Study: Big improvements in the "Big Three" for Medicare beneficiaries

July 31st, 2015

For the 50^th anniversary of Medicare, a new study in JAMA gives something to smile about: Deaths, hospital stays, and costs have decreased for Medicare beneficiaries over the last 15 years.

The researchers, led by Harlan Krumholz, looked at outcomes for more than 68 million fee-for-service and Medicare Advantage beneficiaries between 1999 and 2013. All-cause mortality declined to 4.45% from 5.3%. Hospital stays per 100,000 patients fell by 8,344 in that time period, and costs declined by nearly $500 per patient.

While this is all fantastic news – we certainly want the aging Medicare population to live longer outside of the hospital and to save money – the one thing the study does lack is the why, though we can speculate. Healthcare technology and medicine have come a long way in 15 years, and great strides have been made in keeping older patients healthier and out of the hospital. Greater emphasis has also been placed on care coordination across the continuum to ensure that nothing falls through the cracks (see Hospital Case Management and Case Management Advisor for more information). And CMS is basing more physician and hospital reimbursement on patient safety and quality measures (though it’s still early in the game to know how well those are working). "It is impossible to know what is most responsible for the improvement and it is likely to be many factors," Krumholz said.

Though improvements are being made and are going in the right direction, more needs to be done, Krumholz said. “Rather than wave the victory flag, we want to see that trend continue. There’s no reason to take our foot off the pedal.”