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AHIP report finds Medicare Advantage is reducing preventable hospital readmissions for seniors

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Findings from report released by America’s Health Insurance Plans (AHIP) show seniors in Medicare Advantage have lower risk-adjusted hospital readmission rates than patients in Medicare’s traditional fee-for-service (FFS) program. The study analyzed data from nine states and found reductions in risk-adjusted hospital readmission rates averaging 14-29 percent among seniors in Medicare Advantage compared with Medicare FFS enrollees.

According to a study published in the New England Journal of Medicine, nearly one-fifth (19.6 percent) of Medicare fee-for-service beneficiaries who had been discharged from a hospital were rehospitalized within 30 days, and 34 percent were rehospitalized within 90 days. Moreover, half of patients who were rehospitalized within 30 days did not have a physician visit between the time of discharge and rehospitalization – suggesting that one of the reasons patients ended up back in the hospital was lack of needed follow-up care.

The new AHIP report was based on an analysis of hospital discharge datasets provided by the Agency for Healthcare Research and Quality (AHRQ) as well as state discharge data acquired directly from the states of Pennsylvania and Texas. In the states studied, estimated risk-adjusted readmission rates were about 27-29 percent lower in Medicare Advantage than Medicare FFS per enrollee, 16-18 percent lower per person with an admission, and14-17 percent lower as measured per hospitalization.

Read more: Working Paper: Using State Hospital Discharge Data to Compare Readmission Rates in Medicare Advantage and Medicare’s Traditional Fee-for-Service Program, AHIP Center for Policy and Research, May 2010

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