Why Medicare Advantage networks may reduce avoidable hospitalizations

Differences in the clinicians Medicare Advantage and traditional Medicare beneficiaries see have some effect on differences in avoidable hospitalization rates between the two programs, a study published Nov. 10 in JAMA Health Forum found. 

The study compared a nationally representative sample of Medicare Advantage and traditional Medicare beneficiaries with five ambulatory care sensitive conditions. When the sample was controlled by primary care clinician, MA beneficiaries had lower rates of avoidable hospitalizations by 2.6 percentage points. 

The difference suggests Medicare Advantage beneficiaries see clinicians who have lower rates of avoidable hospitalizations among their patients than the clinicians their counterparts in traditional Medicare see. 

"We found that MA beneficiaries' care was being managed by clinicians with lower rates of avoidable hospital stays," the researchers concluded. "Our findings suggest that provider networks may play an important role in sorting beneficiaries to clinicians with desirable performance metrics." 

The study was authored by researchers at Baltimore-based Johns Hopkins University and the University of Colorado in Aurora. Read the full study here

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