{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:59:17Z","timestamp":1787702357125,"version":"build-2784847793"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241031-4\"><jats:title>Importance<\/jats:title><jats:p>Medicare Advantage (MA) has grown significantly over the last decade; however, MA\u2019s performance for patients with serious conditions, such as cancer, remains unclear.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241031-5\"><jats:title>Objective<\/jats:title><jats:p>To compare resource use and care quality between MA and traditional Medicare (TM) beneficiaries undergoing cancer chemotherapy.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241031-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study used TM claims and MA encounter records from January 2015 to December 2019. Participants were MA and TM beneficiaries who initiated cancer chemotherapy between January 2016 and July 2019. Inverse probability of treatment weighting balanced characteristics between MA and TM beneficiaries, and regression estimation was used. The analysis was conducted between August 2023 and May 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241031-7\"><jats:title>Exposure<\/jats:title><jats:p>Chemotherapy initiation after a 1-year washout period.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241031-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Resource use and care quality were measured during a 6-month period following chemotherapy initiation. Resource use was measured using standardized prices for services in both MA and TM, covering hospital inpatient services, outpatient care, Part D drugs, and hospice services. Chemotherapy utilization was examined for Part B chemotherapy, Part B supportive drugs, and Part D chemotherapy. Quality measures included chemotherapy-related emergency department (ED) visits and hospitalizations, avoidable ED visits, preventable hospitalizations during the 6-month episode, and survival days up to 18 months from chemotherapy initiation.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241031-9\"><jats:title>Results<\/jats:title><jats:p>The study comprised 122\u202f966 MA enrollees contributing to 125\u202f518 episodes (mean [SD] age, 73.2 [7.6] years; 68\u202f479 [54.6%] female; 8900 [7.1%] Hispanic, 18\u202f423 [14.7%] non-Hispanic Black, and 94\u202f817 [75.5%] non-Hispanic White participants) and 274\u202f666 TM beneficiaries, contributing 282\u202f200 episodes (mean [SD] age, 73.1 [8.4] years; 155\u202f709 [55.2%] female; 10\u202f666 [3.8%] Hispanic, 22\u202f088 [7.8%] non-Hispanic Black, and 241\u202f113 [85.4%] non-Hispanic White participants). Adjusted total resource use per enrollee during the 6-month episode was $8498 (95% CI, $8178 to $8817) lower in MA than TM ($61\u202f004 vs $69\u202f502). Part B chemotherapy resource use accounted for most of the difference in total resource use, with MA enrollees having $4765 (95% CI, $4547 to $4982) lower use than TM beneficiaries. Lower resource use for Part B chemotherapy in MA was associated with 1.03 fewer chemotherapy visits (95% CI, 0.99 to 1.06 visits) and $277 (95% CI, $183 to $272) less expensive chemotherapy per visit. Findings on quality were mixed, but importantly, survival did not differ between MA and TM patients who initiated chemotherapy.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241031-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study of Medicare beneficiaries with cancer undergoing chemotherapy, MA enrollment was associated with lower resource use but not shorter survival.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.34707","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T15:31:25Z","timestamp":1726846285000},"page":"e2434707","source":"Crossref","is-referenced-by-count":15,"title":["Resource Use and Care Quality Differences Among Medicare Beneficiaries Undergoing Chemotherapy"],"prefix":"10.1001","volume":"7","author":[{"given":"Yamini","family":"Kalidindi","sequence":"first","affiliation":[{"name":"McDermott+ Consulting, Washington, 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Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,9,20]]},"reference":[{"issue":"2","key":"zoi241031r3","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1257\/app.20170295","article-title":"Health care spending and utilization in public and private Medicare.","volume":"11","author":"Curto","year":"2019","journal-title":"Am Econ J Appl Econ"},{"issue":"12","key":"zoi241031r4","doi-asserted-by":"publisher","first-page":"2609","DOI":"10.1377\/hlthaff.2012.0179","article-title":"Analysis Of Medicare Advantage HMOs compared with traditional Medicare shows lower use of many services during 2003-09.","volume":"31","author":"Landon","year":"2012","journal-title":"Health Aff 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