Comparing Utilization of Home Health Care Between Traditional Medicare and Medicare Advantage by Rural-Urban Status
Link
Date
09/2025
Description
This report describes differences in utilization of home health care between beneficiaries enrolled in Traditional Medicare (TM) and Medicare Advantage (MA), a publicly-funded, privately-managed option for Medicare beneficiaries, and by rural-urban status. Researchers examined differences in use of home health overall, provision of specific services during home health, and receipt of care from high-quality home health agencies by enrollment in TM and MA, including plan type (e.g., preferred provider organization, health maintenance organization), and by rural-urban status, including intra-rural variation.
Key Findings:
- Beneficiaries enrolled in MA who are also living in rural communities may be underutilizing home health. Compared to beneficiaries enrolled in TM, utilization of home health was significantly lower among beneficiaries enrolled in MA, regardless of type of MA plan. Utilization of home health was also significantly lower among beneficiaries living in rural versus urban communities, with progressively decreasing likelihood of home health utilization as rurality increased.
- Beneficiaries enrolled in MA were also significantly less likely to receive care from a high-quality home health agency compared to beneficiaries enrolled in TM, regardless of MA plan type, but there was no association between receiving care from a high-quality home health agency and rural-urban status.
- Utilization of specific services during home health varied based on enrollment in MA versus TM and rural-urban status. In general, utilization of specific services was significantly lower for beneficiaries enrolled in MA compared to TM, but this pattern was not consistent for all services across all types of MA plans. Beneficiaries living in rural communities generally had significantly lower utilization of physical therapy, occupational therapy, speech-language pathology, and medical social work services, but significantly higher utilization of home health aide services.
Center
WWAMI Rural Health Research Center
Authors
Tracy Mroz, Lisa Garberson, Holly Andrilla, Davis Patterson