Role of Patient Sorting in Avoidable Hospital Stays in Medicare Advantage vs Traditional Medicare.

ABSTRACT:

Importance

Unlike traditional Medicare (TM), Medicare Advantage (MA) plans limit in-network care to a specific network of Medicare clinicians. MA plans thus play a role in sorting patients to a subset of clinicians. It is unknown whether the performance of physicians who treat MA and TM beneficiaries is different.

Objective

To examine whether avoidable hospital stay differences between MA and TM can be explained by the primary care clinicians who treat MA and TM beneficiaries.

Design, setting, and participants

This was a cross-sectional study of a nationally representative sample of MA and TM beneficiaries in 2019 with any of 5 chronic ambulatory care-sensitive conditions (ACSCs). The relative risk (RR) of avoidable hospital stays in MA compared with TM was estimated

SUBMITTER: Xu JF 

PROVIDER: S-EPMC10638641 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature