Medicare Advantage patients less likely to use post-acute care

Medicare Advantage patients use fewer post-acute care services following hospital discharge compared to traditional Medicare fee-for-service beneficiaries, according to recently released analysis from Avalere.

The analysis found 77 percent of MA patients are discharged to the home without home healthcare services after a hospital stay, while the same is true for 63 percent of traditional Medicare patients. Although numerous factors could influence the variation in post-acute care use, the study's findings indicate the variance could be due to differences in how MA plans manage beneficiaries' care.

"Our research demonstrates that MA plans are using post-acute care differently," Fred Bentley, vice president at Avalere, said in a press release. "MA plans are incented to actively manage patients, and they may keep patients in hospital settings longer to facilitate less intensive care for a patient following a hospitalization when appropriate."

Avalere also analyzed discharge destinations following an inpatient hospital stay for the 15 most common diagnostic related groups around the country. In each of the DRGs, more MA patients were discharged directly to the home without home health than traditional Medicare patients. For instance, after a hip or knee replacement, 46 percent of MA patients were discharged to the home compared with 19 percent of traditional Medicare patients.

Nearly 18 million beneficiaries (31 percent) received Medicare benefits through MA plans in 2016, and Avalere experts predict MA will expand by more than 20 percent by 2020 — almost double the rate at which the overall Medicare program is expected to grow.

For the analysis, Avalere analyzed the Medicare Part A Standard Analytic Files and Inovalon's Medical Outcomes Research for Effectiveness and Economics Registry. The analysis includes all admissions to long-term acute care hospitals, inpatient rehabilitation facilities, skilled nursing facilities and home health agencies within seven days of discharge from an inpatient hospital. Results were adjusted for differences between Medicare FFS and MA patients.

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