Quality of Hospices Used by Medicare Advantage and Traditional Fee-for-Service Beneficiaries

作者：Lindsay White, Chuxuan Sun, Norma B. Coe · 发表于：JAMA Network Open · 年份：2024 · DOI：10.1001/jamanetworkopen.2024.51227 · 被引用次数：3 · 研究领域：Palliative Care and End-of-Life Issues、Healthcare Policy and Management、Geriatric Care and Nursing Homes

Importance: Although enrollment in both hospice care and Medicare Advantage (MA) have grown substantially, little is known about the quality of hospice care received by MA beneficiaries relative to traditional Medicare fee-for-service (FFS) beneficiaries. Objective: To compare hospice enrollment and the quality of hospices serving MA and FFS beneficiaries. Design, Setting, and Participants: This population-based cross-sectional study used Medicare enrollment and claims data from January 1, 2018, through December 31, 2019, and Hospice Quality Reporting Program (HQRP) data released between November 1, 2020, and August 30, 2022, to compare the probability of enrolling in hospice before death and the probability of using high- vs low-quality hospices between MA and FFS beneficiaries. Two sample populations were assessed: (1) all Medicare beneficiaries who died in 2018 or 2019, and (2) all Medicare hospice enrollees in 2018 and 2019, excluding beneficiaries with hospice use in 2017. Data were analyzed between April 1, 2023, and April 30, 2024. Exposures: MA enrollment was assessed 6 months prior to death for decedents and in the month of hospice admission for hospice enrollees. MA beneficiaries were further classified by plan type: regular MA, special needs plan (SNP), and Medicare-Medicaid plan (MMP). Main Outcomes and Measures: For decedents, the outcome of interest was the prevalence of any hospice use in the last 6 months of life. For hospice enrollees, the outcome of interest...