Health Care Costs
California Medicare beneficiaries whose benefits are administered by HMOs spend significantly fewer days hospitalized during the last two years of life than beneficiaries of Medicare fee-for-service plans, researchers report in a study in the American Journal of Managed Care.
The authors attributed the lower number of hospital days to efforts to reduce the average length of stay per hospitalization, rather than efforts to avoid hospitalizations altogether. In addition, the study pointed out that HMOs, especially the Kaiser Foundation Health Plan, avoid unnecessary or unwanted hospitalizations and take advantage of care alternatives, such as skilled nursing facilities and hospices.
Researchers call for additional research on the issue, highlighting the high cost of care delivered during the last two years of life and many patients' wishes to die at home (Fonkych et al., American Journal of Managed Care, August 2008).