Another study suggests that Medicare Advantage (MA) beneficiaries have less access to high-quality home health services.

In a study comparing traditional Medicare beneficiaries and MA beneficiaries in 2019, traditional Medicare beneficiaries used outpatient, inpatient, and home health services more frequently than beneficiaries in MA plans.

This applied regardless of whether there was a monthly premium for the MA plan or not.

“When you compare traditional Medicare to MA insurance of all types, there aren’t as many barriers to entry,” Jennifer Schiller, executive director of the Research Institute for Home Care, told Home Health Care News. “With traditional Medicare, there are no barriers to entry — for home care, inpatient care or outpatient care — like there are with Medicare Advantage plans.”

The Research Institute for Home Care (RIHC) funds research in the field of home care and recently published a study on the transition from hospital to home care.

The most recently published study focuses on MA beneficiaries of all plan types and comparisons between traditional beneficiaries and their MA member counterparts.

Home care is generally preferable to inpatient post-acute care when possible. Patients prefer it and the health care system saves money because it costs less.

MA plans tend to pay less for home health services than traditional Medicare insurance, which has become increasingly burdensome for providers as MA penetration has increased over the years.

“If you just look at patients on traditional Medicare and Medicare Advantage, they initially look similar,” Schiller said. “But when you break them down, … there’s a bigger story to tell.”

The researchers used the 2019 Medicare Current Beneficiary Survey (MSBS) cost supplement, which represents “a nationally representative sample of Medicare beneficiaries.”

Differences between utilization by MA members and traditional Medicare beneficiaries have also been confirmed elsewhere, including in a study published earlier this year by researchers in the Department of Rehabilitation Medicine at the University of Washington.

Given the focus year of the study, Schiller expressed some reservations.

“This provides an important foundation,” she said. “But obviously a few things have happened since 2019. We had COVID-19, we had the Patient-Driven Groupings Model (PDGM), and we also had an increase in Medicare Advantage penetration, right? So there are additional factors to consider.”

RIHC plans to review more current data as they become available.