ISG Benefits and Insurance Services Blog
In a report published by PLOS Medicine, they have observed Medicare Advantage enrollees spend less time in nursing facility and rehab after surgery. Also, these patients are also highly unlikely to be readmitted to a hospital compared to others who are in a traditional Medicare.
Details of the Study
Upon observing patients who are seeking treatment for hip fractures, patients in Medicare Advantage required less time in nursing facilities. They have spent 463 minutes less time in therapy, too. Patients in Medicare Advantage were able to get back to their communities immediately after their release.
But what makes these patients different from other fee-for-service Medicare patients?
The Answer: Better Health Care
With the rise of seniors turning on Medicare Advantage for their health care needs, CMS or Centers for Medicare & Medicaid Services created a value-based model to help cut the spending on skill-nursing homes. They want to reduce unnecessary expenses on care that are preventable by taking proactive solutions.
As it seems, providing high-valued care shortens the time patients need to recover from their treatments. By spending less time in rehab and skilled-nursing homes, their patients are much healthier. They are less likely to go back to hospitals or become a resident in nursing homes.
How Did They Do It?
Medicare Advantage chose to streamline their network by seeking providers with high-quality scores and low spending habits. Also, they also want to instate case manager and nurse practitioners to monitor their patients’ health and improvement even after they leave the hospital. These extra steps will help them make sure and prevent future hospitalizations by providing better health care.
Of course, other factors might have also contributed to the outcome like the patient’s age, chronic illness, general health, environment, social support, as well as the circumstance that lead them to seek care.
They are now working on conducting more research and studies, soon. It would include people with a variety of complex conditions. The results will help them refine their model before it can be fully implemented.
The cost for medical services would only rise as time pass. It helps a lot if you have Medicare Advantage plans to make sure you get the care when you need it the most.
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