Room Use


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