AHIP: Better results for seniors with Medicare Advantage

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An analysis of data from the Agency for Healthcare Research and Quality (AHRQ) shows that seniors in Medicare Advantage spend fewer days in the hospital and are less likely to be readmitted or unnecessarily admitted.

The study, released earlier this week by America’s Health Insurance Plans (AHIP), analyzed statewide data on hospital admissions in California and Nevada compiled by AHRQ. According to AHIP, the data from these states allowed for direct comparisons of utilization rates among enrollees in Medicare Advantage plans and in fee-for-service (FFS) Medicare.

The report found:

  • Medicare Advantage beneficiaries in California spent 30 percent fewer days in hospitals than patients with FFS Medicare, while Nevada seniors in Medicare Advantage plans spent 23 percent fewer days in the hospital.
  • Medicare Advantage enrollees were re-admitted to the hospital in the same quarter for the same condition 15 percent less often in California and 33 percent less often in Nevada, compared with FFS Medicare.
  • Seniors in Medicare Advantage in Nevada and California were 6 percent less likely than seniors in FFS Medicare to be admitted to the hospital for conditions described by AHRQ as "potentially avoidable," such as dehydration, urinary tract infection, or uncontrolled diabetes.
  • Medicare Advantage beneficiaries spent an average of 18 percent fewer days in the hospital than seniors in FFS Medicare.
  • Seniors in Medicare Advantage had an average of 27 percent fewer visits to the emergency room than those seniors in traditional Medicare.
  • Seniors enrolled in Medicare Advantage health plans also experienced a 42 percent lower rate of hospital re-admissions than those seniors in FFS Medicare.
  • Avoidable admissions to the hospital were 13 percent lower among seniors in Medicare Advantage plans than those in traditional Medicare.