Recent studies examined how Medicare Advantage beneficiaries use hospice care and dental benefits, as well as the reasons behind differences in diagnosis coding between traditional Medicare and MA enrollees.
Here are seven recent studies on Medicare Advantage to note:
- Medicare Advantage beneficiaries are more likely to use hospice care than beneficiaries in traditional Medicare, a study published in JAMA Network Open found. Enrollees in traditional Medicare and standard MA plans received hospice care from providers of similar quality, but enrollees in D-SNP plans were more likely to receive care from lower-quality hospice providers than their peers.
- While most Medicare Advantage plans offer dental benefits, few of these benefits are comprehensive, a study published in JAMA found. The small number of comprehensive benefits could explain why only around half of MA beneficiaries visit a dentist annually, the study's authors wrote, a similar percentage to those enrolled in traditional Medicare.
- Two studies published in the December issue of Health Affairs examined coding differences between Medicare Advantage and traditional Medicare. A study by researchers at Brown University used skilled nursing facility assessments to compare the health statuses of traditional Medicare and MA beneficiaries. Among enrollees with similar health statuses, MA beneficiaries had higher claims-based disease scores than their peers in traditional Medicare. The researchers attributed 60% of the score difference to chart reviews conducted by MA plans. Differences in health risk scores between MA and traditional Medicare likely result from upcoding rather than differences in enrollee health status, the researchers concluded.
- A second study in the December issue of Health Affairs found a lack of coding for certain conditions in traditional Medicare could account for around 20% of the difference between risk scores in traditional Medicare and Medicare Advantage.
- The share of local Medicare Advantage plans has shrunk since 2012, while national insurers have increased their market share, according to a study published in the December issue of Health Affairs.
- Medicare spends more on beneficiaries who switch from Medicare Advantage to traditional Medicare compared to those who remained enrolled in traditional Medicare, a report from KFF found.
- Medicare Advantage plans were paid more than $1 billion for veterans who did not use any Medicare services, according to a study published in the November issue of Health Affairs.