{"subscriber":false,"subscribedOffers":{}} Home Health Use In Medicare Advantage Compared To Use In Traditional Medicare | Health Affairs

Research Article

Home Health

Home Health Use In Medicare Advantage Compared To Use In Traditional Medicare

Affiliations
  1. Laura Skopec ([email protected]) is a senior research associate in the Health Policy Center, Urban Institute, in Washington, D.C.
  2. Stephen Zuckerman is vice president for health policy, Urban Institute.
  3. Joshua Aarons is a research analyst in the Health Policy Center, Urban Institute.
  4. Douglas Wissoker is a senior fellow in the Statistical Methods Group, Urban Institute.
  5. Peter J. Huckfeldt is an assistant professor in the Division of Health Policy and Management, School of Public Health, University of Minnesota, in Minneapolis.
  6. Judith Feder is an institute fellow in the Health Policy Center, Urban Institute, and a professor of public policy at Georgetown University, in Washington, D.C.
  7. Robert A. Berenson is an institute fellow in the Health Policy Center, Urban Institute.
  8. Judith Dey is a social science analyst in the Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, in Washington, D.C.
  9. Iara Oliveira is a social science analyst in the Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services.
PUBLISHED:June 2020No Accesshttps://doi.org/10.1377/hlthaff.2019.01091

Abstract

Medicare covers home health benefits for homebound beneficiaries who need intermittent skilled care. While home health care can help prevent costlier institutional care, some studies have suggested that traditional Medicare beneficiaries may overuse home health care. This study compared home health use in Medicare Advantage and traditional Medicare, as well as within Medicare Advantage by beneficiary cost sharing, prior authorization requirement, and plan type. In 2016 Medicare Advantage enrollees were less likely to use home health care than traditional Medicare enrollees were, had 7.1 fewer days per home health spell, and were less likely to be admitted to the hospital during their spell. Among Medicare Advantage plans, those that imposed beneficiary cost sharing or prior authorization requirements had lower rates of home health use. Qualitative interviews suggested that Medicare Advantage payment and contracting approaches influenced home health care use. Therefore, changes in traditional Medicare home health payment policies implemented in 2020 may reduce these disparities in home health use and spell length.

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