Seniors in Medicare Advantage Receive Higher Quality Care, New Reports Show

To view the full report, please visit: www.AHIPResearch.org.

WASHINGTON, Sept. 15 /PRNewswire-USNewswire/ -- Seniors in Medicare Advantage
spent fewer days in a hospital, were subject to fewer hospital re-admissions,
and were less likely to have "potentially avoidable" admissions, for common
conditions ranging from uncontrolled diabetes to dehydration, according to a
new analysis of publicly available AHRQ data released today by America's
Health Insurance Plans (AHIP).

The new study echoes the findings of an earlier analysis of AHIP member data
showing that seniors in Medicare health plans can receive higher quality care
compared to fee-for-service (FFS) Medicare.

"Medicare Advantage plans coordinate care, help seniors manage chronic
conditions, and focus on prevention to help seniors stay healthy in the first
place," said Karen Ignagni, President and CEO of AHIP.

Instead of focusing almost exclusively on treating beneficiaries when they are
sick, Medicare Advantage plans place a strong emphasis on preventive health
care services that detect diseases at an early stage and disease management
programs for seniors with chronic illnesses to help them keep their conditions
under control. These programs are working to help keep patients out of the
hospital and avoid potentially harmful complications.

The new study analyzed statewide datasets on hospital admissions in California
and Nevada compiled by the Agency for Healthcare Research and Quality (AHRQ).
The unique data in these states allows for direct comparisons of utilization
rates among enrollees in Medicare Advantage plans and in FFS Medicare. These
comparisons were adjusted for health status using the Medicare risk score
process for age, sex, and 70 Hierarchical Condition Categories that are used
as a basis for Medicare risk adjustment. Key findings from the report
include:

-- Medicare Advantage beneficiaries in California spent 30 percent fewer
days in the hospitals than patients with FFS Medicare, and in Nevada,
seniors in Medicare Advantage plans spent 23 percent fewer days in the
hospital.
-- Medicare Advantage enrollees were re-admitted to the hospital in the
same quarter for the same condition 15 percent less often in
California
and 33 percent less often in Nevada compared to FFS Medicare.

-- In both California and Nevada, seniors in Medicare Advantage were 6
percent less likely than seniors in FFS Medicare to be admitted to the
hospital for conditions described by AHRQ as "potentially
avoidable," such as dehydration, urinary tract infection, or
uncontrolled diabetes.

The new analysis follows a previous AHIP study comparing utilization rates
among patients in eight Medicare health plans compared to seniors in FFS
Medicare. This study among seniors with certain chronic conditions in
California and Nevada also found that:

-- Medicare Advantage beneficiaries spent an average of 18 percent fewer
days in the hospital than seniors in FFS Medicare.
-- Seniors in Medicare Advantage had an average of 27 percent fewer
visits
to the emergency room than those seniors in traditional Medicare.
-- Seniors enrolled in Medicare Advantage health plans also experienced a
42 percent lower rate of hospital re-admissions than those seniors in
FFS Medicare.

-- Avoidable admissions to the hospital were 13 percent lower among
seniors
in Medicare Advantage plans than those in traditional Medicare.

Policymakers and stakeholders recognize that reducing preventable hospital
admissions and readmissions are important steps towards improving the quality
and safety of patient care and helping to put our health care system on a more
sustainable path. These studies demonstrate that the programs Medicare
Advantage plans have implemented provide a model for how this can be
accomplished.

The health care reform proposals currently being considered in Congress
include significant cuts to the Medicare Advantage program that would risk the
health security of millions of seniors across the country. Seniors would face
higher premiums, reduced benefits, and, in some parts of the country, would
lose access to their Medicare Advantage plan altogether.

"The entire Medicare program, including Medicare Advantage, should be
carefully evaluated as part of comprehensive health care reform. However,
seniors in Medicare Advantage should not be forced to fund a disproportionate
share of the costs to reform the health care system," said Ignagni.

To read the full reports, please visit www.AHIPResearch.org.

America's Health Insurance Plans - Providing Health Benefits to More Than 200
Million Americans

SOURCE America's Health Insurance Plans

Robert Zirkelbach of America's Health Insurance Plans, +1-202-778-8493