Skip to main content
Journal cover image

Does Favorable Selection Among Medicare Advantage Enrollees Affect Measurement of Hospital Readmission Rates?

Publication ,  Journal Article
Wong, ES; Hebert, PL; Maciejewski, ML; Perkins, M; Bryson, CL; Au, DH; Liu, C-F
Published in: Med Care Res Rev
August 2014

Literature indicates favorable selection among Medicare Advantage (MA) enrollees compared with fee-for-service (FFS) enrollees. This study examined whether favorable selection into MA affected readmission rates among Medicare-eligible veterans following hospitalization for congestive heart failure in the Veterans Affairs Health System (VA). We measured total (VA + Medicare FFS) 30-day all-cause readmission rates across hospitals and all of VA. We used Heckman's correction to adjust readmission rates to be representative of all Medicare-eligible veterans, not just FFS-enrolled veterans. The adjusted all-cause readmission rate among FFS veterans was 27.1% (95% confidence interval [CI] = 26.5% to 27.7%), while the adjusted readmission rate among Medicare-eligible veterans was 25.3% (95% CI = 23.6% to 27.1%) after correcting for favorable selection. Readmission rate estimates among FFS veterans generalize to all Medicare-eligible veterans only after accounting for favorable selection into MA. Estimation of quality metrics should carefully consider sample selection to produce valid policy inferences.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Med Care Res Rev

DOI

EISSN

1552-6801

Publication Date

August 2014

Volume

71

Issue

4

Start / End Page

367 / 383

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Patient Readmission
  • Medicare Part C
  • Male
  • Humans
  • Heart Failure
  • Health Policy & Services
  • Female
  • Fee-for-Service Plans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wong, E. S., Hebert, P. L., Maciejewski, M. L., Perkins, M., Bryson, C. L., Au, D. H., & Liu, C.-F. (2014). Does Favorable Selection Among Medicare Advantage Enrollees Affect Measurement of Hospital Readmission Rates? Med Care Res Rev, 71(4), 367–383. https://doi.org/10.1177/1077558714533823
Wong, Edwin S., Paul L. Hebert, Matthew L. Maciejewski, Mark Perkins, Chris L. Bryson, David H. Au, and Chuan-Fen Liu. “Does Favorable Selection Among Medicare Advantage Enrollees Affect Measurement of Hospital Readmission Rates?Med Care Res Rev 71, no. 4 (August 2014): 367–83. https://doi.org/10.1177/1077558714533823.
Wong ES, Hebert PL, Maciejewski ML, Perkins M, Bryson CL, Au DH, et al. Does Favorable Selection Among Medicare Advantage Enrollees Affect Measurement of Hospital Readmission Rates? Med Care Res Rev. 2014 Aug;71(4):367–83.
Wong, Edwin S., et al. “Does Favorable Selection Among Medicare Advantage Enrollees Affect Measurement of Hospital Readmission Rates?Med Care Res Rev, vol. 71, no. 4, Aug. 2014, pp. 367–83. Pubmed, doi:10.1177/1077558714533823.
Wong ES, Hebert PL, Maciejewski ML, Perkins M, Bryson CL, Au DH, Liu C-F. Does Favorable Selection Among Medicare Advantage Enrollees Affect Measurement of Hospital Readmission Rates? Med Care Res Rev. 2014 Aug;71(4):367–383.
Journal cover image

Published In

Med Care Res Rev

DOI

EISSN

1552-6801

Publication Date

August 2014

Volume

71

Issue

4

Start / End Page

367 / 383

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Patient Readmission
  • Medicare Part C
  • Male
  • Humans
  • Heart Failure
  • Health Policy & Services
  • Female
  • Fee-for-Service Plans