Outcomes improve, costs decline for Medicare beneficiaries

A new study finds "remarkable" improvements in hospitalization and mortality rates as well as per-patient costs for 65-and-over beneficiaries.

For the study, published by the Journal of the American Medical Association, researchers led by Harlan Krumholz, M.D., a professor at the Yale School of Medicine, analyzed Medicare denominator and inpatient files for nearly 70 million beneficiaries age 65 and up from 1990 through 2013.

The study found that among both Medicare Advantage and fee-for-service beneficiaries, mortality rates dropped from 5.4 percent in 1999 to 4.5 percent in 2013, representing a 16 percent change.

"It's a jaw-dropping finding," Krumholz told USA Today. "We didn't expect to see such a remarkable improvement over time."

In studying just the fee-for-service beneficiaries, for whom more data was available, the study found that for every 100,000 enrollees, there were about 10,000 fewer hospitalizations. In the last six months of their lives, hospitalizations among fee-for-service beneficiaries also decreased, the study shows.

For those patients who were hospitalized, their chances of dying in 30 days as well as one year after hospitalization declined over the period studied. Further, the average cost for a hospitalized fee-for-service Medicare patient dropped from $3,290 to $2,801.  

"This decline represents millions of hospitalizations averted and hundreds of thousands of deaths delayed," Krumholz said in an announcement.

Changes in behaviors, technology and systems in healthcare, as well as more team-based care models and greater health consciousness among the public, may be driving the improvements, Krumholz said in a recorded interview that accompanied the study.

With more than 55 million Americans currently covered by Medicare, the program hopes to continue improving, Andy Slavitt, Centers for Medicare & Medicaid Services acting administrator, said in a statement marking the program's 50th anniversary.

"As we preserve and advance Medicare for future generations, we are focused on helping build a better system with smarter spending that keeps people healthier."

To learn more:
- here's the study abstract
- read the announcement
- check out the USA Today article
- here's Slavitt's statement

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