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Likelihood of hospital readmission in Medicare Advantage and Fee‐For‐Service within same hospital
Author(s) -
Jung Daniel H.,
DuGoff Eva,
Smith Maureen,
Palta Mari,
GilmoreBykovskyi Andrea,
Mullahy John
Publication year - 2020
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13315
Subject(s) - medicine , medicaid , odds ratio , confidence interval , odds , logistic regression , hospital readmission , emergency medicine , fee for service , health care , medical emergency , economics , economic growth
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.