DIFFERENCES IN HOME HEALTH SERVICES AND OUTCOMES FOR MEDICARE ADVANTAGE PLANS WITH EPISODIC VS. PER-VISIT PAYMENTS
2024

Differences in Home Health Services for Medicare Advantage Plans

Sample size: 285297 publication Evidence: moderate

Author Information

Author(s): Rachel Prusynski, Anthony D’Alonzo, Michael Johnson

Primary Institution: University of Washington

Hypothesis

Patients with Medicare Advantage plans have different outcomes based on the payment structure of their home health services.

Conclusion

Medicare Advantage plans with episodic payments provide fewer home health services and mixed outcomes compared to Traditional Medicare, while per-visit plans have higher rates of inpatient admissions.

Supporting Evidence

  • Patients with episodic MA plans had lower rates of improvement in mobility and self-care compared to TM.
  • Patients with per-visit MA plans had higher rates of community discharge than TM.
  • Episodic MA plans had fewer administrative restrictions for home health providers.

Takeaway

Older adults with Medicare Advantage plans get less help at home than those with Traditional Medicare, and how they pay for that help can change their health outcomes.

Methodology

The study analyzed 285,297 home health episodes from 2019-2022 using inverse probability of treatment weighting.

Participant Demographics

Older adults receiving home health services.

Digital Object Identifier (DOI)

10.1093/geroni/igae098.3835

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