Does Medicare Benefit Plans Improve The Quality Of Care?

Does Medicare Benefit Plans Improve The Quality Of Care?

From the Medicare Modernization Act of 2003, the Medicare Advantage program we know today was born. These types of polices permit older people and people qualified for Medicare as a result to a disability to obtain health insurance from private health coverage firms. Private insurance companies that offer Medicare Advantage (MA) plans must provide the same rewards provided by Medicare Parts A & B. Part A includes hospital coverage, while Part B includes medical coverage. In addition to outpatient and outpatient coverage, Advantage plans found with also cover some prescription drugs. That’s why these policies are in some cases called Medicare Part C. The plan combines Medicare Part A, B and sometimes Part D.

As MA plans are available, they have become a popular alternative to Original Medicare. In 2010 alone, approximately 25% of all Medicare beneficiaries were enrolled in Medicare Advantage plans. With an initial enrollment of 5.3 million, subscribers have more than doubled and numbers still increase every year. Medicare Advantage plans paved the way for beneficiaries to expand traditional Medicare benefits. Since the program began, the success of Medicare Advantage plans among the elderly has been a matter of debate. Recently, data on the quality of care that MA subscribers receive has been published.

Medicare Advantage plans offer better quality of care

According to a study by Niall Brennan (acting director of the Office of Policies of the Centers for Medicare and Medicaid Services) and Mark Shepard (candidate for a doctorate in economics at Harvard University), MA plans offer increased attention quality compared to Medicare service charge plans for hospital use and care using widely accepted quality measures. In 2006, when the first data on the Medicare Advantage plans were available, Brennan and Shepard used 11 measurements to analyze the underutilization of an effective treatment. Of the 11 measurements, the MA plans performed significantly better than the service rate plans in 9 service rate plans. Payment-for-service plans only exceeded Medicare Advantage plans in some measures that were not so significant for general care.

The United States Health Insurance Plans (AHIP) conducted a similar study using HEDIS measurements (Data set and information on health effectiveness). The study shows improvements in the quality of medical care for AM members with diabetes and heart disease. The results show that, compared to service rate plans, people with insured MA have less hospital readmissions and shorter stays. As for patients with heart disease, the trend was the same. MA’s plans have done a better job of avoiding unnecessary hospitalizations by increasing the use of medical appointments and outpatient services. Re-entries have also decreased due to well-planned, superior and well-planned procedures and the coordination of medical care.