Dive Brief:
- Medicare Advantage beneficiaries received fewer home health visits and were less likely to improve self-care and mobility function compared with patients covered by traditional Medicare, according to a study published in JAMA Health Forum.
- Patients insured under the privatized program were 5% more likely to be discharged to the community compared with Medicare, the study found. Average home health length of stay was also shorter by 1.62 days for MA beneficiaries.
- Fewer visits and less time in home healthcare is likely related to cost containment strategies used by MA insurers, like cost-sharing or prior authorization requirements that aren’t used in traditional Medicare, researchers wrote.
Dive Insight:
MA, where insurers contract with the federal government to manage care for seniors, has soared in popularity over the past decade, covering more than half the eligible Medicare population last year.
The plans may offer attractive benefits like vision and dental coverage as well as gym stipends. But some watchdogs and lawmakers have raised red flags about MA’s growing cost to the government and inappropriate care denials.
Last year, the CMS finalized a rule that requires MA plans to follow coverage rules in traditional Medicare, following reports insurers would sometimes deny prior authorization requests and delay care.
The latest research, which studied more than 285,000 MA and traditional Medicare beneficiaries from 2019 through 2022, found patients in the private program also had worse health outcomes.
MA patients had 3% lower adjusted odds of improving mobility, and 4% lower odds of bettering self-care functions, which included tasks like grooming, dressing and bathing.
The MA population was younger and less clinically complex at admission, according to the study authors. But they were also more likely to live alone or in rural and other disadvantaged areas. They were also less likely to have around-the-clock support at home.
“Higher rates of community discharge combined with lower functional improvement may have negative associations in terms of independence and caregiver burden for MA patients,” researchers wrote.
The study follows other research published last month that found MA plans covered less intensive post-acute care compared with traditional Medicare.
