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Questions about nursing home care quality and Medicare Advantage

January 24, 2018
by I Advance Senior Care
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A new Brown University study suggests typical Medicare Advantage members may often receive poor care at their nursing facilities, according to a story from Forbes.

Last year, about 19 million Americans, one-third of Medicare participants, were enrolled in MA plans. This model holds the promise of fully integratinghealth care and long-term services and supports—a great benefit for frail older adults. But critics worry that when managed care organizations are at financial risk for the cost of care, they may skimp on quality to save money. That certainly was my concern when visiting my friend. And  a new study in the journal Health Affairs (paywall) suggests that fear may be well-founded when it comes to skilled nursing care.

The research, by David Meyers, Vince Mor, and Momotazur Rahman at Brown University, concludes that seniors in traditional fee-for-service Medicare are more likely to be admitted to high quality nursing facilities than MA enrollees. And they found that members of lower-quality MA plans were the most likely to receive care in the poorest quality SNFs.

The paper used two ways to measure SNF quality: the Centers for Medicare and Medicaid Services (CMS)  star rating system  (1 is the lowest and 5 is the highest ) and hospital readmission rates.

You can read more about this study at Forbes.