Traditional Medicare and Medicare Advantage patients show disparities in health outcomes

A recent study in Jama Health Forum examining nearly 300,000 Medicare beneficiaries has revealed significant differences in home health care between patients enrolled in Medicare Advantage plans and those in traditional Medicare. According to this research, Medicare Advantage recipients receive fewer home health visits and show worse outcomes in self-care and mobility compared to traditional Medicare patients with similar needs. 

Medicare Advantage plans, which are offered by private companies to those over 65 as an alternative to traditional Medicare, now serve over 30 million Americans. Medicare Advantage plans can include additional services like dental and vision care but tend to come with restrictions on post-acute and outpatient services.

While the health care available through traditional Medicare and Medicare Advantage plans can vary, this study focused on differences in access to home health care services between the two types of plans. Home health care is a benefit provided to homebound individuals in need of care for an illness or injury. Researchers found that, for patients with similar medical needs, Medicare Advantage patients had shorter home health lengths of stay, and fewer visits from nurses, physical therapists, occupational therapists, and other health aides compared with patients with traditional Medicare plans. Despite less functional improvement, people with Medicare Advantage plans were more likely to be discharged to the community, which could result in less independence for patients, and greater burdens for their caregivers. 

Assistant Professor Rachel Prusynski, PhD, DPT, led the study team, which also included Associate Professor Tracy Mroz, PhD, OTR/L. 

The UW Medicine Newsroom has more coverage of this study, including video soundbites with Dr. Prusynski. 

JAMA Heath Forum also recorded a podcast featuring Dr. Prusynski speaking about this study.