Medicare’s triple triumph: Deaths, hospitalizations and costs fall

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The Medicare program has scored three remarkable achievements, concerning dramatic drops in the rates of deaths, hospitalizations and costs. Specifically, 1999 and 2013, the rate of deaths among Medicare patients dropped by 16 percent. In terms of hospitalizations, during the same time period, rates for Medicare patients fell by 24 percent. Finally, the costs for these hospitalized patients fell by 15 percent during the same time period. These milestones are very good news for the overall U.S. healthcare system.

Dramatic drops for mortality rates

These healthcare-related findings were revealed in a study published in the Journal of the American Medical association (JAMA). In regard to reduced deaths, the study’s researchers found that from 1999 to 2013, Medicare patients’ mortality rates dropped by 16 percent. This represents more than 300,000 fewer deaths in 2013 than in 1999.

For the study, the researchers utilized records gathered from more than 68 million Medicare patients. “It’s a jaw-dropping finding,” stated Harlan Krumholz, a cardiologist and professor at the Yale School of Medicine, as well as the study’s lead researcher. “We didn’t expect to see such a remarkable improvement over time.”

Reductions in hospitalization rates and costs

The study also found that during this same 1999-2013 period, costs for hospitalized Medicare patients were reduced by 15 percent. In particular, the researchers focused on Medicare’s traditional “fee-for-service” program. With this program, physicians and hospitals are paid for each procedure or visit.

Hospitalization rates for Medicare patients fell during the 1999-2013 period. Here, the researchers again focused on Medicare’s traditional fee-for-service patients. The findings showed that hospitalization rates fell by 24 percent. This equates to more than 3 million fewer hospitalizations in 2013 than 1999. The study also found that for those patients admitted to the hospitals:

  • 45 percent were less likely to die during their stay
  • 24 percent were less likely to die within a month of admission
  • 22 percent were less likely to die within a year.

A push to transform hospital quality

According to the researchers, these reductions in deaths, hospitalizations and costs are probably related to a variety of healthcare-related trends. One major factor has been the decades-long initiative to improve hospitals’ safety and their treatments, in general. “There has been tremendous focus on making sure that our hospitals are safer and that treatments are more timely and effective,” said Krumholz. The hospitals’ staff deserves a share of this credit for these improvements, as well. 

This movement for improved hospitals may have really taken off in 1999. That year, a report published in the Institute of Medicine revealed that due to hospital errors, as many as 98,000 people a year were killed. “That was one of the first shots fired in the patient safety movement,” stated P.J. Brennan, chief medical officer at the University of Pennsylvania Health System.

Another factor may be public health improvements. Among these are: the availability of drugs for common conditions (cancer, heart disease), fewer smokers and better air quality. Additionally, a focus on outpatient care would likely benefit these nationwide improvements in healthcare. Outpatient care includes those services provided by home health aides or in nursing homes.

But despite these impressive reductions it’s important not to become complacent. “The things we’re trying to do to make things better are working,” states Krumholz. “Rather than wave the victory flag, we want to see that trend continue. There’s no reason to take our foot off the pedal.”

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