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Are Medicare Advantage Plans Leading to Lower Quality Nursing Homes?

Posted by Brad Sarkauskas | Aug 16, 2018 | 0 Comments

A study conducted by Brown University concluded that people enrolled in a Medicare Advantage plan were more likely to enter lower quality nursing homes than those in traditional Medicare. The study poses alarming questions regarding whether or not Medicare Advantage plans are influencing beneficiaries to choose a lower quality nursing home for their loved ones.

What are Medicare Advantage Plans?

Medicare Advantage plans are an alternative to traditional Medicare. These plans are provided by private insurers rather than the federal government, but must still cover all of the services that traditional Medicare covers. However, unlike Original Medicare, Medicare Advantage plans typically have a preferred network of providers that serves most of the enrollees. This means that any care that falls outside of this network requires additional fees at a higher rate.

What this Means in Regards to Nursing Homes

The study examined Medicare beneficiaries that entered nursing homes between 2012 and 2014. When compared to traditional Medicare beneficiaries, those under a Medicare Advantage plan tended to enter lower quality nursing homes on average.

There was no direct conclusion regarding whether or not Medicare Advantage beneficiaries were worse off than those of Original Medicare; however, they did find that those enrolled in Medicare Advantage plans had higher re-hospitalization rates. This could mean that Medicare Advantage plans may have a significant influence on the nursing homes beneficiaries choose, and these nursing homes are typically of lower quality.

When looking to enroll in both Medicare and Medicare Advantage plans, it's essential to do your research regarding the discrepancies in care and affordability and it should also be noted that Medicare will only cover limited stays in a nursing home. If you or a loved one needs help planning for long-term care, or have questions about Medicare in general, contact an elder law attorney today.

Brad Sarkauskas of Heritage Law Offices can address any concerns you may have and help you come up with a plan for your future care. Contact the office at (414) 253-8500 for a free case evaluation today.

Bradley J. Sarkauskas, Attorney-at-Law

About the Author

Brad Sarkauskas

As the founding member of the Heritage Law Office of Wisconsin, LLC, attorney Brad Sarkauskas is equipped with the tools--through his extensive background in finance--to effectively represent his clients legal economic interests. With over 20 years of experience in finance, insurance, and taxati...


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