A nurse visiting a senior patient at home.

Medicare Advantage plans’ emphasis on cost savings and efficiency may be leading some to skimp on post-acute offerings. Traditional Medicare, by contrast, often provides more intensive post-acute care, leading to better health outcomes in the long run, according to a new study published in JAMA Health Forum.

Despite receiving less intensive post-acute care, MA enrollees experienced similar health outcomes as traditional Medicare beneficiaries, the study found. Both groups had similar rates of 30-day mortality and hospital readmissions.

The researchers analyzed more than 4,600 hospital visits by Ohio retirees. In 2016, retired public employees in Ohio were given a choice of whether to stick with healthcare coverage already provided by a Humana group MA plan, or to switch to traditional Medicare. About 75% switched to traditional Medicare. Comparing claims by both populations, the researchers found that MA plans were less likely to cover home health or more intensive post-acute services after a hospitalization than traditional Medicare.

And retirees enrolled in traditional Medicare were more likely to receive additional services — including costly options such as inpatient rehabilitation facility care — on top of home health care after a hospital visit, compared to MA beneficiaries.

Tools like prior authorization and curated provider networks allow MA plans to offer care more efficiently, according to the researchers, but they also might lead some insurers to cut corners in the name of generating savings. Plans’ use of “case management” to match patients with the most appropriate mode of post-acute care can lead to barriers to critical services — which can only be overcome with “extensive effort, persistence and clinical justification.” And in reducing costs, they noted, MA plans may focus on services that maintain short-term health outcomes while neglecting those more intensive services that promote long-term health.

“MA plans generate savings by reducing the use of PAC, which may have adverse effects on patients and caregivers,” they noted in the study. “Moreover, the concern with the lower use of inpatient rehabilitation facilities in MA is that beneficiaries who would benefit from the more intensive rehabilitation services may not be allowed access to these services.”