Modeling the Impact of Medicare Advantage Payment Cuts on Ambulatory Care Sensitive and Elective Hospitalizations

Health Services Research, Forthcoming

28 Pages Posted: 18 Jun 2011

See all articles by Lauren Hersch Nicholas

Lauren Hersch Nicholas

University of Michigan at Ann Arbor - Institute for Social Research (ISR)

Date Written: May 24, 2011

Abstract

Objective. To assess relationships between changes in Medicare Advantage (MA) payment rates and Medicare beneficiary hospitalizations and to simulate the effects of scheduled payment cuts on ambulatory care sensitive and elective hospitalization rates.

Data. State Inpatient Database discharge abstracts from Arizona, Florida, and New York merged with administrative Medicare enrollment and MA payment data.

Study Design. Retrospective, fixed effect regression analysis of the relationship between Medicare Advantage payment rates and rates of ambulatory care sensitive and elective hospitalizations amongst Medicare beneficiaries in counties with at least 10,000 Medicare beneficiaries and 3 percent MA penetration from 1999 - 2005.

Principal Findings. MA payment rates were negatively related to rates of ACS admissions. Simulations suggest that payment cuts could be associated with higher rates of ACS admissions. No relationship between MA payments and rates of elective hospitalizations was found.

Conclusions. Reductions in Medicare Advantage payment rates may result in a small increase in ambulatory care sensitive admissions. Trends in ambulatory care sensitive admissions amongst chronically ill Medicare beneficiaries should be tracked following MA payment cuts.

Keywords: Medicare Advantage, payments, hospitalization rates, managed care, quality

JEL Classification: H51, I11, I12, I18

Suggested Citation

Nicholas, Lauren Hersch, Modeling the Impact of Medicare Advantage Payment Cuts on Ambulatory Care Sensitive and Elective Hospitalizations (May 24, 2011). Health Services Research, Forthcoming, Available at SSRN: https://ssrn.com/abstract=1865893

Lauren Hersch Nicholas (Contact Author)

University of Michigan at Ann Arbor - Institute for Social Research (ISR) ( email )

Ann Arbor, MI 48106-1248
United States

HOME PAGE: http://www.psc.isr.umich.edu/people/profile/792/Lauren_Nicholas

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
20
Abstract Views
781
PlumX Metrics