Rates of Hospitalization for Ambulatory Care Sensitive Conditions in the Medicare+Choice Population

This article evaluates the feasibility of developing hospitalization rates for ambulatory care sensitive conditions (ACSCs) for the Medicare+Choice (M+C) population. M+C inpatient encounter data were used to calculate 15 ACSC rates. We found the initial reporting year of M+C inpatient encounter data had no apparent volume or diagnosis-based biases and over 90 percent of M+C organizations had sufficient enrollment to produce statistically reliable rates. Further, our study results support the premise that ACSCs could be used as sentinel events for potentially vulnerable populations; the oldest old and the disabled experienced statistically significant higher rates of ACSC admissions than younger Medicare beneficiaries.