Medicare Advantage: Fewer Home Health Visits – MedPAC Report
Medicare Advantage enrollees are receiving fewer home health visits compared to those in traditional Medicare, a significant finding revealed in the latest MedPAC report. The report highlights the role of home health care, indicating that MA enrollees experience approximately 11% fewer visits. the study also showed that while hospitalization increases the likelihood of home health use in MA plans, different plan structures impact utilization. Skilled nursing and physical therapy remain the most common services. Read this in-depth report from News Directory 3, which also provides expert insights into what’s happening with home health care payments. Discover what’s next …
MedPAC Report Highlights Home Health Care Role in Medicare Advantage
Updated June 14, 2025
Medicare Advantage (MA) enrollees receive fewer home health visits compared to those in customary Medicare, according to a June report from the Medicare Payment Advisory Commission (medpac) to Congress. The report examined the role of home health care and found that MA enrollees experience approximately 11% fewer visits.
The MedPAC report indicated that differences in home health utilization between MA and fee-for-service beneficiaries were “relatively modest.” However, factors such as prior-year hospitalization and the type of MA plan significantly influenced utilization rates.
The study found that 8.3% of MA enrollees used home health services, compared to 8.6% of fee-for-service beneficiaries.However, among patients who had been hospitalized, MA enrollees showed a 3.2% higher probability of using home health care. This suggests that home health care may serve as a substitute for more expensive post-acute care options like skilled nursing facilities (SNF) within MA plans.
The type of MA plan also impacts home health care utilization. Plans with cost-sharing features saw lower rates of home health use and fewer visits overall. Enrollees in preferred provider association plans tended to have a higher number of visits, but were just as likely to use home health care as those in HMO plans.
Skilled nursing and physical therapy emerged as the most frequently used home health services in both traditional medicare and MA programs. Among MA enrollees, those receiving home health for wound care averaged 25.1 visits, while patients needing medication management and surgical aftercare received approximately 14.5 visits.
“We emphasize that it is indeed not possible to draw conclusions on the appropriateness of care based solely on observing differences in use (and most of the differences we observed are relatively modest),” the report stated.
The report also noted that the availability of other post-acute care providers, MA plan types, provider networks, supplemental benefits, and prior hospitalization all influence home health care utilization.
What’s next
This report arrives after medpac’s March recommendation to Congress for a 7% reduction in Medicare fee-for-service home health payments, echoing a similar recommendation from 2024. MedPAC argues that current payments exceed costs,undermining the value of efficient and appropriate home health care.