Medicare Advantage (MA) beneficiaries have the same likelihood of survival after a heart attack as do people with traditional Medicare coverage.
That’s according to researchers from Harvard and the University of Michigan, who are studying the implications of rapid Medicare Advantage expansion on outcomes and treatment processes for specific conditions.
In 2022, nearly half (48%) of the Medicare-eligible population was enrolled in Medicare Advantage program plans, in which private insurers provide federally funded health and drug coverage. By 2030, that number is expected to grow to 60%.
Using data from more than 2 million patients hospitalized with STEMI and NSTEMI heart attacks, the investigators aimed to compare care the programs provided from 2009 to 2018. This included differences in heart attack-specific treatments and post-acute care transitions.
Coverage gap closes
In 2009, MA beneficiaries who experienced a heart attack had a significantly lower adjusted 30-day mortality rate, with a 1.5 percentage point survival difference over their peers in traditional Medicare. But this is no longer the case, the researchers found.
By 2018, mortality had declined in all groups, but there was no longer a significant difference between MA and traditional Medicare, reported Bruce Landon, MD, of Harvard, and John Ayanian, MD, of U of M.
Meanwhile, some differences between the two programs remained. When compared to 2009, people covered by MA in 2018 still were more likely to be prescribed cholesterol-lowering drugs and other recommended medications, for example. They also had a lower chance of being admitted to an intensive care unit or being readmitted to the hospital within 30 days of discharge.
Post-acute differences
However, these gaps between coverage providers shrank over the study period, the researchers reported. This may be explained in part by the 2012 institution of financial penalties for hospital readmissions of traditional Medicare patients, they theorized.
In addition, investigators found that MA participants in 2018 remained just as likely to be discharged home rather than to a post-acute care facility than they were in 2009. In contrast, traditional Medicare participants are now much more likely to be sent directly home than they once were, the researchers reported.
In an accompanying editorial, researchers from Brown University said that going forward, it will be important to study the variation between specific MA plans, focusing on the value of care, reducing overpayments and social and demographic factors.
Full findings were published in JAMA.
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