Medicare Advantage Plans Help Keep Patients out of Hospital

[Arianrhod]

http://www.medscape.com/viewarticle/860776?src=wnl_edit_tpal&uac=127342PX

To the adults among us, this is significant. Who doesn't appreciate cost-saving? USMB RWs, apparently. Watch the reaction:

www.medscape.com

Medicare Advantage Plans Help Keep Patients out of Hospital

Marcia Frellick March 22, 2016

Medicare Advantage (MA) patients are 10% less likely to have avoidable hospitalizations than traditional fee-for-service Medicare (TM) enrollees, a new 12-state study shows.

That finding held steady, even after controlling for age, sex, race or ethnicity, region, severity of illness, and other health-related factors, report Stephen Petterson, PhD, and colleagues at the Robert Graham Center in Washington, DC, who performed on behalf of the Better Medicare Alliance.

"Under [MA], the emphasis on primary care, care coordination, disease management, and supportive services pays real dividends," Allyson Y. Schwartz, president and chief executive officer of the Better Medicare Alliance, said in a news release. "In the effort to reform Medicare, [MA] is moving us in the right direction."

In unadjusted analysis, "[f]or the 12 study states combined, there are 243.2 hospitalizations per 1,000 TM beneficiaries, which is 31% higher than the rate for MA beneficiaries (185.4 per 1,000); TM hospitalizations for marker conditions are 27% higher than those for MA beneficiaries," the authors write. "To the extent that the presence of marker conditions reflects the underlying health of TM and MA beneficiaries, these results are consistent with previous studies showing that MA beneficiaries are healthier than TM beneficiaries. At the same time, the difference in avoidable hospitalization rates is 40.2%, which is 9% higher than the difference in overall hospitalization rates and 13% higher than the difference in marker condition hospitalization rates."

In multivariate models, in which the analysis was restricted to marker and avoidable hospitalizations, the researchers estimate that MA enrollees have a 10% reduction in hospitalization risk (odd ratio [OR], 0.90; 95% confidence interval [CI], 0.89 - 0.92), compared with TM enrollees. In contrast, MA enrollees were more likely to have referral-sensitive hospitalizations, which is seen as an indicator of better outpatient care, compared with TM enrollees (OR, 1.06; 95% CI, 1.05 - 1.08).

Mixed Results From Previous Studies

The new findings are in agreement with previous studies, but the reasons for the apparent success of the MA plans has been debated. Proponents argue that there are fewer hospitalizations because of the focus on prevention, primary care, and good care management, and critics contend that it is a result of selection bias toward healthier individuals who need fewer services.

The authors acknowledge the previous evidence has been mixed: "A large study comparing MA enrollees and TM beneficiaries found that MA enrollment was concentrated in subpopulations with poorer health," they write. "Compared with TM beneficiaries, MA enrollees had lower education levels, were more likely to be African American or Hispanic, and had lower incomes. On the other hand, they reported better self-perceived health status, which may imply that they were generally healthier than TM beneficiaries." Other studies have had mixed results as well.

This study has several advantages, the authors say. One is that researchers divided the inpatient care into three groups. In addition to avoidable hospitalizations, which could have been prevented by better outpatient care, they looked at marker condition hospitalizations, which are for conditions such as appendicitis, hip fractures, or heart attack that better outpatient care would not have prevented, and referral-sensitive hospitalizations, which are planned to prevent worse outcomes.

One finding that argues against the criticism of selection bias is that the states studied had varied results, and several (Rhode Island, Oregon, and Massachusetts) stand out as having higher rates of avoidable hospitalizations for MA enrollees than for TM beneficiaries. In each of these states, other types of hospitalizations, including those for unavoidable conditions, are also more common among MA enrollees.

"This suggests that MA plans attract less healthy patients in these states," the authors write.

The researchers also used more recent Healthcare Cost and Utilization Project data from a greater number of states to estimate differences. The 12 states all had data that differentiated MA from TM and were "fairly representative of all 50 states and the District of Columbia," the researchers note.

MA was also linked with a positive "spillover effect" on TM beneficiaries, meaning counties with more MA penetration had fewer avoidable hospitalizations for both MA enrollees and TM beneficiaries, even after controlling for other factors.

The findings are particularly important in light of recent growth projections. The Congressional Budget Office last year predicted that "enrollment in MA and other group health plans will grow each year over the next decade and could reach 30 million patients — roughly 40% of Medicare beneficiaries — by 2025," the authors note.

Support for the research was provided by Better Medicare Alliance. Two of the authors are employees of the Robert Graham Center.

"Understanding the Impact of Medicare Advantage on Hospitalization Rates: A 12-State Study." Robert Graham Center. Published online March 15, 2016. Full text


Medscape Medical News © 2016 WebMD, LLC

Send comments and news tips to [email protected].

Cite this article: Medicare Advantage Plans Help Keep Patients out of Hospital. Medscape. Mar 22, 2016.

 

[Mac1958]

Yep.

Expand the Medicare/Medicare Supplement/Medicare Advantage system out from the current, completely arbitrary age 65 point to everyone.

Take a massive monkey off the backs of American employers. Open up vast markets to insurance companies for competition and innovation. Increase the overall health of the populace via foundational preventive, diagnostic and basic care. Relieve insurance companies of some of the massive costs of tracking, administering and paying for low-end services. And rid this country once and for all of this absurd seven-part (none of which communicate directly with each other) health delivery/payment system.

No, no, that would make too much fucking sense.
.

 

[LoneLaugher]

Yep.

Expand the Medicare/Medicare Supplement/Medicare Advantage system out from the current, completely arbitrary age 65 point to everyone.

Take a massive monkey off the backs of American employers. Open up vast markets to insurance companies for competition and innovation. Increase the overall health of the populace via foundational preventive, diagnostic and basic care. Relieve insurance companies of some of the massive costs of tracking, administering and paying for low-end services. And rid this country once and for all of this absurd seven-part (none of which communicate directly with each other) health delivery/payment system.

No, no, that would make too much fucking sense.
.

That's very PC of you.

Why not just call it "Single Payer"? Don't want to offend anyone?

 

[Arianrhod]

Yep.

Expand the Medicare/Medicare Supplement/Medicare Advantage system out from the current, completely arbitrary age 65 point to everyone.

Take a massive monkey off the backs of American employers. Open up vast markets to insurance companies for competition and innovation. Increase the overall health of the populace via foundational preventive, diagnostic and basic care. Relieve insurance companies of some of the massive costs of tracking, administering and paying for low-end services. And rid this country once and for all of this absurd seven-part (none of which communicate directly with each other) health delivery/payment system.

No, no, that would make too much fucking sense.
.

That's very PC of you.

Why not just call it "Single Payer"? Don't want to offend anyone?

Be nice.

 

[LoneLaugher]

Yep.

Expand the Medicare/Medicare Supplement/Medicare Advantage system out from the current, completely arbitrary age 65 point to everyone.

Take a massive monkey off the backs of American employers. Open up vast markets to insurance companies for competition and innovation. Increase the overall health of the populace via foundational preventive, diagnostic and basic care. Relieve insurance companies of some of the massive costs of tracking, administering and paying for low-end services. And rid this country once and for all of this absurd seven-part (none of which communicate directly with each other) health delivery/payment system.

No, no, that would make too much fucking sense.
.

That's very PC of you.

Why not just call it "Single Payer"? Don't want to offend anyone?

Be nice.

Nope. Not to earmuffs. Thanks for your comment, though.

 

[Mac1958]

Yep.

Expand the Medicare/Medicare Supplement/Medicare Advantage system out from the current, completely arbitrary age 65 point to everyone.

Take a massive monkey off the backs of American employers. Open up vast markets to insurance companies for competition and innovation. Increase the overall health of the populace via foundational preventive, diagnostic and basic care. Relieve insurance companies of some of the massive costs of tracking, administering and paying for low-end services. And rid this country once and for all of this absurd seven-part (none of which communicate directly with each other) health delivery/payment system.

No, no, that would make too much fucking sense.
.

That's very PC of you.

Why not just call it "Single Payer"? Don't want to offend anyone?

Be nice.

My little stalker friend isn't capable.

If I wanted single payer, I would say so.

But the hardcore partisan ideologues gotta keep stuff simple 'n stuff.
.

 

[LoneLaugher]

Yep.

Expand the Medicare/Medicare Supplement/Medicare Advantage system out from the current, completely arbitrary age 65 point to everyone.

Take a massive monkey off the backs of American employers. Open up vast markets to insurance companies for competition and innovation. Increase the overall health of the populace via foundational preventive, diagnostic and basic care. Relieve insurance companies of some of the massive costs of tracking, administering and paying for low-end services. And rid this country once and for all of this absurd seven-part (none of which communicate directly with each other) health delivery/payment system.

No, no, that would make too much fucking sense.
.

That's very PC of you.

Why not just call it "Single Payer"? Don't want to offend anyone?

Be nice.

My little stalker friend isn't capable.

If I wanted single payer, I would say so.

But the hardcore partisan ideologues gotta keep stuff simple 'n stuff.
.

Medicare for all is single payer.

You may now spin.

 

[Mac1958]

Be nice.

Additionally, most people don't even know what Medicare covers and doesn't cover, hence the need for, and value of, Medicare Advantage and Medicare Supplement plans. In this video describing Single Payer, it says ALL medical costs are paid for by the government, "just like Medicare". Which is F-A-L-S-E. You can go into the hospital with only basic Medicare and come out owing thousands. Medicare has significant gaps in coverage, hence the need for and value of those other two supplemental options:



The Sanders Single Payer advocates don't understand that it's actually not Medicare for All. Even on Sanders' own website, he calls his plan "Medicare for All", yet says that government pays for all services, which is not what Medicare does:

"Bernie’s plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans. Bernie’s plan will cover the entire continuum of health care."

That is not how Medicare works, but they don't realize that. They continue to confuse Medicare for All with Single Payer. Even Sanders. Hey, who cares, right? It's just politics.

Too many ignorant, deceitful people out there.

Source: Medicare for All: Leaving No One Behind - Bernie Sanders
.

 

[Sun Devil 92]

This OP belongs in the laugh zone.

 

[Arianrhod]

Be nice.

Additionally, most people don't even know what Medicare covers and doesn't cover, hence the need for, and value of, Medicare Advantage and Medicare Supplement plans. In this video describing Single Payer, it says ALL medical costs are paid for by the government, "just like Medicare". Which is F-A-L-S-E. You can go into the hospital with only basic Medicare and come out owing thousands. Medicare has significant gaps in coverage, hence the need for and value of those other two supplemental options:



The Sanders Single Payer advocates don't understand that it's actually not Medicare for All. Even on Sanders' own website, he calls his plan "Medicare for All", yet says that government pays for all services, which is not what Medicare does:

"Bernie’s plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans. Bernie’s plan will cover the entire continuum of health care."

That is not how Medicare works, but they don't realize that. They continue to confuse Medicare for All with Single Payer. Even Sanders. Hey, who cares, right? It's just politics.

Too many ignorant, deceitful people out there.

Source: Medicare for All: Leaving No One Behind - Bernie Sanders
.

Whatever. As compared to no insurance, it's progress. Still not equivalent to standard of care in any other industrialiazed nation, but progress.

 

[Mac1958]

Be nice.

Additionally, most people don't even know what Medicare covers and doesn't cover, hence the need for, and value of, Medicare Advantage and Medicare Supplement plans. In this video describing Single Payer, it says ALL medical costs are paid for by the government, "just like Medicare". Which is F-A-L-S-E. You can go into the hospital with only basic Medicare and come out owing thousands. Medicare has significant gaps in coverage, hence the need for and value of those other two supplemental options:



The Sanders Single Payer advocates don't understand that it's actually not Medicare for All. Even on Sanders' own website, he calls his plan "Medicare for All", yet says that government pays for all services, which is not what Medicare does:

"Bernie’s plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans. Bernie’s plan will cover the entire continuum of health care."

That is not how Medicare works, but they don't realize that. They continue to confuse Medicare for All with Single Payer. Even Sanders. Hey, who cares, right? It's just politics.

Too many ignorant, deceitful people out there.

Source: Medicare for All: Leaving No One Behind - Bernie Sanders
.

Whatever. As compared to no insurance, it's progress. Still not equivalent to standard of care in any other industrialiazed nation, but progress.

"Whatever" is precisely what we get when a bunch of under-informed people discuss and create a health care "system" at a massive cost that is only marginally better crap.

Single payer and "Medicare for All" are two different things, and obedient little partisans can't even get THAT right.

This is a critical issue, and because people are allowing their partisan ideology to get in the way, we're getting "whatever".
.

 

[Arianrhod]

Be nice.

Additionally, most people don't even know what Medicare covers and doesn't cover, hence the need for, and value of, Medicare Advantage and Medicare Supplement plans. In this video describing Single Payer, it says ALL medical costs are paid for by the government, "just like Medicare". Which is F-A-L-S-E. You can go into the hospital with only basic Medicare and come out owing thousands. Medicare has significant gaps in coverage, hence the need for and value of those other two supplemental options:



The Sanders Single Payer advocates don't understand that it's actually not Medicare for All. Even on Sanders' own website, he calls his plan "Medicare for All", yet says that government pays for all services, which is not what Medicare does:

"Bernie’s plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans. Bernie’s plan will cover the entire continuum of health care."

That is not how Medicare works, but they don't realize that. They continue to confuse Medicare for All with Single Payer. Even Sanders. Hey, who cares, right? It's just politics.

Too many ignorant, deceitful people out there.

Source: Medicare for All: Leaving No One Behind - Bernie Sanders
.

Whatever. As compared to no insurance, it's progress. Still not equivalent to standard of care in any other industrialiazed nation, but progress.

"Whatever" is precisely what we get when a bunch of under-informed people discuss and create a health care "system" at a massive cost that is only marginally better crap.

Single payer and "Medicare for All" are two different things, and obedient little partisans can't even get THAT right.

This is a critical issue, and because people are allowing their partisan ideology to get in the way, we're getting "whatever".
.

Maybe if the opposition presented some facts to accompany their opinions, it might clarify the issue.

 

[Mac1958]

Be nice.

Additionally, most people don't even know what Medicare covers and doesn't cover, hence the need for, and value of, Medicare Advantage and Medicare Supplement plans. In this video describing Single Payer, it says ALL medical costs are paid for by the government, "just like Medicare". Which is F-A-L-S-E. You can go into the hospital with only basic Medicare and come out owing thousands. Medicare has significant gaps in coverage, hence the need for and value of those other two supplemental options:



The Sanders Single Payer advocates don't understand that it's actually not Medicare for All. Even on Sanders' own website, he calls his plan "Medicare for All", yet says that government pays for all services, which is not what Medicare does:

"Bernie’s plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans. Bernie’s plan will cover the entire continuum of health care."

That is not how Medicare works, but they don't realize that. They continue to confuse Medicare for All with Single Payer. Even Sanders. Hey, who cares, right? It's just politics.

Too many ignorant, deceitful people out there.

Source: Medicare for All: Leaving No One Behind - Bernie Sanders
.

Whatever. As compared to no insurance, it's progress. Still not equivalent to standard of care in any other industrialiazed nation, but progress.

"Whatever" is precisely what we get when a bunch of under-informed people discuss and create a health care "system" at a massive cost that is only marginally better crap.

Single payer and "Medicare for All" are two different things, and obedient little partisans can't even get THAT right.

This is a critical issue, and because people are allowing their partisan ideology to get in the way, we're getting "whatever".
.

Maybe if the opposition presented some facts to accompany their opinions, it might clarify the issue.

I don't know who the opposition is.

The Left wants Single Payer, the Right wants, uh, something else, I don't know.

Neither end has pushed what I suggest.
.

 

[Arianrhod]

Be nice.

Additionally, most people don't even know what Medicare covers and doesn't cover, hence the need for, and value of, Medicare Advantage and Medicare Supplement plans. In this video describing Single Payer, it says ALL medical costs are paid for by the government, "just like Medicare". Which is F-A-L-S-E. You can go into the hospital with only basic Medicare and come out owing thousands. Medicare has significant gaps in coverage, hence the need for and value of those other two supplemental options:



The Sanders Single Payer advocates don't understand that it's actually not Medicare for All. Even on Sanders' own website, he calls his plan "Medicare for All", yet says that government pays for all services, which is not what Medicare does:

"Bernie’s plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans. Bernie’s plan will cover the entire continuum of health care."

That is not how Medicare works, but they don't realize that. They continue to confuse Medicare for All with Single Payer. Even Sanders. Hey, who cares, right? It's just politics.

Too many ignorant, deceitful people out there.

Source: Medicare for All: Leaving No One Behind - Bernie Sanders
.

Whatever. As compared to no insurance, it's progress. Still not equivalent to standard of care in any other industrialiazed nation, but progress.

"Whatever" is precisely what we get when a bunch of under-informed people discuss and create a health care "system" at a massive cost that is only marginally better crap.

Single payer and "Medicare for All" are two different things, and obedient little partisans can't even get THAT right.

This is a critical issue, and because people are allowing their partisan ideology to get in the way, we're getting "whatever".
.

Maybe if the opposition presented some facts to accompany their opinions, it might clarify the issue.

I don't know who the opposition is.

The Left wants Single Payer, the Right wants, uh, something else, I don't know.

Neither end has pushed what I suggest.
.

All I want is for all Americans to be able to take care of their health needs. A healthy nation is a strong nation. That should be self-evident, and neither a political football nor a cash cow for pharma/insurance stockholders.

 

[Mac1958]

Additionally, most people don't even know what Medicare covers and doesn't cover, hence the need for, and value of, Medicare Advantage and Medicare Supplement plans. In this video describing Single Payer, it says ALL medical costs are paid for by the government, "just like Medicare". Which is F-A-L-S-E. You can go into the hospital with only basic Medicare and come out owing thousands. Medicare has significant gaps in coverage, hence the need for and value of those other two supplemental options:



The Sanders Single Payer advocates don't understand that it's actually not Medicare for All. Even on Sanders' own website, he calls his plan "Medicare for All", yet says that government pays for all services, which is not what Medicare does:

"Bernie’s plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans. Bernie’s plan will cover the entire continuum of health care."

That is not how Medicare works, but they don't realize that. They continue to confuse Medicare for All with Single Payer. Even Sanders. Hey, who cares, right? It's just politics.

Too many ignorant, deceitful people out there.

Source: Medicare for All: Leaving No One Behind - Bernie Sanders
.

Whatever. As compared to no insurance, it's progress. Still not equivalent to standard of care in any other industrialiazed nation, but progress.

"Whatever" is precisely what we get when a bunch of under-informed people discuss and create a health care "system" at a massive cost that is only marginally better crap.

Single payer and "Medicare for All" are two different things, and obedient little partisans can't even get THAT right.

This is a critical issue, and because people are allowing their partisan ideology to get in the way, we're getting "whatever".
.

Maybe if the opposition presented some facts to accompany their opinions, it might clarify the issue.

I don't know who the opposition is.

The Left wants Single Payer, the Right wants, uh, something else, I don't know.

Neither end has pushed what I suggest.
.

All I want is for all Americans to be able to take care of their health needs. A healthy nation is a strong nation. That should be self-evident, and neither a political football nor a cash cow for pharma/insurance stockholders.

We can have a combination of the best of both, if the politicians and partisans would just let it happen.

The system already exists, that's what so frustrating. Just expand the freaking thing.
.