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Traditional Medicare offers better home care benefits than Medicare Advantage

Written by Diane Archer

If you have Medicaid or can afford supplemental coverage to fill gaps in traditional Medicare, here’s another reason to think twice before signing up for a Medicare Advantage plan. Researchers at Brown University’s School of Public Health have found that Medicare Advantage plans do not offer the high quality home health care benefits that traditional Medicare offers. Traditional Medicare home health care services are better, they report in JAMA Network.

People in traditional Medicare, overall, have access to far higher quality providers than people in Medicare Advantage plans. Last year, researchers at Brown University found that traditional Medicare offers higher quality skilled nursing facility benefits than Medicare Advantage plans. Medicare Advantage plans contract with poorer quality providers.

Of course, people in good health need not be too concerned about the quality of care their health insurance offers them. But, all of us can be hit by a car, or slip and fall, or otherwise develop a costly condition at any time. So, it’s important to pick a Medicare plan that will meet your needs in the long-term.

Unfortunately, data about the quality of care in particular Medicare Advantage plans is not available. But, the Brown University researchers found that people with costly health conditions were more likely to leave their Medicare Advantage plans and enroll in traditional Medicare. That’s another sign that Medicare Advantage plans are not meeting people’s needs when they need costly care.

For their home health care study, the researchers analyzed data from 4.4 million people who received home health care. They could not independently assess the quality of the home health agencies serving people in Medicare Advantage plans. Instead, they determined quality based on star ratings, which can be seriously flawed. They found a “significantly” greater likelihood of getting high-quality care in traditional Medicare than in Medicare Advantage. Consequently, people in Medicare Advantage plans may suffer negative health outcomes.

The researchers posit that Medicare Advantage plans save money by contracting with lower quality home health care agencies, just as they save money by contracting with lower quality skilled nursing facilities. Unfortunately, the Centers for Medicare and Medicaid Services does not factor in the quality of home health care agencies in a plan’s network when determining a Medicare Advantage plan’s star rating.

The Kaiser Family Foundation has also looked at the quality of providers in Medicare Advantage plans and found that people in these plans are less likely to be able to use centers of excellence when they have cancer.

Here’s more from Just Care:


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