ICYMI: New York Times Economix Blog Highlights Higher Quality Care Medicare Advantage Plans Provide

Princeton economist Uwe Reinhardt recently wrote a blog post on the New York Times Economix blog highlighting research showing that beneficiaries in Medicare Advantage plans receive higher quality care compared to those in the fee-for-service (FFS) part of Medicare.  The blog post features research from AHIP demonstrating that seniors and people with disabilities enrolled in a Medicare Advantage plan have significantly lower hospital readmission rates than those in FFS Medicare.

From the Economix blog post:

As noted, a search for literature on the relative performance on quality by traditional Medicare and Medicare Advantage plans yields slim pickings.

Several studies undertaken by or at the behest of the American Health Insurance Plans, or AHIP, report that hospital readmission rates under Medicare Advantage are substantially lower than they are under traditional Medicare. Although not all hospital readmissions result from poor clinical care during the original admission, lower readmission rates are widely taken as indicative of superior quality.

 Another study published by researchers from AHIP reports that hospital admissions for diabetes were found lower in a Medicare Advantage plan concentrating on special-needs patients than they were for a comparable sample of patients in traditional Medicare. These data, too, would be interpreted as superior quality.

 study by researchers independent of the insurance industry found that patients in Medicare Advantage plans had fewer preventable hospital admissions than did comparable patients in traditional Medicare. That study also focused on referrals by primary-care physicians to specialists, finding mixed results. It is not clear to me what that metric tells us anyhow, as a low referral rate by primary-care physicians to specialists may be judged either good or bad.

 Another study by independent researchers comparing the clinical quality of care between traditional and Medicare Advantage plans found that “Medicare Advantage plans scored substantially better (4-16 percentage points; median, 7.8 percentage points) on eight measures, slightly better (1.5 percentage points) on one measure and worse than fee-for-service (2-5 percentage points; median, 4.1 percentage points) on two measures.”

Finally, yet another independent study came to the carefully hedged conclusions that “overall, Medicare Advantage H.M.O. enrollees might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare.”

For more information on the high quality care Medicare Advantage plans provide, please visit AHIP’s Coverage Blog here: http://www.ahipcoverage.com/tag/ma/.


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