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Medicare Advantage HMO Enrolles Use Fewer Outpatient Surgery Benefits

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Medicare Advantage HMO plans may be offering more efficient care than Medicare Part A and Part B plans, according to a study published in the journal Health Affairs.

According to the study, MA HMO enrollees receive fewer hip and knee replacements and use fewer benefits for outpatient surgeries and procedures, inpatient stays and emergency department visits.

Based on a national comparison of data from MA HMO and traditional Medicare plans from 2003 to 2009, the researchers found that utilization rates in some areas — like ER and ambulatory surgery — were around 20 percent lower in MA HMO plans.

MA HMO enrollees also received about 10 percent fewer hip and knee replacements and initially had lower rates of ambulatory visits and hospitalizations.

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