Earlier this year, Inovalon published one of the most robust comparisons between Medicare Advantage (MA) and fee-for-service Medicare (FFS) to date, proving that MA delivers better patient outcomes, consistently outperforming FFS on cost and quality—despite MA covering a lower income and more clinically complex population.
Recent analysis from the Coalition to Strengthen America’s Healthcare is deeply flawed, and the report itself admits that its findings “have not been risk-adjusted to account for differences in demographic and/or clinical risk profiles.”
While both analyses cover the same time period, 2018-2022, Inovalon controlled for differential selection and used a detailed claims analysis to compare beneficiaries with similar clinical, demographic, and social risk factors. This allows for a true, apples-to-apples comparison between the two programs.
The results are clear.
Comparing similar individuals who enrolled in MA versus FFS, MA beneficiaries experience 40% fewer hospital admissions; 30% fewer inpatient days; 126% fewer 30-day readmissions; and 71% fewer preventable hospitalizations. In summary, MA beneficiaries are less likely to be admitted to the hospital in the first place and far less likely to be readmitted due to complications.
The evidence demonstrates that MA beneficiaries experience better health care outcomes than those enrolled in FFS. That’s one of the primary reasons MA is the health coverage of choice for a growing majority of Medicare enrollees.