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Regional associations between Medicare Advantage penetration and administrative claims-based measures of hospital outcomes.

Authors :
Kulkarni VT
Shah SJ
Bernheim SM
Wang Y
Normand SL
Han LF
Rapp MT
Drye EE
Krumholz HM
Source :
Medical care [Med Care] 2012 May; Vol. 50 (5), pp. 406-9.
Publication Year :
2012

Abstract

Background: Risk-standardized measures of hospital outcomes reported by the Centers for Medicare and Medicaid Services include Medicare fee-for-service (FFS) patients and exclude Medicare Advantage (MA) patients due to data availability. MA penetration varies greatly nationwide and seems to be associated with increased FFS population risk. Whether variation in MA penetration affects the performance on the Centers for Medicare and Medicaid Service measures is unknown.<br />Objective: To determine whether the MA penetration rate is associated with outcomes measures based on FFS patients.<br />Research Design: In this retrospective study, 2008 MA penetration was estimated at the Hospital Referral Region (HRR) level. Risk-standardized mortality rates and risk-standardized readmission rates for heart failure, acute myocardial infarction, and pneumonia from 2006 to 2008 were estimated among HRRs, along with several markers of FFS population risk. Weighted linear regression was used to test the association between each of these variables and MA penetration among HRRs.<br />Results: Among 304 HRRs, MA penetration varied greatly (median, 17.0%; range, 2.1%-56.6%). Although MA penetration was significantly (P<0.05) associated with 5 of the 6 markers of FFS population risk, MA penetration was insignificantly (P≥0.05) associated with 5 of 6 hospital outcome measures.<br />Conclusion: Risk-standardized mortality rates and risk-standardized readmission rates for heart failure, acute myocardial infarction, and pneumonia do not seem to differ systematically with MA penetration, lending support to the widespread use of these measures even in areas of high MA penetration.

Details

Language :
English
ISSN :
1537-1948
Volume :
50
Issue :
5
Database :
MEDLINE
Journal :
Medical care
Publication Type :
Academic Journal
Accession number :
22456113
Full Text :
https://doi.org/10.1097/MLR.0b013e318245a0f9