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Study Finds MA Enrollees Lower Chance of Admittance to High Quality Hospitals

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RevCycle Intelligence writes: Medicare Advantage (MA) enrollees had a 2.8 percentage point lower probability of being admitted to a highly rated hospital compared to traditional Medicare enrollees, according to a report from Brown University School of Public Health, published in JAMA Network Open

The cross-sectional study of 12,190,280 hospitalizations in the US from 2012 to 2016 showed that there were notable differences in the quality of hospitals MA patients were admitted to, which suggested that Medicare Advantage contracts may be steering their patients toward specific hospitals.

Using Medicare Provider and Analysis Review (MedPAR) claims, researchers assessed trends in hospital entrance over time. The main portion of the study focused on 2016 data.

The data showed that Medicare Advantage enrollees were more likely to be treated at an average ranking hospital according to the 5-star rating system used by CMS. The enrollees had a 5.5 percentage point higher probability of being admitted to one of these average hospitals compared to their traditional Medicare counterparts. However, Medicare Advantage enrollees were also less likely to be admitted to a low-quality hospital.

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