American hospitals have reduced deaths, hospitalizations, and costs among people over the age of 65 in the past couple of decades, according to a new report released Tuesday.

“We didn’t expect to see such a remarkable improvement over time,” said Harlan Krumholz, a cardiologist at the Yale School of Medicine and lead author of the study, which appeared in the Journal of the American Medical Association (JAMA).

Krumholz and his colleagues looked at over 68 million Medicare beneficiaries between 1999 and 2013. The group was chosen for their “fee-for-service” structure, where doctors and hospitals would be paid per procedure or visit.

They found that hospitalization rates for this group plummeted 24%, saving more than 3 million people unnecessary hospital visits. Their chance of survival and recovery had improved from less than two decades ago: patients were 45% less likely to die during their stay, 24% less likely to die within a month of being admitted, and 22% less likely to die within the year.

Deaths among the group fell 16%, meaning 300,000 lives were saved in the 14-year span, according to the report. Patients who visited the hospital also saw a 15% drop in their bills compared to 1999.

Krumholz said that better training for hospital staff led to many of the improvements.

“There has been tremendous focus on making sure that our hospitals are safer and that treatments are more timely and effective,” Krumholz told USA Today.

People are also living healthier, longer lives—smoking less, breathing cleaner air, and able to take advantage of scientific breakthroughs in medicine.

Despite doing so well, Krumholz doesn’t think it’s time for hospitals to get lax.

“The things we’re trying to do to make things better are working,” Krumholz noted. “Rather than wave the victory flag, we want to see that trend continue. There’s no reason to take our foot off the pedal.”

Get our Health Newsletter. Sign up to receive the latest health and science news, plus answers to wellness questions and expert tips. Please enter a valid email address. Sign Up Now Check the box if you do not wish to receive promotional offers via email from TIME. You can unsubscribe at any time. By signing up you are agreeing to our Terms of Use and Privacy Policy . This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Thank you! For your security, we've sent a confirmation email to the address you entered. Click the link to confirm your subscription and begin receiving our newsletters. If you don't get the confirmation within 10 minutes, please check your spam folder.

Write to Tanya Basu at tanya.basu@time.com.