Study Data from Truven Health Analytics Provide New Insights into Managed Care (Managed care and inpatient mortality in adults: effect of primary…

Insurance Weekly News

Study Data from Truven Health Analytics Provide New Insights into Managed Care (Managed care and inpatient mortality in adults: effect of primary payer)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Research findings on Managed Care are discussed in a new report. According to news reporting out of Bethesda, Maryland, by VerticalNews editors, research stated, "Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care."

Our news journalists obtained a quote from the research from Truven Health Analytics, "To date, research on this topic has been inconclusive, largely because of variation in research methods and covariates. Patient age has been the only consistently evaluated outcome predictor. This study provides a comprehensive assessment of the association between managed care and inpatient mortality for Medicare and privately insured patients. A cross-sectional design was used to examine the association between managed care and inpatient mortality for four common inpatient conditions. Data from the 2009 Healthcare Cost and Utilization Project State Inpatient Databases for 11 states were linked to data from the American Hospital Association Annual Survey Database. Hospital discharges were categorized as managed care or fee for service. A phased approach to multivariate logistic modeling examined the likelihood of inpatient mortality when adjusting for individual patient and hospital characteristics and for county fixed effects. Results showed different effects of managed care for Medicare and privately insured patients. Privately insured patients in managed care had an advantage over their fee-for-service counterparts in inpatient mortality for acute myocardial infarction, stroke, pneumonia, and congestive heart failure; no such advantage was found for the Medicare managed care population. To the extent that the study showed a protective effect of privately insured managed care, it was driven by individuals aged 65 years and older, who had consistently better outcomes than their non-managed care counterparts. Privately insured patients in managed care plans, especially older adults, had better outcomes than those in fee-for-service plans. Patients in Medicare managed care had outcomes similar to those in Medicare FFS."

According to the news editors, the research concluded: "Additional research is needed to understand the role of patient selection, hospital quality, and differences among county populations in the decreased odds of inpatient mortality among patients in private managed care and to determine why this result does not hold for Medicare."

For more information on this research see: Managed care and inpatient mortality in adults: effect of primary payer. BMC Health Services Research, 2017;17():1-17. BMC Health Services Research can be contacted at: Biomed Central Ltd, 236 Grays Inn Rd, Floor 6, London WC1X 8HL, England. (BioMed Central - www.biomedcentral.com/; BMC Health Services Research - www.biomedcentral.com/bmchealthservres/)

Our news journalists report that additional information may be obtained by contacting S.O. Raetzman, Truven Hlth Analyt, Bethesda, MD 20814, United States. Additional authors for this research include S.O. Raetzman, M.L. Barrett, E. Moy and R.M. Andrews.

Keywords for this news article include: Bethesda, Maryland, United States, North and Central America, Health Policy, Managed Care, Medicare, Hospital, Truven Health Analytics.