A study by America’s Health Insurance Plans (AHIP) found that beneficiaries enrolled in Medicare Advantage (MA) plans spent fewer days in the hospital and had fewer readmissions than seniors enrolled in traditional fee-for-service (FFS) Medicare.  The study examined 2006 Agency for Healthcare Research and Quality (AHRQ) data from California and Nevada, finding that seniors in MA plans were 6 percent less likely than seniors in FFS Medicare to be admitted to the hospital for reasons AHRQ categorizes as “potentially avoidable.”

From the report:

The Agency for Healthcare Research and Quality (AHRQ) has compiled statewide datasets on hospital admissions in California and Nevada that allow direct, risk-adjusted comparisons of utilization rates among enrollees in Medicare Advantage (MA) plans and in Medicare’s traditional fee-for-service (FFS) program. Based on the AHRQ data for these states in 2006, risk-adjusted rates of inpatient days per patient were 30 percent lower for MA enrollees than for FFS enrollees in California, and 23 percent lower in Nevada. Same-quarter re-admission rates for the same DRG (Medicare’s “diagnosis-related group” codes for each type of hospitalization) were 15 percent lower among MA patients in California and 33 percent lower among MA patients in Nevada. Based on classifications for 13 potentially avoidable admissions defined by AHRQ – ranging from dehydration to urinary tract infection to uncontrolled diabetes – risk-adjusted MA patients had a 6 percent lower rate of avoidable admissions than FFS enrollees in both California and Nevada.

Full report: Reductions in Hospital Days, Re-admissions, and Potentially Avoidable Admissions (PDF | 796.82 KB)

America's Health Insurance Plans, Center for Policy and Research.  (2009). Reductions in hospital days, re-admissions, and potentially avoidable admissions among Medicare Advantage enrollees in California and Nevada.