How Medicare Advantage, traditional Medicare differ on end-of-life care

Medicare Advantage enrollees were less likely to receive burdensome treatments or transfers in the last months of life compared to their peers in traditional Medicare, a study published July 19 in JAMA Health Forum found. 

MA beneficiaries were less likely to die in a hospital than their counterparts in traditional Medicare, the study found. MA enrollees were more likely to receive home-based care at the end-of-life. This home-based care can improve quality but can also leave patients without adequate assistance after a hospitalization, the study's authors wrote. 

Though Medicare Advantage beneficiaries were less likely to be hospitalized during the last months of life than their counterparts in traditional Medicare, once hospitalized, MA enrollees were more likely to die in the hospital and less likely to be discharged to rehabilitative or skilled nursing facilities. 

It is not possible to determine from the data if the lower rates of facility-based care at the end of life align with MA enrollees' preferences, the study's authors wrote. 

"The higher rates of discharge home after hospitalization may shift care burdens to informal caregivers if Medicare beneficiaries enrolled in MA plans lack adequate formal support services after a hospitalization," the authors wrote.

The study analyzed data including over 1 million Medicare beneficiary decedents from 2018 to 2021. The study was authored by researchers at the University of Colorado (Aurora) Medical School, and the Johns Hopkins School of Medicine and Johns Hopkins Bloomberg School of Public Health in Baltimore. 

Read the full study here. 

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