ArticleThe American journal of managed care2018
Medicare Advantage control of postacute costs: perspectives from stakeholders.
Article in The American journal of managed care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Trends and Disparities in Post-acute Care Utilization After Hospitalization for Sepsis in the United States: A Systematic Review.Medical care · 2026Pooled it
- Prior Authorization Requirements in Medicare Advantage and County Social Vulnerability.The American journal of managed care · 2026Article
- Health System Integration and Prior Authorization in Medicare Advantage.Health services research · 2026Article
- Can I Stay, or Must I Go Now? A Cohort Study of Discharge Appeals in a Post-Acute Skilled Nursing Facility.Journal of the American Medical Directors Association · 2026Article
- Medicare Plan Switching and Hospice Care Among Decedents With Advanced Cancer.JAMA network open · 2026Article
- Medicare Advantage reimbursement structures impact home health delivery and outcomes.The American journal of managed care · 2025Article
- Postacute Care Use and Outcomes Among Medicare Advantage vs Traditional Medicare Beneficiaries.JAMA network open · 2025Article
- Older adults living with dementia enrolled in similar Medicare Advantage plans compared to those without dementia.Alzheimer's & dementia. Behavior & socioeconomics of aging · 2025Article
- Do Medicare Beneficiaries Under Accountable Care or Medicare Advantage Use Lower Quality Nursing Homes?Journal of the American Geriatrics Society · 2025Article
- The Effect of Extending the Window to Disenroll From Medicare Advantage Among Post-Acute Users.Medical care research and review : MCRR · 2025Article
- Long-term outcomes after rehabilitation in Medicare Advantage and fee-for-service beneficiaries.Journal of the American Geriatrics Society · 2024Article
- Differences in Home Health Services and Outcomes Between Traditional Medicare and Medicare Advantage.JAMA health forum · 2024Article
- Postacute Care Services Use and Outcomes Among Traditional Medicare and Medicare Advantage Beneficiaries.JAMA health forum · 2023Article
- Comparison of the Pathway to Hospice Enrollment Between Medicare Advantage and Traditional Medicare.JAMA health forum · 2023Article
- Aligning Medicaid and Medicare Advantage Managed Care Plans for Dual-Eligible Beneficiaries.Medical care research and review : MCRR · 2022Article
- Opening the black box: Evaluating the care of people with serious illness in Medicare Advantage.Journal of the American Geriatrics Society · 2021Article
- Trends in Older Adults' Knowledge of Medicare Advantage Benefits, 2010 to 2016.Journal of the American Geriatrics Society · 2020Article
- Family and Friend Perceptions of Quality of End-of-Life Care in Medicare Advantage vs Traditional Medicare.JAMA network open · 2020Article
- Switching Between Medicare Advantage And Traditional Medicare Before And After The Onset Of Functional Disability.Health affairs (Project Hope) · 2020Article
- Policy in Clinical Practice: Medicare Advantage and Observation Hospitalizations.Journal of hospital medicine · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivesMedicare Advantage (MA) plans have strong incentives to control costs, including postacute spending; however, to our knowledge, no research has examined the methods that MA plans use to control or reduce postacute costs. This study aimed to understand such MA plan efforts and the possible unintended consequences. STUDY
designA multiple case study method was used.
methodsWe conducted 154 interviews with administrative and clinical staff working in 10 MA plans, 16 hospitals, and 25 skilled nursing facilities (SNFs) in 8 geographically diverse markets across the United States.
resultsParticipants discussed how MA plans attempted to reduce postacute care spending by controlling the SNF to which patients are discharged and SNF length of stay (LOS). Plans typically influenced SNF selection by providing patients with a list of facilities in which their care would be covered. To influence LOS, MA plans most commonly authorized patient stays in SNFs for a certain number of days and required that SNFs adhere to this limitation, but they did not provide guidance or assistance in ensuring that the LOS goals were met. Hospital and SNF responses to the largely authorization-based system were frequently negative, and participants expressed concerns about potential unintended consequences.
conclusionsIn their interactions with hospitals and SNFs, MA plans attempted to influence the choice of SNF and LOS to control postacute spending. However, exerting too much influence over hospitals and SNFs, as these results seem to indicate, may have the negative consequences of delayed hospital discharge and SNFs' avoidance of burdensome plans.
Indexed as
Identifiers
30586487PMC6344939What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.