Managed Healthcare Executive April 8, 2023
A study in this month’s Health Affairs shows that Medicare Advantage penetration has a ripple effect on the patterns of postacute care usage among those in traditional Medicare. As Medicare Advantage penetration increased, use of postacute care services by beneficiaries in traditional Medicare decreased.
Research has shown that beneficiaries in Medicare Advantage plans tend to use fewer postacute care services, particularly those delivered in institutional settings such as nursing homes, than beneficiaries in traditional Medicare. The plans use prior authorization and other managed care strategies to limit access to the institutional care and steer patient toward care that is less expensive. How the decrease affects patients is perhaps debatable, but by some accounts the outcomes are similar if...
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