Rehospitalization and survival for stroke patients in managed care and traditional Medicare plans

Stroke affects more than 500,000 older persons each year in the United States. This study including HIP Investigator Dr. Maureen Smith sought to compare utilization and outcomes after stroke in Medicare HMO and FFS by reviewing administrative data in 11 regions from Medicare and a large national health plan.

This data suggests that rehospitalization can not be used to compare quality for HMO and FFS patient, and it would be inappropriate to assume that changes in service mix between the two automatically lead to poorer quality care. The data are also consistent with the conclusion that FFS reimbursement changes are causing FFS patterns of care to more closely mimic HMO patterns of care.