Quality and utilization of surgical care among Medicare Advantage beneficiaries

Abstract

Background

Over half of Medicare beneficiaries are now enrolled in Medicare Advantage, but there is little understanding of how Medicare Advantage impacts care for common surgical conditions.

Methods

This is a retrospective cross-sectional study of Medicare beneficiaries who underwent appendectomy, cholecystectomy, colectomy, or hernia repair from 2016 to 2020. Inverse Propensity Score-Weighted analysis was used to compare risk-adjusted rates of postoperative morbidity, mortality, and utilization.

Results

Of the 1,617,490 Medicare beneficiaries who underwent one of the operations, 574,412 (36 ​%) were enrolled in Medicare Advantage. Medicare Advantage enrollees demonstrated similar complications (29.6 % vs 29.2 ​%, aOR 1.02 [95 ​% CI, 1.01–1.03]) and 30-day mortality (5.9 % vs 6.1 ​%, aOR 0.96 [95 ​% CI, 0.94–0.98]), but were more likely to be discharged home (77.8 % vs 74.1 ​%, aOR 1.31 [95 ​% CI, 1.28–1.33]) and had fewer readmissions (12.8 % vs 15.2 ​%, OR 0.82 [95 ​% CI, 0.81–0.83]).

Conclusions

Medicare Advantage may reduce post-acute care use and readmissions for common surgical procedures without compromising postoperative outcomes.