Understanding the Impact of Medicare Advantage on Hospitalization Rates

Greater use of Medicare Advantage (MA) over traditional fee-for-service Medicare (TM) in certain populations, and even across small areas, has been associated with fewer overall hospitalizations and avoidable hospitalizations. Proponents suggest that these associations stem from successful care management, and a focus on preventive services and primary care among MA users. Detractors intimate that selection bias of healthier individuals into MA plans and other external factors may favorably influence hospitalization rates more than the structure of MA plans and the incentives this structure creates. We set out to update and advance previous analyses using the most contemporary multi-state hospitalization data.