When it comes to emergency department visits and ambulatory surgeries, utilization rates are lower for beneficiaries enrolled in a Medicare Advantage plan compared with traditional Medicare, according a study in this month's Health Affairs.
Researchers looked at the utilization patterns of enrollees in Medicare and Medicare Advantage, which is the private, managed care option, from 2003 through 2009. Currently, there are 12.8 million people enrolled in an MA plan, which represents 27 percent of all Medicare beneficiaries.
The study found emergency department visits were about 25 to 35 percent lower in MA HMOs, and inpatient medical days for MA beneficiaries were also 20 to 25 percent lower. Ambulatory service utilization was 25 percent lower for MA enrollees in 2003, but that difference dwindled to 7 percent by 2008.
However, MA beneficiaries had higher utilization rates for some services, particularly coronary artery bypass graft surgeries and some other heart procedures.
The authors wrote the "findings suggest that overall, Medicare Advantage HMO enrollees might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare," but further research must be done to include clinical data and health outcomes.
This is the second major study on MA in the past couple months. In October, Physicians for a National Health Program found Medicare has overpaid MA insurers $282.6 billion since 1985.
Researchers looked at the utilization patterns of enrollees in Medicare and Medicare Advantage, which is the private, managed care option, from 2003 through 2009. Currently, there are 12.8 million people enrolled in an MA plan, which represents 27 percent of all Medicare beneficiaries.
The study found emergency department visits were about 25 to 35 percent lower in MA HMOs, and inpatient medical days for MA beneficiaries were also 20 to 25 percent lower. Ambulatory service utilization was 25 percent lower for MA enrollees in 2003, but that difference dwindled to 7 percent by 2008.
However, MA beneficiaries had higher utilization rates for some services, particularly coronary artery bypass graft surgeries and some other heart procedures.
The authors wrote the "findings suggest that overall, Medicare Advantage HMO enrollees might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare," but further research must be done to include clinical data and health outcomes.
This is the second major study on MA in the past couple months. In October, Physicians for a National Health Program found Medicare has overpaid MA insurers $282.6 billion since 1985.
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