Seniors in Medicare Advantage spent fewer days in a hospital, were subject to fewer hospital readmissions, and were less likely to have “potentially avoidable” admissions, for common conditions ranging from uncontrolled diabetes to dehydration, according to a new analysis of publicly available Agency for Healthcare Research and Quality (AHRQ) data released by America’s Health Insurance Plans (AHIP).
The study analyzed statewide datasets on hospital admissions in California and Nevada. The unique data in these states allows for direct comparisons of utilization rates among enrollees in Medicare Advantage plans and in fee-for-service (FFS) Medicare. These comparisons were adjusted for health status using the Medicare risk score process for age, sex, and 70 Hierarchical Condition Categories that are used as a basis for Medicare risk adjustment. Key findings from the report include:
- Medicare Advantage beneficiaries in California spent 30 percent fewer days in the hospitals than patients with FFS Medicare, and in Nevada, seniors in Medicare Advantage plans spent 23 percent fewer days in the hospital.
- Medicare Advantage enrollees were readmitted 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 to FFS Medicare.
- In both California and Nevada, seniors in Medicare Advantage 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.
