Health plan industry trade group America's Health Insurance Plans has released a study concluding that Medicare Advantage plans may be doing a better job of controlling costs and preventing harm to patients.
To conduct its analysis, AHIP looked at statewide datasets on hospital admits in California and Nevada. This risk-adjusted data allowed researchers to make direct comparisons of utilization rates for Medicare Advantage plans and fee-for-service Medicare, researchers said. After doing the analysis, researchers concluded that Medicare Advantage enrollees had significantly lower inpatient days per patient, lower readmission rates and lower rates of avoidable hospital admissions.
Specifically, AHIP's team found that risk-adjusted rates for inpatient days per patient were 30 percent lower for MA enrollees than FFS enrollees in California, and 23 percent lower in Nevada. Also, same-quarter re-admission rates for the same DRG were 15 percent lower for California's MA patients and 33 percent lower in for Nevada's.
Meanwhile, researchers concluded that for a group of 13 potentially-avoidable admissions, risk-adjusted MA patients had 6 percent lower rates of avoidable admissions in both states.
To examine AHIP's research further:
- read the AHIP report (.pdf)