Medicare Advantage Enrollees Could Significantly Reduce Medical Costs by Switching Plans

Issue 572
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
July 5, 2017

AHRQ Stats: Hospital Care for Septicemia

Hospital stays for septicemia (blood infection) nearly tripled between 2005 and 2014 and exceeded more than 1.5 million stays by 2014. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #225: Trends in Hospital Inpatient Stays in the United States, 2005-2014.)

Today's Headlines:

Medicare Advantage Enrollees Could Significantly Reduce Medical Costs by Switching Plans

Seniors enrolled in Medicare Advantage insurance plans could save 19 percent annually on health care spending by switching to a lower-cost Medicare Advantage alternative offered in their area, an AHRQ study found. More than 16 million Americans are covered by Medicare Advantage plans, which are offered by private insurers as alternatives to traditional Medicare. For each year that enrollees remained in their Medicare Advantage plans, researchers found, premium and out-of-pocket costs increased by roughly $50. Beneficiaries who remained in their plans for six or more years were most at risk of spending higher amounts, paying $786 more each year than they would have spent in the lowest-cost plan available to them. While some enrollees may intentionally choose higher-cost plans, the option to passively re-enroll in the same plan year after year may help explain these findings, study authors concluded. Access the study abstract, which appeared in the American Journal of Managed Care

New AHRQ Grantee Profile Highlights Work of Gordon D. Schiff, M.D., To Improve Diagnostic Safety

Our latest grantee profile explores how AHRQ funding helped Gordon D. Schiff, M.D., an associate professor of medicine at Harvard Medical School, shed light on the impact of diagnostic errors. Earlier in his career at Chicago’s Cook County Hospital, Dr. Schiff led an AHRQ-funded investigation that highlighted the magnitude and patterns of diagnostic error, leading to the development of a widely used error classification system. He also led the AHRQ-funded Proactive Reduction of Outpatient Malpractice: Improving Safety, Efficiency, and Satisfaction (PROMISES) project, which revealed that nearly three-fourths of primary care malpractice cases were due to errors of diagnosis. This finding led to recommendations on how to reduce ambulatory safety risk. Dr. Schiff is currently working on an AHRQ-funded project to improve prescribing safety in computerized order entry systems. Check out his profile and other AHRQ grantees who have made major advances in health services research.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

July 17 Webinar To Highlight Technology’s Potential To Improve Care Planning and Communication With Aging Adults

Register now for an AHRQ webinar on July 17 from 2:30 to 4p.m. ET about technologies developed to improve care planning and communication with aging adults. Presenters will discuss technologies designed to integrate information about seniors’ homes with their medical records. Discussions will also highlight technologies that provide health information, resources and tools to connect aging adults with families, providers and peers to aid in healthy aging. Earn 1.5 hours of continuing medical education / continuing education credits for participating.

New AHRQ Views Blog Post

Registration Open for Aug. 2 Webinar on How Practice Facilitators Can Support Learning Health Systems

Register now for an AHRQ webinar on Aug. 2 from noon to 1 p.m. on "Creating a Learning Health Care System: The Role of Practice Facilitators in Primary Care." The event, part of the agency’s EvidenceNOW initiative, will explore how practice facilitators can help primary care practices become learning health care systems, which are organizations that systematically collect, analyze and use evidence to improve care. EvidenceNOW practice facilitators will share insights on how to foster a culture of learning and quality improvement in small- and medium-sized primary care practices.

Featured Case Study: Pennsylvania Psychiatric Institute Slashes Readmission Rates With Discharge Program Based on AHRQ Tool

Readmission rates dropped from 20 percent to 10.4 percent after the Pennsylvania Psychiatric Institute implemented a discharge program modeled after AHRQ’s Re-Engineered Discharge (RED) toolkit. Three key RED tools guided the Institute’s discharge efforts: How to Deliver the Re-Engineered Discharge, How to Conduct a Post-Discharge Follow-up Phone Call, and the Monitor Implementation Outcomes. Access the Impact Case Study.

AHRQ in the Professional Literature

Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010-2012. Gounder PP, Seeman SM, Holman RC, et al. Prev Med Rep 2016 Apr 4;4:614-21. Access the abstract on PubMed®.

Geriatric conditions in patients undergoing defibrillator implantation for prevention of sudden cardiac death: prevalence and impact on mortality. Green AR, Leff B, Wang Y, et al. Circ Cardiovasc Qual Outcomes 2016 Jan;9(1):23-30. Epub 2015 Dec 29. Access the abstract on PubMed®.

Improving care delivery and outcomes in pediatric rheumatic diseases. Harris JG, Bingham CA, Morgan EM. Curr Opin Rheumatol 2016 Mar;28(2):110-6. Access the abstract on PubMed®.

Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009. Herrinton LJ, Harrold L, Salman C, et al. Perm J 2016 Winter;20(1):4-12. Epub 2015 Dec 21. Access the abstract on PubMed®.

Managed care and inpatient mortality in adults: effect of primary payer. Hines AL, Raetzman SO, Barrett ML, et al. BMC Health Serv Res 2017 Feb 8;17(1):121. Access the abstract on PubMed®.

Protocol for the analysis of a natural experiment on the impact of the Affordable Care Act on diabetes care in community health centers. Huguet N, Angier H, Marino M, et al. Implement Sci 2017 Feb 10;12(1):14. Access the abstract on PubMed®.

Inadequate utilization of diagnostic colonoscopy following abnormal FIT results in an integrated safety-net system. Issaka RB, Singh MH, Oshima SM, et al. Am J Gastroenterol 2017 Feb;112(2):375-82. Epub 2016 Dec 13. Access the abstract on PubMed®.

Screening for obstructive sleep apnea in adults: evidence report and systematic review for the US Preventive Services Task Force. Jonas DE, Amick HR, Feltner C, et al. JAMA 2017 Jan 24;317(4):415-33. Access the abstract on PubMed®.

Contact Information

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Page last reviewed July 2017
Page originally created July 2017
Internet Citation: Medicare Advantage Enrollees Could Significantly Reduce Medical Costs by Switching Plans. Content last reviewed July 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletter/e-newsletter/e-newsletter/572.html