Medicare Advantage enrollees report using post-acute care services less than traditional Medicare enrollees, a new study found.

The study, published in JAMA Health Forum, was conducted by researchers at Vanderbilt University Medical Center in Nashville, Tennessee. It analyzed 2,357 Medicare beneficiaries and their self-reported use of post-acute care services between 2015 and 2017. Of this study sample, 815 beneficiaries were enrolled in Medicare Advantage plans and 1,542 were enrolled in traditional Medicare plans. Participants were 70 years and older and community-dwelling adults, meaning those living outside of nursing homes.  

The researchers found that between 16.2% and 17.7% of Medicare Advantage enrollees reported using post-acute care services, compared to 22.4% to 24.1% of traditional Medicare enrollees. Medicare Advantage beneficiaries also had a shorter duration of services than traditional Medicare beneficiaries.

In addition, Medicare Advantage enrollees had “less functional improvement” during their post-acute care than traditional Medicare (TM) enrollees. Of those who stopped their post-acute care, Medicare Advantage enrollees reported not meeting their goals more often than traditional Medicare beneficiaries, though these “differences were not statistically significant,” the researchers said.

“In this cohort study of older community-dwelling Medicare beneficiaries, we found that fewer MA enrollees reported using post-acute care services than TM beneficiaries,” the report stated. “Among participants with post-acute care use, MA enrollees had shorter duration of services, but the services did not differ from those used by TM beneficiaries in terms of location of care or reason for using these services. Enrollees in MA who used post-acute care services reported less functional improvement while receiving these services.”

The findings track with previous studies done on the topic that have also found that Medicare Advantage enrollees use post-acute care services less than traditional Medicare enrollees. These previous studies relied on administrative data and found that MA enrollees have better outcomes for measures like readmission and successful discharge to the community. This study differs by relying on self-reported outcomes, which showed “less favorable outcomes” for Medicare Advantage enrollees versus traditional Medicare enrollees. 

“We believe that the use of self-reported outcomes adds important evidence since patient-reported outcomes are needed to improve care delivery processes,” the researchers said. “As enrollment in MA continues to grow, understanding differences in the use of services and outcomes by enrollment status is important, particularly if differential service use is associated with perceived differences in care for MA enrollees. We found that MA enrollment was associated with less improvement in self-reported outcomes. These findings highlight the importance of self-reported outcomes, especially as MA and other payment models seek to reduce use of post-acute care services.”

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