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Likelihood of hospital readmission in Medicare Advantage and Fee-For-Service within same hospital.
Health Serv Res. 2020 Aug; 55(4):587-595.HS

Abstract

OBJECTIVE

To assess the extent to which all-cause 30-day readmission rate varies by Medicare program within the same hospitals.

STUDY DESIGN

We used conditional logistic regression clustered by hospital and generalized estimating equations to compare the odds of unplanned all-cause 30-day readmission between Medicare Fee-for-Service (FFS) and Medicare Advantage (MA).

DATA COLLECTION

Wisconsin Health Information Organization collects claims data from various payers including private insurance, Medicare, and Medicaid, twice a year.

PRINCIPAL FINDINGS

For 62 of 66 hospitals, hospital-level readmission rates for MA were lower than those for Medicare FFS. The odds of 30-day readmission in MA were 0.92 times lower than Medicare FFS within the same hospital (odds ratio, 0.93; 95 percent confidence interval, 0.89-0.98). The adjusted overall readmission rates of Medicare FFS and MA were 14.9 percent and 11.9 percent, respectively.

CONCLUSION

These findings provide additional evidence of potential variations in readmission risk by payer and support the need for improved monitoring systems in hospitals that incorporate payer-specific data. Further research is needed to delineate specific care delivery factors that contribute to differential readmission risk by payer source.

Authors+Show Affiliations

Department of Public Health Sciences, University of Chicago, Chicago, IL.Health Services Administration, University of Maryland at College Park, College Park, MD.Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA. Health Innovation Program, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI. Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.School of Nursing, University of Wisconsin-Madison, Madison, WI. William S Middleton Memorial Veterans Hospital, Geriatric Research Education and Clinical Center (GRECC), Madison, WI. Division of Geriatrics, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32608522

Citation

Jung, Daniel H., et al. "Likelihood of Hospital Readmission in Medicare Advantage and Fee-For-Service Within Same Hospital." Health Services Research, vol. 55, no. 4, 2020, pp. 587-595.
Jung DH, DuGoff E, Smith M, et al. Likelihood of hospital readmission in Medicare Advantage and Fee-For-Service within same hospital. Health Serv Res. 2020;55(4):587-595.
Jung, D. H., DuGoff, E., Smith, M., Palta, M., Gilmore-Bykovskyi, A., & Mullahy, J. (2020). Likelihood of hospital readmission in Medicare Advantage and Fee-For-Service within same hospital. Health Services Research, 55(4), 587-595. https://doi.org/10.1111/1475-6773.13315
Jung DH, et al. Likelihood of Hospital Readmission in Medicare Advantage and Fee-For-Service Within Same Hospital. Health Serv Res. 2020;55(4):587-595. PubMed PMID: 32608522.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Likelihood of hospital readmission in Medicare Advantage and Fee-For-Service within same hospital. AU - Jung,Daniel H, AU - DuGoff,Eva, AU - Smith,Maureen, AU - Palta,Mari, AU - Gilmore-Bykovskyi,Andrea, AU - Mullahy,John, Y1 - 2020/07/01/ PY - 2021/08/01/pmc-release PY - 2020/7/2/pubmed PY - 2020/7/2/medline PY - 2020/7/2/entrez KW - Medicare KW - Medicare Advantage KW - administrative data KW - hospital readmission SP - 587 EP - 595 JF - Health services research JO - Health Serv Res VL - 55 IS - 4 N2 - OBJECTIVE: To assess the extent to which all-cause 30-day readmission rate varies by Medicare program within the same hospitals. STUDY DESIGN: We used conditional logistic regression clustered by hospital and generalized estimating equations to compare the odds of unplanned all-cause 30-day readmission between Medicare Fee-for-Service (FFS) and Medicare Advantage (MA). DATA COLLECTION: Wisconsin Health Information Organization collects claims data from various payers including private insurance, Medicare, and Medicaid, twice a year. PRINCIPAL FINDINGS: For 62 of 66 hospitals, hospital-level readmission rates for MA were lower than those for Medicare FFS. The odds of 30-day readmission in MA were 0.92 times lower than Medicare FFS within the same hospital (odds ratio, 0.93; 95 percent confidence interval, 0.89-0.98). The adjusted overall readmission rates of Medicare FFS and MA were 14.9 percent and 11.9 percent, respectively. CONCLUSION: These findings provide additional evidence of potential variations in readmission risk by payer and support the need for improved monitoring systems in hospitals that incorporate payer-specific data. Further research is needed to delineate specific care delivery factors that contribute to differential readmission risk by payer source. SN - 1475-6773 UR - https://www.unboundmedicine.com/medline/citation/32608522/Likelihood_of_hospital_readmission_in_Medicare_Advantage_and_Fee-For-Service_within_same_hospital L2 - https://doi.org/10.1111/1475-6773.13315 DB - PRIME DP - Unbound Medicine ER -
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