Study: Medicare Advantage Cut ER Visits 33% Compared To Fee-For-Service

A new study by health research firm Avalere Health shows that Medicare beneficiaries enrolled in a Medicare Advantage plan have 33% less Emergency Room visits and 23% fewer stays in the hospital compared to those enrolled in traditional fee-for-service Medicare.

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The 32-page report, funded by the insurance-industry backed Better Medicare Alliance comes at the same time that the services Medicare Advantage plans can offer seniors has been expanded. The new study shows how these plans have thus far guided seniors to lower cost services and coordinated care to keep them out of the hospital and ER. The study looked at 1.5 million Medicare Advantage beneficiaries and 1.2 million traditional fee-for-service Medicare beneficiaries with chronic conditions like high blood pressure, diabetes, and high cholesterol.

"Utilization of costly healthcare services was lower for Medicare Advantage beneficiaries, including 23% fewer inpatient stays (249 versus 324 per 1,000 beneficiaries in fee-for-service Medicare) and 33% fewer emergency room visits (511 versus 759 per 1,000 beneficiaries in fee-for-service Medicare)," the Avalere report said.

The report argues that MA plans are better at encouraging seniors to regularly see a primary care physician, resulting in higher rates of screenings and tests. “Medicare Advantage plans’ focus on preventive care may help avoid downstream utilization of high-cost services driven by acute-care and emergency needs,” said Christie Teigland, vice president at Avalere.