Home health patients covered under Medicare Advantage (MA) plans are sicker and have more chronic conditions than other Medicare home health patients. That is according to the 2022 Home Care Chartbook by the Research Institute for Home Care.
The study analyzing home health statistics found 43% of MA beneficiaries who used home health reported being in fair or poor health in 2022, compared to 20% of all Medicare enrollees and 41.3% of home health users enrolled in both traditional Medicare plans and MA plans. Additionally, a larger percentage of MA beneficiaries using home health reported their health deteriorated in the past year compared to Medicare beneficiaries overall and Medicare beneficiaries using home health.
MA members using home health also had more chronic conditions than those in the other two categories. The report said nearly 50% of MA home health users had five or more chronic conditions compared to 22% of all Medicare enrollees overall and 45% of all Medicare home health users.
The report comes at a time when MA plans are growing in popularity with aging baby boomers and drawing increased scrutiny from lawmakers and government watchdogs in Washington. Last year, the Office of Inspector General accused MA plans of denying or delaying services covered under Medicare.
In its analysis of government data, the Research Institute for Home Care found some evidence to support that charge. More than a third of MA home health users said they had trouble accessing needed care due to cost, coverage and other reasons.
The report could draw additional scrutiny from the Centers for Medicare & Medicaid Services. Last summer, CMS requested feedback from the public on ways to strengthen MA plans in ways that align with Medicare. ATI Advisory, which has conducted research on the private plans, called on CMS to improve data collection and craft MA policies that promote “person-centeredness” and equitable outcomes.
MA plans account for approximately 48% of all Medicare beneficiaries and more than half of all Medicare spending, according to a report last year by the Kaiser Family Foundation.
