• Cameron J Gettel, Wafa Salah, Craig Rothenberg, Yixuan Liang, Hope Schwartz, Kirstin W Scott, Ula Hwang, Susan N Hastings, and Arjun K Venkatesh.
• Department of Emergency Medicine, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT. Electronic address: cameron.gettel@yale.edu.
• Ann Emerg Med. 2024 Sep 1; 84 (3): 285294285-294.

Study ObjectiveWe sought to quantify differences in total and out-of-pocket health care costs associated with treat-and-release emergency department (ED) visits among older adults with traditional Medicare and Medicare Advantage.MethodsWe conducted a repeated cross-sectional analysis of treat-and-release ED visits using 2015 to 2020 data from the Medicare Current Beneficiary Survey. We measured total and out-of-pocket health care spending during 3 time periods: the 30 days prior to the ED visit, the treat-and-release ED visit itself, and the 30 days after the ED visit. Stratified by traditional Medicare or Medicare Advantage status, we determined median total costs and the proportion of costs that were out-of-pocket.ResultsAmong the 5,011 ED visits by those enrolled in traditional Medicare, the weighted median total (and % out-of-pocket) costs were $881.95 (13.3%) for the 30 days prior to the ED visit, $419.70 (10.1%) for the ED visit, and $809.00 (13.8%) for the 30 days after the ED visit. For the 2,595 ED visits by those enrolled in Medicare Advantage, the weighted median total (and % out-of-pocket) costs were $484.92 (24.0%) for the 30 days prior to the ED visit, $216.66 (21.9%) for the ED visit, and $439.13 (22.4%) for the 30 days after the ED visit.ConclusionOlder adults insured by Medicare Advantage incur lower total health care costs and face similar overall out-of-pocket expenses in the time period surrounding emergency care. However, a higher proportion of expenses are out-of-pocket compared with those insured by traditional Medicare, providing evidence of greater cost sharing for Medicare Advantage plan enrollees.Copyright © 2024 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

22 keywords...

hide…