Service Use at the End-of-Life in Medicare Advantage Versus Traditional Medicare

Medical Care: October 1, 2013

Background: Relative to traditional fee-for-service Medicare, managed care plans caring for Medicare beneficiaries may be better positioned to promote recommended services and discourage burdensome procedures with little clinical value at the end of life.

Objective: To compare end-of-life service use for enrollees in Medicare Advantage health maintenance organizations (MA-HMO) relative to similar individuals enrolled in traditional Medicare (TM).

Research Design, Subjects, Measures: For a national cohort of Medicare decedents continuously enrolled in MA-HMOs or TM in their year of death, 2003–2009, we obtained hospice enrollment information and individual-level Healthcare Effectiveness Data and Information Set utilization measures for MA-HMO decedents for up to 1 year before death. We developed comparable claims-based measures for TM decedents matched on age, sex, race, and location. Read More