A study recently published in JAMA Health Forum found “significant differences in home health service intensity” between patients enrolled in Medicare Advantage plans and patients enrolled in traditional Medicare. The study was entitled “Differences in Home Health Services and Outcome between Traditional Medicare and Medicare Advantage.” Some of its key findings were:
- Medicare Advantage patients had shorter home health lengths of stay
- Medicare Advantage patients received fewer visits from nursing, physical, occupational and speech therapists
- Medicare Advantage patients were discharged into the community at a higher rate than traditional Medicare patients, which may have negative implications in reduced independence for patients and/or increased caretaker burden
- Medicare Advantage patients had 3% lower odds of improving mobility than traditional Medicare patients
- Medicare Advantage patients had 4% lower odds of improving self-care than traditional Medicare patients
The study found that fewer visits and shorter home health lengths of stay “are likely associated with cost-containment strategies used by MA plans, such as cost-sharing or prior authorization requirements for visits beyond a pre-established limit, which do not occur within TM [Traditional Medicare.]” Medicare Advantage plans are paid on a capitated per-member per-month basis, which incentivizes these plans to reduce costs to increase profits.
The study surveyed home health patients 65 and older with two or fewer 60-day home health episodes in 19 states. The results were adjusted for patient demographic, clinical and community factors. This study is important because more than half of Medicare eligible beneficiaries are now enrolled in Medicare Advantage plans.
The study as published in JAMA Health Forum is linked here.