Medicare spends more on post-hospital care than private insurers

Post-hospital spending for Medicare patients is consistently higher than that of private insurers, according to a study published in Health Affairs.

For the study, researchers from the University of Michigan in Ann Arbor analyzed data on more than 25,000 Michigan patients age 60 and older hospitalized for one of five conditions: heart attack, heart failure, cardiac bypass surgery, stroke, hip replacement or colon surgery. Patients either had traditional Medicare coverage or private insurance from Blue Cross Blue Shield of Michigan. All sought care at hospitals participating in the Michigan Value Collaborative, a statewide quality improvement initiative funded by BCBSM. Researchers used statistical analysis techniques to compare post-hospital care utilization and costs for both groups.

They found Medicare spent more on post-hospital care for nearly every condition and form of post-acute care. For example, post-hospital spending by Medicare was nearly double that of private insurers for hip replacement patients. Despite these differences in spending, both patients demonstrate similar readmission rates.

"This shows that providers are making similar clinical decisions about what to do regarding post-hospital care for both types of patients, but that Medicare is far more permissive regarding the volume of services delivered and therefore the costs," lead author Scott Regenbogen, MD, co-director of the Michigan Value Collaborative and chief of colorectal surgery at Ann Arbor-based Michigan Medicine, said in a news release.

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