Nearly half of Americans with Medicare have health insurance through a private company that participates in the federal Medicare Advantage program.
But choose one of these plans Doesn’t give as many benefits over traditional Medicare as it once didnew research shows — at least when it comes to heart attack care.
In fact, the reduction in post-heart attack mortality seen in the Medicare Advantage program in 2009 was no longer evident in 2018, a new study found. jam It’s by a team from Harvard and the University of Michigan.
MI stands for myocardial infarction, and in the two most common types of heart attacks called STEMI and NSTEMI, the percentage of people dying within 30 days of a heart attack decreased to about 17% in both groups. However, the 1.5% survival gap that existed in 2009 narrowed to almost zero in 2018.
This basically means that the Medicare Advantage Plan is paid by the federal government for care that ultimately produces the same survival rates as care that is not actively managed by insurance companies. the researchers point out.
The narrowing of the survival gap, an effect known as favorable choice, the enrollment of significantly less diseased people into Medicare Advantage, likely explained much of the early mortality differential. also suggests.
But as Medicare Advantage coverage expanded to cover nearly half of all Medicare-eligible adults over age 65 or with disabilities, the options have diminished.
The team was led by Bruce Landon, MD, MBA, M.Sc. Ph.D. from Harvard Medical School and John Z. Ayanian MD, MPP, Institute for Health Policy Innovation, University of Michigan.
The researchers also looked at heart attack care and other aspects of outcomes associated with in-hospital and post-hospital care.
In most cases, by 2018 there will be a statistically significant difference between the two types of Medicare coverage for most aspects of heart attack care, including procedures and surgeries to reopen blocked blood vessels. There was no Previously, Medicare Advantage participants had higher rates of these types of care.
Some differences persisted. For example, people eligible for Medicare Advantage were still more likely to get cholesterol-lowering medications and other recommended medications consistent with national guidelines. less likely to be rehospitalized within
But the gap between the two types of Medicare coverage in these measures also narrowed from 2009 to 2018. The authors found that this occurred in part because, in 2012, hospitals suffered financial penalties when patients covered by traditional Medicare were readmitted within 30 days of discharge. I’m assuming it’s in the beginning. some conditions, including heart attack.
Medicare Advantage participants in 2018 were still more likely to go home directly from the hospital than nursing homes. .
When calculating the results, the researchers took into account demographic and health differences between the two populations enrolled in the two types of Medicare. Note, however, that Medicare is not permitted to take most demographic factors into account when setting payout rates for Medicare Advantage plans.
An accompanying editorial joins three researchers from Brown University, including Dr. Andy Ryan, a former faculty member of the UM School of Public Health. – Please note It’s important to study the differences between specific Medicare Advantage plans.and focus on the value of care, reduce overpayments, and take social and demographic factors into account.
Quote: “Thirty-day mortality in heart attack patients and association between Medicare Advantage and conventional Medicare,” jam.DOI: 10.1001/jama.2022.20982
