Medicare advantage

Comparison of health care utilization by Medicare Advantage and traditional Medicare beneficiaries with complex care needs

By: Dana Drzayich Antol; Richard Schwartz; Ariel Caplan; Adrianne Casebeer; C. Jo Erwin; William H. Shrank; Brian W. Powers

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In this cross-sectional study of 1,844,326 Medicare beneficiaries, we measured differences in rates of health care utilization between those enrolled in traditional Medicare versus Medicare Advantage. We found that those enrolled in MA had lower rates of hospital stays, emergency department visits, and 30-day readmissions. The largest relative differences were observed for hospital stays, which ranged from −9.3% to −11.9% across different cohorts of beneficiaries with complex care needs. Among Medicare beneficiaries with complex care needs, those enrolled in MA had lower rates of acute care utilization, suggesting that managed care activities in MA may influence the nature and quality of care provided to these beneficiaries.

Read article: JAMA Health Forum