Medicare Advantage Members Receive Better Outcomes at Lower Costs to the U.S. Healthcare System

Medicare Advantage members with health conditions that typically cause more ambulance calls and emergency room visits experienced less hospital stays and more direct ER discharges than traditional Medicare members, according to a Harvard-led study. The study found ER visits in general were 30% lower for Medicare Advantage members.

This means Medicare Advantage participants, like ArchWell Health members, are spending less time in the hospital. Fewer ER trips and shorter hospital stays not only keep members happier and more comfortable at home but also result in significant savings for our healthcare system.

And these cost savings are not leading to worse quality of care or patient outcomes, according to researchers. In fact, Medicare Advantage organizations like ArchWell Health either outperformed or were on par with traditional fee-for-service Medicare across several important measures. In 2017, Medicare Advantage members reported:

• 10% fewer knee replacements
• 10% fewer hip replacements
• 30% fewer back surgeries

Spending less time in the hospital could be why a recent eHealth report found that 89% of Medicare Advantage members were satisfied with their health insurance coverage.

Why is Medicare Advantage producing these results? The answer could be in the value-cased care model that ArchWell Health follows.

Value-based care uses a payment model that encourages doctors and health systems to produce better patient outcomes. Created as an alternative to traditional fee-for-service medicine, Value-based care focuses on reducing the effects of chronic diseases and improving overall health. Where fee-for-service medicine rewards doctors for seeing as many patients as possible, value-based care rewards doctors for keeping their patients healthy. This model also puts primary care providers in the driver’s seat, allowing them to direct their patient’s full care team.

Value-based care allows ArchWell Health doctors to look more closely at our members’ lifestyles and find ways to implement preventative healthcare measures. ArchWell Health does this through comprehensive bloodwork and screenings, helping patients recover quickly from injuries and illnesses, and much more. And instead of sending patients all around town for tests, we work to provide members with as much care as possible in our centers. We also work to find the best specialist for members if they need additional care, which helps keep older adults out of the hospital.

ArchWell Health doctors and nurse practitioners can also spend more time with members and see them more often than in traditional primary care clinics. This gives members and providers time to discuss lifestyle choices that could prevent and manage diseases. These more frequent conversations may be another way Medicare Advantage programs provide better outcomes – and keep members happy with their health plan.

To learn more about Medicare Advantage and value-based care at ArchWell Health visit our Medicare Advantage 101 site or call ArchWell Health today.