Medicare Advantage outperforms traditional Medicare when it comes to pneumonia and flu vaccines, diabetic eye exams, post-acute care and avoidable hospitalizations — all of which enable older adults to live longer at home.
That’s according to the findings in a report recently released by Better Medicare Alliance’s Center for Innovation in Medicare Advantage. The report features analysis by Avalere Health based on data representing 1.4 million Medicare Advantage and 7.9 million traditional Medicare high-need beneficiaries. Those beneficiaries include the frail elderly, those with complex chronic conditions, and individuals aged fewer than 65 years old who are part of the Medicare program due to a disability.
“This research paints a compelling picture of how Medicare Advantage’s high-quality, value-based care and care management offers earlier clinical interventions and more frequent use of primary care services and preventive screenings. In turn, beneficiaries stay out of the hospital and avoid costlier settings of care,” said Allyson Y. Schwartz, president and CEO of the Better Medicare Alliance.
“Medicare Advantage beneficiaries had 49% and 11% higher rates of vaccination for pneumonia and the flu and the contrasts are even more pronounced among high-need, high-cost beneficiaries,” Schwartz continued. “For example, beneficiaries with major complex chronic conditions had 57% lower rates of avoidable hospitalizations for acute conditions in Medicare Advantage than in traditional Medicare, while frail elderly beneficiaries had 45% lower rates of avoidable hospitalizations for acute conditions.”
Home health utilization is lower for all three populations in Medicare Advantage compared with traditional FFS Medicare, however, the report authors noted. “One possible explanation is that inappropriate use of these services is minimized in Medicare Advantage relative to Traditional FFS Medicare, but further research is needed to evaluate differences in use of home health services,” they wrote.
