Medicare Advantage members have fewer hospital readmissions than traditional Medicare: Report

Medicare Advantage enrollees have 70% lower hospital readmission rates than their counterparts in fee-for-service Medicare, a white paper from researchers at Boston-based Harvard Medical School and software firm Inovalon found. 

The report, published Nov. 1, used data from Inovalon, which covers around 30% of commercially-insured individuals in the U.S., to control for outcomes as individuals transition to Medicare coverage at age 65. 

Here are five key findings to note: 

  1. FFS Medicare enrollees in Inovalon's sample had 3.6 times higher rates of 30-day hospital readmissions than their counterparts in MA. 

  2. FFS beneficiaries had 1.6 times higher rates of avoidable hospitalizations than MA beneficiaries. This rate was higher for acute conditions, with FFS beneficiaries 2.5 times more likely to have avoidable hospitalizations for these conditions than their counterparts in MA. The difference was smaller for chronic conditions, with FFS beneficiaries 1.3 times more likely to have avoidable hospitalizations than the MA population. 

  3. MA and FFS beneficiaries had similar rates of adherence to medications to treat hypertension, diabetes and cholesterol, and similar rates of engagement in treatment for substance use disorder. 

  4. Rates of inappropriate use of high-risk medications was 1.6 times higher in FFS than in MA. 

  5. The findings that MA beneficiaries are less likely to be readmitted to the hospital lines up with previous findings from Inovalon data that showed MA beneficiaries had lower inpatient utilization rates than FFS beneficiaries. 

Read the full report here. 

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