Data Analysis by Avalere Health
Sponsored by Better Medicare Alliance’s Center for Innovation in Medicare Advantage

Major findings

1. Better outcomes in Medicare Advantage than traditional FFS Medicare for all study populations on 17 of 22 clinical quality of care measures, such as:
   1. Rates of pneumonia vaccination that are 50 to 52 percent higher in Medicare Advantage.
   1. Rates of eye exams for diabetics that are 14 to 56 percent higher in Medicare Advantage.
   1. Rates of depression screenings that are 18 to 27 percent higher in Medicare Advantage.
2. Higher rates of physician office visits within 14 days of a hospital discharge for all high-need, high-cost populations, including nearly three-quarters (74 percent) of frail elderly beneficiaries in Medicare Advantage compared to 52 percent of frail elderly beneficiaries in traditional FFS Medicare.
3. Higher rates of outpatient visits in Medicare Advantage compared to traditional FFS Medicare, including a difference of 66 percent for frail elderly beneficiaries and a difference of 46 percent for beneficiaries under age 65 who are disabled as compared to Traditional FFS Medicare.
4. Lower rates of avoidable hospitalizations for acute conditions for all high-need, high-cost populations in Medicare Advantage compared to traditional FFS Medicare, such as:
   1. 57 percent lower rate of avoidable acute hospitalizations for Medicare Advantage beneficiaries with major complex chronic conditions and a 45 percent lower rate for frail elderly Medicare Advantage beneficiaries.
   1. 12 percent lower rate of 30-day readmissions for Medicare Advantage beneficiaries with major complex chronic conditions.
5. Lower costs of care for all high-need, high-cost populations in Medicare Advantage relative to traditional FFS Medicare, such as:
   1. Inpatient hospital costs that were 9 to 23 percent lower.
   1. Part D drug costs that were 38 to 44 percent lower.
   1. Combined pharmacy and medical care cost that were 8 to 18 percent lower.
6. Higher costs of care for physician services and tests in the primary care setting for all high-need, high-cost beneficiary populations in Medicare Advantage compared to traditional FFS Medicare, ranging from 28 to 41 percent higher.

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