Switching Between Medicare Advantage And Traditional Medicare Before And After The Onset Of Functional Disability.

TitleSwitching Between Medicare Advantage And Traditional Medicare Before And After The Onset Of Functional Disability.
Publication TypeJournal Article
Year of Publication2020
AuthorsAnkuda, CK, Ornstein, KA, Covinsky, KE, Bollens-Lund, E, Meier, DE, Kelley, AS
JournalHealth Aff (Millwood)
Volume39
Issue5
Pagination809-818
Date Published2020 May
ISSN1544-5208
KeywordsActivities of Daily Living, Aged, Humans, Independent Living, Medicare Part C, Quality of Health Care, United States
Abstract

Medicare Advantage (MA) plans have increasing flexibility to provide nonmedical services to support older adults aging in place in the community. However, prior research has suggested that enrollees with functional disability (hereafter, "disability") were more likely than those without disability to leave MA plans. This indicates that MA plans might not meet the needs of older adults with disability. We used data for 2011-16 from the National Health and Aging Trends Study linked to Medicare claims to measure and characterize switches in either direction between Medicare Advantage and traditional Medicare in the twelve months before and after onset of disability. While the rate of switches from Medicare Advantage to traditional Medicare increased slightly after disability onset, people with greater levels of disability were more likely to switch to traditional Medicare, compared to those with lower levels: 36 percent of those who switched from Medicare Advantage to traditional Medicare needed help with two or more activities of daily living, compared to 14.3 percent of those who switched from traditional Medicare to Medicare Advantage. This indicates the potential benefit of including functional measures in MA plan risk adjustment and quality measures. Furthermore, the highest-need older adults with disability may experience lower-quality care in Medicare Advantage and thus leave before accessing the program's expanded benefits.

DOI10.1377/hlthaff.2019.01070
Alternate JournalHealth Aff (Millwood)
PubMed ID32364865
PubMed Central IDPMC7951954
Grant ListK24 AG062785 / AG / NIA NIH HHS / United States
P30 AG044281 / AG / NIA NIH HHS / United States
R01 AG054540 / AG / NIA NIH HHS / United States
R01 AG060967 / AG / NIA NIH HHS / United States