The Medicare Payment Advisory Commission’s (MedPAC) June Report to Congress devotes a full chapter  to the exploration of home health use among Medicare Advantage (MA) enrollees.

MedPAC found that the overall rate of home health use among MA enrollees was slightly lower than among fee-for-service (FFS) beneficiaries (8.3 percent vs. 8.6 percent) and larger differences depending on whether beneficiaries had an acute care hospitalization during the year.

For those with a hospitalization, the adjusted probability of home health care use was 3.2 percent higher among MA enrollees than FFS beneficiaries (41.7 percent vs. 40.4 percent), which could suggest that home health care is sometimes used in MA as a substitute for other types of post-acute care (PAC), such as costlier skilled nursing stays. MedPAC also examined total visits received by home health care users finding fewer visits per beneficiary per year compared with FFS (18.2 vs. 20.4 visits per user).

MedPAC emphasized that it is not possible to draw conclusion on the appropriateness of care based on these differences and in future work, MedPAC plans to examine other PAC providers.