{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:04Z","timestamp":1792787764508,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute on Aging","award":["K76AG064427"],"award-info":[{"award-number":["K76AG064427"]}],"id":[{"id":"https:\/\/ror.org\/049v75w11","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Institute on Aging","award":["P30AG028741"],"award-info":[{"award-number":["P30AG028741"]}],"id":[{"id":"https:\/\/ror.org\/049v75w11","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Hospice use is higher in the growing Medicare Advantage (MA) program compared to Traditional Medicare (TM). It is uncertain if this is due to different hospice referral patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To compare hospice use patterns in MA versus TM across beneficiary characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>United States decedents in the Medicare Current Beneficiary Survey (2010\u20132022).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>We employed a counterfactual modeling approach: among those in MA, we estimated the association between hospice use and sociodemographic, health, and regional characteristics. We then applied these coefficients to the TM population to predict hospice use had they been enrolled in MA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 5153 decedents, 35.3% were in MA at death. Compared to TM decedents, MA decedents were younger, more likely to be Hispanic, less likely to reside in a facility, and less likely to report serious illnesses (dementia, cancer, stroke, heart disease, and lung disease). We estimated that if\n                      <jats:sup>TM<\/jats:sup>\n                      decedents had been enrolled in MA, hospice use would have been 6.1% higher (95% confidence interval, CI, 3.4%\u22128.8%) versus observed hospice use in TM. This difference was pronounced among those with higher education and serious illnesses in TM: for example, 10.1% higher for those with dementia (95% CI 6.9%\u221213.3%) versus without dementia (2.5% higher, 95% CI 1.2% lower\u20136.1% higher).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Relative to TM, hospice use is highest among MA beneficiaries with higher education and specific serious illnesses. Future work needs to assess the drivers of this difference (e.g., palliative care, networks).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261464669","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T09:39:14Z","timestamp":1782553154000},"page":"1549-1554","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["How Would Hospice Use Differ if Every Medicare Beneficiary Were in Medicare Advantage?"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1371-8524","authenticated-orcid":false,"given":"Claire K.","family":"Ankuda","sequence":"first","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA."},{"name":"Dartmouth Health, Lebanon, New Hampshire, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"McKendrick","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Aldridge","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA."},{"name":"James J Peters VA Medical Center, Bronx, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,27]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"1.Freed M Fuglestein Biniek J Damico A et al. Medicare advantage in 2024: Enrollment update and key trends. 2024. Medicare. August 8 2024. Available from: https:\/\/www.kff.org\/medicare\/issue-brief\/medicare-advantage-in-2024-enrollment-update-and-key-trends\/ [Last accessed: October10 2024]."},{"key":"e_1_3_3_3_1","unstructured":"2.Freed M Damico A Biniek JF et al. Medicare advantage 2024 spotlight: First Look. November 15 2023. Available from: https:\/\/www.kff.org\/medicare\/issue-brief\/medicare-advantage-2024-spotlight-first-look\/ [Last accessed: June24 2024]."},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14308"},{"key":"e_1_3_3_5_1","unstructured":"4.Skopec L Berenson RA Feder J. Why do medicare advantage plans have narrow networks? 2018. Available from: https:\/\/view.ckcest.cn\/AllFiles\/ZKBG\/Pages\/865\/why_do_medicare_advantage_plans_have_narrow_networks.pdf [Last accessed: October3 2022]."},{"issue":"12","key":"e_1_3_3_6_1","first-page":"e386","article-title":"Medicare Advantage control of postacute costs: Perspectives from stakeholders","volume":"24","author":"Gadbois EA","year":"2018","unstructured":"5.Gadbois EA, , Tyler DA, , Shield RR, et al. Medicare Advantage control of postacute costs: Perspectives from stakeholders. Am J Manag Care 2018;24(12):e386\u2013e392.","journal-title":"Am J Manag Care"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.4690"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2024.89583"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2024.0325"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.2196\/42253"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0359"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.3080"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaf036"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.20345"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.7639"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17817"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13953"},{"key":"e_1_3_3_18_1","unstructured":"17.CMS.gov. The future of the hospice benefit component of the value-based insurance design (VBID) model. Centers for Medicare & Medicaid Services. 2026. Available from: https:\/\/www.cms.gov\/priorities\/innovation\/innovation-models\/vbid\/vbid-hospice-announcement [Last accessed: January11 2026]."},{"key":"e_1_3_3_19_1","unstructured":"18.(MedPAC) MPAC. Chapter 9: Hospice Services. 2024 Report to Congress. 2024. Available from: https:\/\/www.medpac.gov\/wp-content\/uploads\/2024\/03\/Mar24_Ch9_MedPAC_Report_To_Congress_SEC-1.pdf [Last accessed: September6 2024]."},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2022.5457"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.51227"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2021.00118"},{"issue":"4","key":"e_1_3_3_23_1","first-page":"153","article-title":"A profile of the medicare current beneficiary survey","volume":"15","author":"Adler GS","year":"1994","unstructured":"22.Adler GS. A profile of the medicare current beneficiary survey. Health Care Financ Rev 1994;15(4):153\u2013163.","journal-title":"Health Care Financ Rev"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.0272"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2021.01985"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1204629"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0147"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12479"},{"key":"e_1_3_3_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.27724"},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14354"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000547"},{"key":"e_1_3_3_32_1","unstructured":"31.Ochieng N Freed M Fuglestein Biniek J et al. Medicare advantage in 2025: Enrollment update and key trends. 2025. Available from: https:\/\/www.kff.org\/medicare\/medicare-advantage-enrollment-update-and-key-trends\/ [Last accessed: January2 2026]."},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0055"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218261464669","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10966218261464669","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218261464669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T07:45:58Z","timestamp":1791791158000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10966218261464669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,27]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11,1]]}},"alternative-id":["10.1177\/10966218261464669"],"URL":"https:\/\/doi.org\/10.1177\/10966218261464669","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,27]]}}}