Medicare Advantage Enrollees Use Less Home Health Care In Their Final Days Than Traditional Medicare Patients

End-of-life home health care use and duration are lower among Medicare Advantage (MA) enrollees compared to traditional Medicare enrollees across nearly all populations.

This is especially true among Hispanic people and people identifying as Asian or Pacific Islander, according to a research letter published in the Journal of the American Medical Association.

Researchers found that participants in MA, especially racial or ethnic minorities, are less likely to receive home health care and use fewer days of care at the end of life compared to those enrolled in traditional Medicare.

Using data from the Centers for Medicare & Medicaid Services (CMS), researchers at Mount Sinai in New York and Brown University in Providence, Rhode Island, analyzed adults aged 66 and older who passed away in 2019 and had Medicare coverage during their final year of life. These individuals were potentially eligible for home health care during their last year and were not in a nursing facility, hospital or in hospice care.

The researchers identified more than 1.7 million decedents with an average age of 82. Of these, 51% were female, and 36.5% were MA enrollees. The rate of home health care usage was 37.5% for MA enrollees and 41.7% for those on traditional Medicare.

Home health care usage was lower among MA enrollees than those in traditional Medicare across most demographic groups, according to researchers. However, among the American Indian or Alaska Native population, MA enrollees had slightly higher usage, with 37.9% enrolled in MA compared to 37.1% in traditional Medicare.

For Asian or Pacific Islander patients, 32.6% were enrolled in MA, while 41.8% were in traditional Medicare. Among Hispanic patients, the rates were 33% for MA enrollees versus 44% for traditional Medicare.

Overall, home health users across all racial and ethnic groups had fewer days of home health care in MA than in traditional Medicare. This disparity was notably significant among Hispanics, who averaged 81.9 days of home health care in MA compared to 111.9 days in traditional Medicare.

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