With MA enrollment continuing to expand, SNFs can expect ongoing authorization pressure on length of stay even when admission rates remain comparable to Traditional Medicare.
We sought to describe national trends in hospitalization and post-acute care utilization rates in skilled nursing facilities (SNFs) and home health (HH) for both Medicare Advantage (MA) and Traditional Medicare (TM) beneficiaries, reaching up to the COVID-19 pandemic (2015–2019). Data was analyzed for Medicare beneficiaries aged 66 and older enrolled in Medicare Advantage or Traditional Medicare who were hospitalized and discharged alive. The study found that hospitalizations, SNF stays, and HH stays were all decreasing over time in both populations. Although similar proportions of Medicare Advantage or Traditional Medicare beneficiaries received skilled nursing or home health care, Medicare Advantage beneficiaries received fewer days. The largest difference we found was in the number of post-acute care providers used in Medicare Advantage or Traditional Medicare, with Medicare Advantage using far fewer; however, quality ratings were similar among post-acute care providers used in each program.
— Journal of the American Medical Directors Association, 01 October 2024
Burke, Robert E., et al. “Trends in Post-Acute Care Use in Medicare Advantage Versus Traditional Medicare: A Retrospective Cohort Analysis.” Journal of the American Medical Directors Association, 01 October 2024. https://doi.org/10.1016/j.jamda.2024.105202
Study Examines Post-Acute Care Patterns in Medicare
“One would think Medicare Advantage plans would encourage home health use. But our results didn’t show a big difference between insurance types in nursing facility use.” Medicare Advantage patients received fewer days of post-acute care—a median of 23 days versus 25 days for traditional Medicare beneficiaries—and used a median of 20 providers compared to 32 in traditional Medicare, though quality ratings were similar between programs.
— Penn LDI, 23 October 2024
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✔ Monitor rates and payer trends
