Medicare, Med Advantage Health Care Use Differs Regionally

Geographic variation in the Medicare Advantage population exceeds that of traditional Medicare for use of skilled nursing facility and hospital care, according to study published in the August issue of Health Affairs.

Qijuan Li, M.P.H., Ph.D., from the Brown University School of Public Health in Providence, R.I., and colleagues examined geographic variation in Medicare Advantage, in which insurers are paid on a risk basis that may have incentives and tools to restrain service use, potentially affecting geographic variation. Data were included for 54 million Medicare beneficiaries in 2007 to 2013.

The researchers found that geographic variations in the use of skilled nursing facility and hospital care in the Medicare Advantage population exceeded those in traditional Medicare; variations in home health care use were greater in traditional Medicare. The correlations between use of services in the Medicare Advantage population and traditional Medicare were moderate to strong within hospital referral regions.

"The findings suggest that regional variations in hospital and post-acute care reflect local factors that influence beneficiaries' use of services irrespective of the way they obtain coverage," the authors write.

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