Hospital Readmissions Study in AJMC Shows Favorable Medicare Advantage Quality Outcomes

Study Highlights Value of Medicare Advantage in Helping Patients Avoid Potentially Preventable Hospital Readmissions

WASHINGTON, Feb. 28, 2012 /PRNewswire/ -- America's Health Insurance Plans (AHIP), the national trade association representing the health insurance industry, in conjunction with MedAssurant, Inc., a leading provider of data-driven health care solutions, today announced that The American Journal of Managed Care (AJMC) published a new study in its February 2012 print edition titled "Hospital Readmission Rates in Medicare Advantage Plans." As the nation continues to drive focus on crucial patient safety implications of avoiding preventable hospital readmissions, the study contributes fresh evidence that indicates hospital readmission rates are lower in Medicare Advantage (MA) than in Medicare Fee-for-Service (FFS).

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The research found that unadjusted 30-day readmission rates were 14.5 percent for MA patients between 2006 and 2008, which is 22 percent lower than for Medicare FFS patients. Upon applying risk adjustment and demographic factors, data from the same time period shows MA 30-day readmission rates to be 13 percent to 20 percent lower than Medicare FFS rates. The study is a collaboration between AHIP and MedAssurant leveraging MA cohort population data contained within MedAssurant's Medical Outcomes Research for Effectiveness and Economics Registry (MORE(2) Registry®). The MORE(2) Registry is a comprehensive database containing more than 5.2 billion health care events from 77 million unique de-identified individuals distributed throughout the United States.

Focusing on prevention of avoidable hospital admissions and protection from risks associated with inpatient settings helps avert complications that could lead to hospital readmissions. The United States Department of Health and Human Services' (HHS) Partnership for Patients identified the need for improvement within the readmissions area as a national priority. The HHS initiative set a goal to reach a 20 percent reduction in preventable hospital readmission rates by the end of 2013. As such, the success within MA plans in reducing readmission rates has played a key role in achieving HHS' overall goals.

"Health plans have played a game-changing role in bringing programs to the delivery system that are helping patients get appropriate follow-up care and avoid preventable hospital readmission," said Karen Ignagni, President and CEO of AHIP.

"There is no doubt that reducing avoidable readmissions is an important factor that merits continued assessment and focus in models of care that effectively drive quality and financial outcomes," said Keith Dunleavy, M.D., President and Chief Executive Officer of MedAssurant. "The key to identifying successful paradigms of improvement is a deep understanding of data and a willingness to analyze and hone improvement efforts. We see this repeatedly succeeding in the Medicare Advantage landscape. This study gives strong support to the claimed success of initiatives designed to improve care and quality which ultimately lead to lower readmission rates in Medicare Advantage programs."

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About The American Journal of Managed Care (AJMC)

The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to publishing original research in healthcare outcomes and creating a forum for scientific communication in the ever-evolving field of healthcare delivery. The journal is indexed in MEDLINE/PUBMED. AJMC is published by the Intellisphere Managed Market Group, which is owned by MJH & Associates.

About America's Health Insurance Plans (AHIP)

America's Health Insurance Plans (AHIP) is the national trade association representing the health insurance industry. AHIP's members provide health and supplemental benefits to more than 200 million Americans through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid. AHIP advocates for public policies that expand access to affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality and innovation.

About MedAssurant, Inc.

MedAssurant, Inc. is a leading technology-enabled health care solutions provider focused on the importance of health care data and its ability to drive dramatic, objective improvement in clinical and quality outcomes, care management and financial performance throughout the health care community. Proprietary health care datasets, aggregation and analysis capabilities, combined with a national infrastructure of leading-edge technology, clinical prowess and deep human resources, empower MedAssurant's advanced generation of health care assessment and improvement through highly informed solutions. Driven by a mission to improve today's health care landscape, the employees of MedAssurant proudly apply care, ingenuity and dedication to delivering a new approach to health care touching nearly 120 million Americans – one driven by data and insight – one resulting in meaningful action. Please visit for more information.

MedAssurant's Medical Outcomes Research for Effectiveness and Economics Registry (MORE(2) Registry®) is one of the nation's largest health care data supersets. Containing more than 5.2 billion medical events touching over 77 million unique (and de-identified) individuals, 295,000 physicians, and 185,000 clinical facilities, the MORE(2) Registry contains deep, dynamically updating, longitudinally matched clinical data across gender, age group, payor type (commercial, Managed Medicare, and Managed Medicaid), geography (capturing virtually all U.S. counties), and venue (inpatient and outpatient). Analysis of the MORE(2) Registry has enabled extensive insights into health care quality, outcomes, and financial performance improvement solutions, as well as highly sophisticated business intelligence and health care research programs focused on providing valuable insight and improving care and efficiency throughout the health care community.

SOURCE MedAssurant, Inc.