Comparing Post-Acute Care Use and First Site of Care Among Medicare Advantage Enrollees and Medicare Fee-for-Service Beneficiaries

Using data from the Health Care Cost Institute (HCCI) and Centers for Medicare & Medicaid Services (CMS), we examined trends in inpatient hospital admissions and post-acute care (PAC) utilization among Medicare Advantage (MA) and Fee-for-Service (FFS) beneficiaries. Specifically, we compared how frequently individuals in each group were discharged from the hospital, whether they had evidence of PAC use following discharge from an inpatient stay, and if so, where they first received these services. Between 2012 and 2016, across 28 conditions, we found:

• MA enrollees had fewer inpatient hospital stay discharges than FFS beneficiaries;
• Upon discharge, MA enrollees were less likely to have a claim for any PAC use; and 
• For both groups, use of skilled nursing facilities as the first site of PAC use declined, while home health use increased.