Evidence map›Paper›PMID 41940417›Full record

ArticleJournal of the American Geriatrics Society2026

Association of Medicare Advantage Enrollment With Post-Acute Care Use and Associated Patient Outcomes.

Derek T Lake, Vincent Mor, David C Grabowski, Amal N Trivedi, Pedro L Gozalo

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Derek T LakeDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Vincent MorDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID 0000-0003-0084-1267
David C GrabowskiDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Amal N TrivediDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Pedro L GozaloDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.

Funding

Which Post-Acute Care Setting is Best for Patients' Outcomes?R01AG054656 · NIA · BROWN UNIVERSITY · PI GOZALO, PEDRO L, GRABOWSKI, DAVID C · 2017 to 2019
$1.7M
NIA NIH HHS R01 AG054656NIA NIH HHS R01AG054656
6 · The paper itself

Abstract

importanceEnrollees in Medicare Advantage (MA) receive less intensive post-acute care (PAC) than those in traditional Medicare, but the implications of this lower intensity, particularly for patients with complex needs, remain poorly understood.

objectivesTo estimate the association of MA enrollment with PAC use and patient outcomes for hospitalized beneficiaries with hip fracture or stroke. DESIGN, SETTING, AND

participantsA quasi-experimental difference-in-differences analysis leveraging the geographic expansion of MA from 2012 to 2017. The study included 148,396 stroke and 126,046 hip fracture hospitalizations, representing quasi-exogenous hospitalization events in high MA-growth counties.

main outcome measuresInitial PAC setting, 30-day all-cause hospital readmission, and 30- and 90-day all-cause mortality.

resultsMA enrollment was associated with fewer discharges to inpatient rehabilitation facilities (stroke: -8.9 pp; 95% CI, -9.88 to -7.92; hip fracture: -14.4 pp; 95% CI: -15.38 to -13.42). While 30-day readmissions were modestly lower for MA enrollees in both cohorts, MA enrollees experienced a 7.1% relative increase in 30-day mortality for stroke (0.6 pp; 95% CI: 0.01 to 1.19) and an 11.9% relative increase in 90-day mortality for hip fracture (1.3 pp; 95% CI: 0.52 to 2.08). This adverse mortality effect was concentrated in markets with high baseline IRF use (> = 33.3% of discharges, top tercile), where MA enrollment was associated with an 18.0% relative increase in 90-day mortality for stroke (2.0 pp; 95% CI: 0.82 to 3.18) and a 22.3% relative increase in 90-day mortality for hip fracture (2.3 pp; 95% CI: 0.93 to 3.67).

conclusionsMA enrollment was associated with lower IRF use, modestly lower readmissions, and a higher mortality risk for hip fracture and stroke. These findings suggest that MA's strategy of shifting patients to lower-cost settings may carry unintended adverse consequences for clinically complex patients.

Indexed as

Hip FracturesMedicare Part CStrokeSubacute CareAgedAged, 80 and overFemaleHospitalizationHumansMalePatient ReadmissionUnited Stateship fractureinpatient rehabilitation facilitiesmedicare advantagepostacute carestroke

Identifiers

PMID41940417
PMCPMC13104003

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Registered trials

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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.