MedPAC: Medicare Advantage enrollees receive fewer home health visits 

Advertisement

Medicare Advantage enrollees receive fewer home health visits than their counterparts in fee-for-service Medicare, according to the Medicare Payment and Advisory Commission. 

The commission, which advises Congress on Medicare and Medicaid issues, published a report to Congress June 12. 

Here are five things to know about MA beneficiaries and home healthcare: 

  1. In 2021, 8.3% of Medicare Advantage enrollees received home healthcare, a slightly lower number than the 8.6% of fee-for-service enrollees that received this care.

  2. MA beneficiaries were 3.2% more likely to receive home healthcare after an acute care hospitalization than fee-for-service beneficiaries, according to MedPAC. The difference could suggest home healthcare is sometimes used as a substitute for costlier types of post-acute care in Medicare Advantage, the commission wrote.

  3. MA beneficiaries were 13.7% less likely to use home healthcare without a prior hospital stay than FFS enrollees. This could be related to MA plans’ use of prior authorization or indicate a preference of home health organizations to treat FFS beneficiaries, according to MedPAC.

  4. MA beneficiaries who received home healthcare had 11% fewer visits annually than FFS beneficiaries.

  5. “It is not possible to draw conclusions on the appropriateness of care based solely on observing differences in use,” the commission wrote in its report. Future research will incorporate analyses of MA beneficiaries’ use of other forms of post-acute care in addition to home health, including skilled nursing care, the commission wrote. 

Read the full report here.

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Register to Attend Webinar

Read. Deleted. Ignored. What It Takes to Drive Behavior Change and Lower the Cost of Care

Tuesday, August 4
11:00 AM - 12:00 PM CDT

Presenters: Koleen Cavanaugh, Independence Blue CrossBukata Hayes, HMO Minnesota (Blue Plus)Nathan Foco, Select HealthTrish Cox, SCAN Health PlanJonas Puente, ZS Associates

Advertisement

Next Up in Payer

Advertisement