Inovalon: Higher Hospital Readmissions, Worse Outcomes for Dual Eligibles

Patients who are eligible for both Medicare and Medicaid experience more hospital readmissions, less positive outcomes, and significantly lower Medicare Advantage Star Ratings, according to a new study from Inovalon. The large-scale study, which examined claimed data from more than two million dual eligible patients, found that nearly 80 percent of disparities in patient risk and outcomes were rooted in socioeconomic and demographic factors such as access to community resources and ability to remain in contact with the healthcare system. The Star Rating system does not accurately reflect the reality of the additional burdens low-income and dual-eligible patients are facing, the research asserts, and should be updated to provide more accurate metrics of patient care. Read more