Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Medicare HMOs fail to control costs of colon surgery in elderly patients


The costs of caring for elderly Florida patients hospitalized for colon surgery are not reduced by Medicare HMOs, report University of South Florida researchers in the December issue of the Archives of Surgery.

Despite significantly shorter hospital stays, Medicare HMO beneficiaries who underwent colon resections -- surgery to remove a diseased section of the large intestines -- incurred the same overall hospital charges as patients covered by traditional fee-for-service Medicare. Consequently, the study found, daily hospital charges for the Medicare HMO group were higher than for the traditional Medicare group. The researchers assumed a direct relationship between hospital charges, available from the Agency for Health Care Administration’s Florida database, and actual costs, which are difficult to obtain from hospital executives.

"The Medicare HMO model failed as a cost-saving measure in this particular instance," said the study’s principal investigator Michel Murr, MD, an associate professor of surgery in the USF College of Medicine. "Our finding appears to be confirmed by the recent departure of major HMOs from the Medicare market in Florida."

Dr. Murr and his research team, headed by Dr. Jimmy Sung, examined the outcomes of all colon resections for patients age 70 and older in Florida from 1995 to 1999. Colon resection, usually performed to remove cancer, treat diverticulitis or remove a bowel blockage, is the most common abdominal surgery in elderly patients.

Regardless of the type of Medicare coverage, the researchers noted a 10 to 30 percent increase in hospital charges for colon resections in the four-year study period. Even with an older, frailer patient population and overall decline in length of hospital stay, deaths and complications from this procedure remained low.

The intention of Medicare HMOs is to reduce waste in the system by trying to eliminate unnecessary and inappropriate care, while giving providers incentives to use cost-efficient care. The elderly who opt to enroll in a Medicare HMO, a managed care model that emphasizes preventive care and offers beneficiaries less out-of-pocket costs, tend to be younger and have fewer chronic illnesses than their counterparts who stick with traditional Medicare coverage.

"Medicare HMO patients typically have shorter hospital stays and less secondary illnesses like diabetes, hypertension and pulmonary diseases," Dr. Murr said. "You’d expect operating on these healthier patients would result in lower charges – but it does not."

Results of the Florida study were similar to other studies that have concluded rates of high-cost surgical procedures were not reduced among Medicare HMO enrollees. More research is warranted to determine why daily hospital charges were higher for the Medicare HMO group, Dr. Murr said.

"Unless we adequately plan for an ever-growing population of elderly surgical patients, our health care expenditures will continue to skyrocket."

Anne DeLotto Baier | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung

nachricht High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

How nanoscience will improve our health and lives in the coming years

27.10.2016 | Materials Sciences

OU-led team discovers rare, newborn tri-star system using ALMA

27.10.2016 | Physics and Astronomy

'Neighbor maps' reveal the genome's 3-D shape

27.10.2016 | Life Sciences

More VideoLinks >>>