Comparison of the Use of Top-Ranked Cancer Hospitals Between Medicare Advantage and Traditional Medicare

AJMC October 18, 2021
Daeho Kim, PhD, David J. Meyers, PhD, Momotazur Rahman, PhD, Amal N. Trivedi, MD, MPH

Medicare Advantage enrollees, particularly those with lower out-of-network benefits, may have restricted access to top-ranked hospitals for complex cancer care compared with traditional Medicare enrollees.

ABSTRACT

Objectives: To compare the use of top-ranked cancer hospitals for complex cancer surgery between Medicare Advantage (MA) and traditional Medicare fee-for-service (FFS) enrollees.

Study Design: Cross-sectional analysis of Medicare claims and enrollment data.

Methods: The study used Medicare Provider Analysis and Review files to compare differences in use of top-ranked cancer hospitals for complex cancer surgery (lobectomy, esophagectomy, gastrectomy, colectomy, and the Whipple procedure [pancreaticoduodenectomy]) between MA and FFS enrollees 65 years and older who underwent the surgery in 2015 to 2017.

Results: After adjusting for demographic characteristics and county fixed effects, MA enrollees...

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