Wide Variation In Differences In Resource Use Seen Across Conditions Between Medicare Advantage, Traditional Medicare.

Abstract

Medicare Advantage (MA) is a rapidly growing source of coverage for Medicare beneficiaries. Examining how MA performs compared with traditional Medicare is an important policy issue. We analyzed national MA encounter data and found that the adjusted differences in resource use between MA and traditional Medicare varied widely across medical conditions in 2019. Total resource use in MA was generally lower than in traditional Medicare but by varying amounts across conditions, and it was not significantly different from traditional Medicare for some conditions. This variation was explained by resource use for hospital inpatient services in MA relative to traditional Medicare. Resource use for treatments was considerably lower in MA than in traditional Medicare across all conditions, whereas resource use for imaging and testing was consistently higher in MA for all conditions. As MA grows, efforts are needed to identify mechanisms driving differences in resource use between MA and traditional Medicare and to assess their implications for patient care.