Medicare’s Effectiveness in End-of-Life Care Varies by Type

The effectiveness of Medicare in providing end-of-life care depends significantly on the type of Medicare plan a patient has. Research led by Lauren Hersch Nicholas, Ph.D., MPP, of the University of Colorado, highlights differences in care among more than a million Medicare recipients in their final six months of life.

Published in JAMA Health Forum, the study found that the kind of Medicare plan—Traditional Medicare (Parts A and B) or Medicare Advantage (private plans)—affects the treatments patients receive and whether they die in a hospital or hospice care.

Traditional Medicare offers broader provider choice but less financial protection, while Medicare Advantage includes additional benefits and limited provider networks. Nicholas emphasizes there is no one-size-fits-all answer for which plan is better, as patient needs and wishes vary.

Key findings include:
– Medicare Advantage patients were less likely to receive potentially burdensome treatments near the end of life.
– Those in Medicare Advantage were more likely to die in the hospital if hospitalized in their last six months, compared to Traditional Medicare patients who were more likely to die in hospice care.
– Medicare Advantage patients were more likely to receive home-based care rather than skilled nursing facility care after hospital discharge.

Nicholas stresses the importance of family conversations about end-of-life preferences and notes that differences in supplemental insurance (Medigap) and specific Medicare Advantage Plans were not accounted for in the study.

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