Patients with advanced cancers were more likely to receive hospice care if they were enrolled in a Medicare Advantage plan, according to a study published March 24 in JAMA Network Open.
Hospice care is covered under Medicare Part A, not through Medicare Advantage plans directly.
“When MA beneficiaries elect hospice, responsibility shifts to traditional Medicare for hospice-related services, while MA retains responsibilities to manage or coordinate other services (although minimal) near the end of life,” the study authors wrote. “This carve-out arrangement gives MA plans financial incentives to encourage early hospice enrollment to offset high costs of intensive cancer treatments.”
Researchers from Atlanta-based Winship Cancer Institute at Emory University, Dallas-based UT Southwestern Medical Center, Nashville, Tenn.-based Vanderbilt University Medical Center, Providence, R.I.-based Brown University School of Public Health and the American Cancer Society analyzed Surveillance, Epidemiology and End Results data to identify trends in hospice utilization and Medicare coverage. Beneficiary data included in the study was from 196,536 advanced-stage cancer patients ages 66 years or older who were diagnosed between 2010 and 2019, and died by 2020.
Here are five notes from the study:
- Patients included in the study were diagnosed with distant-stage female breast, colorectal, lung, pancreatic or prostate cancers.
- Hospice enrollment was highest among patients with continuous MA coverage at 74.8%, followed by patients who switched from traditional Medicare to MA at 69%, patients with continuous traditional Medicare coverage at 68.5% and patients who switched from MA to traditional Medicare at 66.4%.
- Patients with continuous Medicare Advantage coverage were more likely to receive hospice care at home and had longer hospice stays compared to patients with continuous traditional Medicare coverage.
- Cancer patients who switched coverage from MA to traditional Medicare were more likely to receive hospice care in a nursing home. This trend increased among patients who were dual Medicare-Medicaid enrollees.
- Very few of the 196,536 patients switched coverage plans near the end of life, with 1.5% switching from traditional Medicare to MA and 1.8% switching from MA to traditional Medicare.
Read the full study here.
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