Medicare Advantage (MA) beneficiaries receive less intensive treatments and experience fewer burdensome transfers in their last six months of life compared to those on traditional Medicare End-of-Life Care, according to a new study.
Hospice Care and Post-Discharge Preferences
The research, published in the JAMA Health Forum, highlights that MA enrollees are more likely to opt for hospice care and less likely to receive facility-based care after a hospital discharge. This shift in care preferences underscores the influence of MA’s cost-control focus, Medicare End-of-Life Care unlike the fee-for-service model of traditional Medicare, which often incentivizes more aggressive treatment.
Financial Incentives and Care Gaps
The study’s authors pointed out that MA’s financial incentives to reduce costs promote less use of potentially burdensome treatments. However, this cost-control approach sometimes leaves patients without adequate post-acute care. “We found that MA enrollment was associated with lower rates of potentially burdensome hospitalizations and treatments, less skilled nursing facility care, and more home care after discharge,” the authors noted.
Research Findings and Data Analysis
Researchers analyzed Medicare claims data for over one million patients who died between 2016 and 2018. The findings revealed that MA beneficiaries were 1.6% less likely than those in traditional Medicare to receive aggressive treatments in the last six months of life. Additionally, they were 3.3% less likely to die in a hospital and 5.2% less likely to be transferred to a skilled nursing facility post-discharge.
Hospice Utilization and Home-Based Care
Although MA enrollment slightly increased the rates of hospice utilization, overall hospice election within the last 30 days before death remained at about 16%. The study also found that MA beneficiaries were somewhat more likely to receive home-based care. However, the authors noted potential challenges, including the burden on family caregivers and the complexity of navigating both MA coverage and the Medicare Hospice Benefit.
