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Medicare Advantage and Traditional Medicare Hospitalization Intensity and Readmissions - Mar 08, 2017

Medicare Advantage and Traditional Medicare Hospitalization Intensity and Readmissions - Mar 08, 2017

AHRQ News Now

Hospital Stays Shown To Be Less Expensive, Shorter for Medicare Advantage Patients With Mental Health Issues

Hospital stays for mental health care were substantially less expensive and shorter for seniors with Medicare Advantage insurance coverage than for those with traditional Medicare in 2013, according to a new AHRQ study of more than 7.8 million hospitalizations in 22 states. The authors did not pinpoint a reason for the difference, but they suggested one factor might have been Medicare Advantage’s emphasis on providing outpatient treatment rather than more appropriate inpatient care. The study also found that Medicare Advantage hospital stays for surgery and injury were costlier and longer than traditional Medicare admissions. The costs and lengths of stay for medical admissions were comparable for the two Medicare programs, the study found. “Medicare Advantage and Traditional Medicare Hospitalization Intensity and Readmissions” was published March 8 in Medicare Care Research and Review. Access the abstract.
SAGE Journals
    Medicare Advantage plans have incentives and tools to optimize patient care. Therefore, Medicare Advantage hospitalizations may have lower cost and higher quality than similar traditional Medicare hospitalizations. We applied a coarsened matching approach to 2013 Healthcare Cost and Utilization Project hospital discharge data from 22 states to compare hospital cost, length of stay, and readmissions for Traditional Medicare and Medicare Advantage. We found that Medicare Advantage hospitalizations were substantially less expensive and shorter for mental health stays but costlier and longer for injury and surgical stays. We found little difference in the cost and length of medical stays and in readmission rates. One explanation is that Medicare Advantage plans use outpatient settings for many patients with behavioral health conditions and for injury and surgical patients with less complex health needs. Alternatively, the observed differences in behavioral health cost and length of stay may represent skimping on appropriate care.
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