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Advance Care Planning: Disparities Between MA and FFS Enrolled Medicare Beneficiaries

November 3, 2022ate Smith, PhD; Tatiana Fofanova, PhD; Desh Mohan, MDCareJourneyMedicare ACOs/MSSP,Care Transitions & PlanningCareJourney

CareJourney and Koda Health today announced new findings on the adoption rate of Advance Care Planning (ACP)1, using Medicare claims and enrollment data from 2015 to 2019.2 Overall, adoption rates of ACP are sluggish, with significant disparities across race and dual-status between Medicare Advantage (MA) and Fee-for-Service (FFS) beneficiaries. However, Accountable Care Organizations (ACOs) are administering ACP at higher rates among FFS beneficiaries, and at higher rates compared to MA beneficiaries.

Similar to prior studies, the analysis found that fewer than 7.2% of Medicare beneficiaries engaged in ACP overall as of 2019. However, minority populations, including Black/African-American (8.3% vs 7.1%), Hispanic (6.7% vs 6.1%), and Asian/Pacific-Islander beneficiaries (9.9% vs 8.1%) had higher levels of engagement when enrolled in MA rather than FFS. “Recent studies have shown that many physicians avoid these conversations with folks that don’t look like them,” says Dr. Tatiana Fofanova, CEO of Koda Health, “so it’s encouraging to see the MA approach slowly closing this disparity.”

Advance Care Planning is the process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care.

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