Much has been said about the growing penetration of Medicare Advantage plans into the skilled-care sector. By all accounts, this managed care approach might become not just a major player, but the dominant one.
For those unfamiliar with the concept, more seniors are enrolling in Medicare Advantage plans as a way to bundle their various health-related needs, while presumably saving money.
But a new report casts doubt on how well these are working for participants when it comes to skilled-care placements.
According to researchers at Brown University’s School of Public Health, these enrollees are more likely to be guided into lower-quality facilities, at least as far as Five-Star ratings are concerned.
David Meyers helped author the investigation. He estimates that about 13,000 people a year end up in lower-rated nursing homes, because that’s where their Medicare Advantage plan directs them to go.
Does that mean those in Medicare Advantage are getting worse care? Not necessarily. And to be fair, it’s not an issue that has been studied, yet.
But in the immortal words of Bob Dylan, you don’t need a weatherman to know which way the wind blows. All things being more or less equal, it’s not much of a stretch to conclude there just might be a connection between placement in a higher-rated facility and better outcomes.
And it appears that many older Americans have come to a similar conclusion. A 2015 study from the same university found that when elderly patients are about to need costly services such as skilled care, they are more likely to switch back from Medicare Advantage plans to traditional public Medicare. Hmm, I wonder why that might be?
Taken together, these studies suggest something quite ominous: When it comes to skilled care placements, being in a Medicare Advantage plan just might be a real disadvantage.
John O’Connor is McKnight’s Editorial Director.