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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Topics: Health System / Hospital, Insurance, Medicare, Medicare Advantage, Provider, Survey / Study, Trends
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