Medicare Advantage beneficiaries are less likely to receive aggressive end-of-life care.
According to a recent study, Medicare Advantage (MA) users are less likely to undergo intense treatments or onerous transfers in their final six months of life than those on conventional Medicare.
According to a study published in JAMA Health Forum, MA members were also more likely to obtain hospice care and less likely to receive facility-based care following hospital discharge.
A crucial element is MA’s emphasis on cost containment, whereas fee-for-service Medicare encourages more aggressive treatment, according to academics. However, they discovered gaps in which patients do not always receive enough post-acute care.
“We discovered 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 research authors said. “Financial incentives to reduce costs in MA appear to promote less use of potentially burdensome treatments but also leave some patients without home-based or facility care after hospitalization.”
For the study, researchers looked at Medicare claims data for almost 1 million patients who died between 2016 and 2018.
According to the findings, MA beneficiaries were 1.6% less likely than standard Medicare beneficiaries to undergo aggressive treatment in their final six months of life, and 3.3% less likely to die in a hospital. In addition, MA participants were 5.2% less likely to see a skilled
MA enrollment was also somewhat linked with greater rates of hospice care. However, the total hospice election rate in the last 30 days preceding death was roughly 16%.
Though MA patients were somewhat more likely to get home-based care, the study authors recognized significant limitations, such as the possible stress on family caregivers and the difficulty of negotiating both MA coverage and the Medicare Hospice Benefit.
“Financial incentives in Medicare Advantage, the managed care alternative to traditional Medicare, were designed to reduce overutilization,” the paper’s authors said. “For patients near the end of life, MA incentives may reduce potentially burdensome care and encourage hospice but could also restrict access to costly but necessary services.”
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