MA Beneficiaries Use Less Home Care Than Fee-For-Service

The trend of home health agencies expanding their patient share to Medicare Advantage (MA) patients is on the rise, but overall, MA beneficiaries are using less home health compared with seniors on traditional fee-for-service (FFS) Medicare.

Home health utilization is a large source of Medicare costs, but, up until this point, it was unknown if Medicare Advantage (MA) beneficiaries were using more or less home care than FFS Medicare beneficiaries.

It was revealed that patients on fee-for-service (FFS) plans appear to be using more care, according to a recent study in the American Journal of Managed Care. The study used the information from 30,837,130 FFS beneficiaries and 10,594,658 MA beneficiaries, but did not include dual-eligible patients.

When it comes to functional outcomes, or measurable goals that help patients perform specific daily activities, there was a similarity between patients using FFS and MA plans, but length of episodes in home care were 33% longer in FFS patients.

Even more, FFS beneficiaries who used home health were enrolled for an average of 75.8 days, compared to MA beneficiaries who were enrolled for an average of 56.3 days.

Of the patients enrolled in FFS, 6.3% had at least one home health episode, and of those in MA, 3.9% did, the study found. The odds of a FFS patient receiving home health were 1.82 times those of MA, the study found.

“The MA versus FFS comparison of home health utilization across regions is of interest because MA plans, which are paid a capitated rate to cover all needed services, have a direct incentive to minimize financial costs, whereas there is no real equivalent incentive for FFS,” the report added.

Written by Alana Stramowski

Alana Stramowski