Percent of Medicare Enrollees Who Use Home-Based Health Care and Number of Visits Among Respondents to the Medicare Current Beneficiary Survey by Plan Option
Restricted accessResearch articleFirst published online June, 2025
Percent of Medicare Enrollees Who Use Home-Based Health Care and Number of Visits Among Respondents to the Medicare Current Beneficiary Survey by Plan Option
Using beneficiary reports of health care utilization from the 2019 Medicare Current Beneficiary Survey Cost Supplement, we compare the prevalence of home-based care and number of visits among Medicare beneficiaries aged 65 and older, by plan option, excluding dual-eligible beneficiaries. Traditional Medicare (TM) beneficiaries were significantly more likely to receive home-based medical visits (10.4% vs. 8.0%) with greater differences observed in vulnerable subgroups. While average number of visits were comparable for TM (35.6) and Medicare Advantage (MA) (34.9) beneficiaries, the distribution of the number of visits varied by plan option. Compared with TM beneficiaries, MA beneficiaries were 4.5 times more likely to receive a single home-based medical visit (17.5% vs. 3.9%) and roughly 1.5 times more likely to have the fewest (two to four visits; 12.2% vs. 8.0%) and greatest number of home visits (90+ visits; 11.1% vs. 7.7%). Access to, and number of, home-based medical care differs significantly by plan option.
AnkudaC. K.OrnsteinK. A.CovinskyK. E.Bollens-LundE.MeierD. E.KelleyA. S. (2020). Switching between Medicare Advantage and Traditional Medicare before and after the onset of functional disability: Measuring and characterizing enrollees who switch between Medicare Advantage and Traditional Medicare in the twelve months before and after onset of a functional disability. Health Affairs, 39(5), 809–818.
2.
AntolD. D.SchwartzR.CaplanA.CasebeerA.ErwinC. J.PowersB. W. (2022). Comparison of health care utilization by Medicare Advantage and Traditional Medicare beneficiaries with complex care needs. JAMA Health Forum, 3(10), Article e223451.
3.
BenjaminA. E. (1993). An historical perspective on home care policy. The Milbank Quarterly, 71, 129–166.
4.
BerensonR. A.GarrettB.ShartzerA. (2022). Understanding Medicare Advantage payment. Urban Institute.
5.
CasebeerA. W.RonningD.SchwartzR.LongC.BhattacharyaR.UribeC.ShrankW. (2022). A comparison of home health utilization, outcomes, and cost between Medicare Advantage and Traditional Medicare. Medical Care, 60(1), 66–74.
6.
Centers for Medicare and Medicaid Services. (2019a). Office of enterprise data and analytics. 2019 Data users guide: Cost supplement file.
7.
Centers for Medicare and Medicaid Services. (2019b). Office of enterprise data and analytics. 2019 MBS methodology report.
8.
GadaE.PangburnP.SahrC.SchabenC. P.YoungR. (2024). Unfulfilled home health referrals lead to higher mortality among Medicare Advantage members. American Journal of Managed Care, 30(7), 310–314.
9.
GrimmC. A. (2023). Some Medicare Advantage organization denials of prior authorization requests raise concerns about beneficiary access to medically necessary care. US Department of Health and Human Services Office of Inspector General.
10.
JacobsP. D.KronickR. (2018). Getting what we pay for: How do risk-based payments to Medicare Advantage plans compare with alternative measures of beneficiary health risk?Health Services Research, 53(6), 4997–5015.
11.
JungJ.CarlinC.FeldmanR.TranL. (2022). Implementation of resource use measures in Medicare Advantage. Health Services Research, 57(4), 957–962.
KronickR. (2017). Projected coding intensity in Medicare Advantage could increase Medicare spending by $200 billion over ten years. Health Affairs, 36(2), 320–327.
14.
LeffB.RitchieC.CieminsE.DunningS. (2023). Prevalence of use and characteristics of users of home-based medical care in Medicare Advantage. Journal of the American Geriatrics Society, 71(2), 455–462.
15.
LiJ.QiM.WernerR. M. (2020). Assessment of receipt of the first home health care visit after hospital discharge among older adults. JAMA Network Open, 3(9), Article e2015470.
16.
LoomerL.KosarC. M.MeyersD. J.ThomasK. S. (2021). Comparing receipt of prescribed post-acute home health care between Medicare Advantage and Traditional Medicare beneficiaries: An observational study. Journal of General Internal Medicine, 36, 2323–2331.
17.
MaC.RajewskiM.SmithJ. M. (2024). Medicare Advantage and home health care: A systematic review. Medical Care, 62(5), 333–345.
18.
MarrJ.RitchieC.LeffB.OrnsteinK. A. (2023). Home-based medical care use in Medicare Advantage and Traditional Medicare in 2018: Study examines home-based medical care use in Medicare Advantage and Traditional Medicare. Health Affairs, 42(9), 1198–1202.
19.
McWilliamsJ. M.HsuJ.NewhouseJ. P. (2012). New risk-adjustment system was associated with reduced favorable selection in Medicare Advantage. Health Affairs, 31(12), 2630–2640.
Medicare Payment Advisory Commission (MedPAC). (2021). June 2021 report to the congress: Medicare and health care delivery system.
22.
Medicare Payment Advisory Commission (MedPAC). (2024a). Initial estimates of home health care use among Medicare Advantage enrollees.
23.
Medicare Payment Advisory Commission (MedPAC). (2024b). Health care spending and the Medicare Program, July 2024.
24.
MeyersD. J.MorV.RahmanM.TrivediA. N. (2021). Growth in Medicare Advantage greatest among Black and Hispanic enrollees: Study examines the extent to which growth in Medicare Advantage is being driven by increased participation of racial/ethnic minorities and other traditionally marginalized groups. Health Affairs, 40(6), 945–950.
25.
OchiengN.BiniekJ. F.FreedM.DamicoA.NeumanT. (2024). Medicare Advantage in 2023: Enrollment Update and Key Trends. Kaiser Family Foundation.
26.
ParkS.WhiteL.FishmanP.LarsonE. B.CoeN. B. (2020). Health care utilization, care satisfaction, and health status for Medicare Advantage and Traditional Medicare beneficiaries with and without Alzheimer disease and related dementias. JAMA Network Open, 3(3), Article e201809.
27.
PrusynskiR. A.D’AlonzoA.JohnsonM. P.MrozT. M.LelandN. E. (2024). Differences in home health services and outcomes between Traditional Medicare and Medicare Advantage. JAMA Health Forum, 5(3), Article e235454.
28.
SkopecL.ZuckermanS.AaronsJ.WissokerD.HuckfeldtP. J.FederJ.OliveiraI. (2020). Home health use in Medicare Advantage compared to use in Traditional Medicare: Study compares home health use in Medicare Advantage and Traditional Medicare by beneficiary cost sharing, prior authorization requirement, and plan type. Health Affairs, 39(6), 1072–1079.
29.
SmolderenK. G.HeathK.AmeliO.SpencerD.NatwickT.MusichS.MiedicoT. M.Mena-HurtadoC. (2023). In-home visits and subsequent health outcomes in Medicare Advantage beneficiaries with coronary artery disease, diabetes, hypertension, and depression. Medical Care, 61(6), 366–376.
30.
WaxmanD. A.MinL.SetodjiC. M.HansonM.WengerN. S.GanzD. A. (2016). Does Medicare Advantage enrollment affect home healthcare use. American Journal of Managed Care, 22(11), 714–720.
31.
WernerR. M.CoeN. B.QiM.KonetzkaR. T. (2019). Patient outcomes after hospital discharge to home with home health care vs to a skilled nursing facility. JAMA Internal Medicine, 179(5), 617–623.
