AHA comments to MedPAC on differences in post-acute care use between MA, fee-for-service Medicare beneficiaries

The AHA provided comments to the Medicare Payment Advisory Commission Oct. 2 on a discussion from the commission’s September meeting on its examination of differences in post-acute care use between beneficiaries enrolled in Medicare Advantage and fee-for-service Medicare. The AHA said MedPAC’s preliminary findings reinforced concerns the AHA repeatedly shared with the commission, Congress and federal agencies. MedPAC found that MA beneficiaries used less post-acute care overall than FFS beneficiaries and were less likely to receive care in inpatient rehabilitation facilities. The commission also found that acute care hospital stays were longer for MA beneficiaries than FFS beneficiaries regardless of their post-acute care destination. “These patterns are consistent with hospitals’ and health systems’ experiences: MA prior authorization and utilization management practices delay hospital discharge and restrict access to the level of post-acute care recommended by the treating clinical team,” the AHA wrote.

The AHA encouraged MedPAC to follow several recommendations, including adjusting comparisons for beneficiary characteristics while stratifying results for clinically meaningful populations; examining outcomes associated with different post-acute settings; and analyzing the time between acute care discharge readiness, prior authorization submission, plan determination and transfer to a post-acute setting.