Health Plans Providing Value to Medicare Advantage Beneficiaries

A report by the American Hospital Association finds that rates of chronic disease are growing among Medicare patients and increasing costs.

According to the report, “…in 2008, two-thirds of all Medicare beneficiaries had at least two or more chronic conditions, and the number continues to climb.”

Health plans are working with seniors and people with disabilities in Medicare Advantage plans to ensure that beneficiaries receive health care services on a timely basis, while also emphasizing prevention and providing access to disease management services for their chronic conditions.  These coordinated care systems provide for the seamless delivery of health care services across the continuum of care. Physician services, hospital care, prescription drugs, and other health care services are integrated and delivered through an organized system whose overriding purpose is to prevent illness, improve health status, and employ best practices to swiftly treat medical conditions as they occur, rather than waiting until they have advanced to a more serious level.

A study published in the January 2012 edition of Health Affairs found that beneficiaries with diabetes in a Medicare Advantage special needs plan (SNP) had “seven percent more primary care physician office visits; nine percent lower hospital admission rates; 19 percent fewer hospital days; and 28 percent fewer hospital readmissions compared to patients in FFS Medicare.”

A study published in the American Journal of Managed Care found that unadjusted 30-day readmission rates for Medicare Advantage patients were approximately 22% lower than fee-for-service Medicare. The transitional care interventions used by Medicare Advantage plans and improved communication among providers of care have been shown to play a role in reducing readmission rates and are being looked to as a model elsewhere in the health care system.

More information on the value health plans are providing to Medicare Advantage beneficiaries:

This entry was posted in Issue Alert and tagged , . Bookmark the permalink.

Comments are closed.