Quality and utilization of surgical care among Medicare Advantage beneficiaries

Background: Over half of Medicare beneficiaries are now enrolled in Medicare Advantage, but there is little understanding of how Medicare Advantage impacts care for common surgical conditions. Methods: This is a retrospective cross-sectional study of Medicare beneficiaries who underwent appendectomy, cholecystectomy, colectomy, or hernia repair from 2016 to 2020. Inverse Propensity Score-Weighted analysis was used to compare risk-adjusted rates of postoperative morbidity, mortality, and utilization. Results: Of the 1,617,490 Medicare beneficiaries who underwent one of the operations, 574,412 (36 %) were enrolled in Medicare Advantage. Medicare Advantage enrollees demonstrated similar complications (29.6 % vs 29.2 %, aOR 1.02 [95 % CI, 1.01-1.03]) and 30-day mortality (5.9% vs 6.1 %, aOR 0.96 [95 % CI, 0.94-0.98]), but were more likely to be discharged home (77.8 % vs 74.1 %, aOR 1.31 [95 % CI, 1.28-1.33]) and had fewer readmissions (12.8 % vs 15.2 %, OR 0.82 [95 % CI, 0.81-0.83]). Conclusions: Medicare Advantage may reduce post-acute care use and readmissions for common surgical procedures without compromising postoperative outcomes.