Observational studyJournal of general internal medicine2021
Comparing Receipt of Prescribed Post-acute Home Health Care Between Medicare Advantage and Traditional Medicare Beneficiaries: an Observational Study.
Observational study in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 18 citations in OpenAlex.
- Medicare Advantage Prior-Authorizations Are Linked to Racial Differences in End-of-Life Home Health Use.Journal of the American Geriatrics Society · 2026Article
- Defining and Measuring Delays in Postacute Care: Toward a Standardized Definition of Rehabilitation Access.Medical care · 2026Article
- Racial and Ethnic Differences in Post-acute Home Health Services Among Older Adults With Alzheimer's Disease and Related Dementias.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Home Health Value-Based Purchasing and Postacute Home Health Visits Among Older Adults With Dementia.JAMA network open · 2026Observational
- Association of Dual Eligibility and Medicare Type With Quality of Postacute Care After Stroke.JAMA network open · 2026Article
- Methodological Approaches to Examining Home Health Using Traditional Medicare and Medicare Advantage Claim Data.Health services research · 2026Article
- Medicare Advantage reimbursement structures impact home health delivery and outcomes.The American journal of managed care · 2025Article
- Specialization of Home Health Agencies to Deliver Care for Medicare Advantage Patients.JAMA network open · 2025Article
- Payment Source Shift for Surgical Care Among Veterans Enrolled in Medicare Advantage Plans.JAMA health forum · 2025Article
- Trends in hospital discharge outcomes among high-risk Medicare beneficiaries before and during the COVID-19 pandemic.Health affairs scholar · 2025Article
- Prior authorization and utilization management for post-acute home health in Medicare Advantage: the motivations, players, processes, unique challenges, and impacts on patient care.Health affairs scholar · 2025Article
- Skilled home healthcare utilization and outcomes for older adults with dementia: A scoping review.Journal of the American Geriatrics Society · 2025Article
- Differences in Home Health Services and Outcomes Between Traditional Medicare and Medicare Advantage.JAMA health forum · 2024Article
- Postacute Care for Medicare Advantage Enrollees Who Switched to Traditional Medicare Compared With Those Who Remained in Medicare Advantage.JAMA health forum · 2024Article
- Prevalence of use and characteristics of users of home-based medical care in Medicare Advantage.Journal of the American Geriatrics Society · 2023Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMedicare Advantage (MA) covers more than 1/3rd of all Medicare beneficiaries. MA plans are required to provide the same benefits as Traditional Medicare (TM), but can impose utilization management tools to control costs.
objectiveTo assess differences between TM and MA enrollees in the probability of receiving prescribed post-acute home health (HH) care and to describe MA plan characteristics associated with HH receipt.
designRetrospective cross-sectional analysis of claims data, HH patient assessment data, and MA plan data from 2011 to 2017.
participantsMedicare beneficiaries aged 66 and older with an incident hospitalization for joint replacement, pneumonia, chronic obstructive pulmonary disease, stroke, urinary tract infection, septicemia, acute renal failure, or congestive heart failure. MAIN MEASURES: Receipt of prescribed HH as indicated by a HH discharge code and corresponding HH patient assessment within 14 days of hospital discharge. KEY
resultsThere were 2,723,245 beneficiaries prescribed HH at discharge (68% TM, 32% MA). About 75% of TM enrollees and 62% of MA enrollees received prescribed post-acute HH. In adjusted analyses, MA enrollees had an -11.7 percentage point (pp) (95% confidence interval (CI): -16.8, -6.5) lower probability of receiving HH compared with TM enrollees. In adjusted analyses, HMO enrollees in plans with cost sharing (- 8.4 pp; 95% CI: - 14.3, - 2.5), referrals (- 3.7 pp; 95% CI: - 6.1, - 1.2), and pre-authorization (- 5.1 pp; 95% CI: - 8.3, - 2.0) were less likely to receive prescribed HH. In adjusted analyses, PPO enrollees in plans with cost sharing were -7.0 pp (95% CI: - 12.7, - 1.4) less likely to receive HH, but there was no difference for those with referrals (1.1 pp; 95% CI, - 1.5, 3.7) or pre-authorization (1.6 pp; 95% CI: - 0.6, - 3.9).
conclusionsAmong Medicare beneficiaries, MA enrollees were less likely to receive prescribed post-acute HH compared with TM. As enrollment in MA continues to grow, it is important to examine how differences in utilization relate to outcomes.
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What 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.