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How Would Hospice Use Differ if Every Medicare Beneficiary Were in Medicare Advantage?
Claire K. Ankuda, Karen McKendrick, Melissa Aldridge. Journal of Palliative Medicine, 2026-06-27
Topic: Risk, prevention and care in population studies
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 TM decedents had been enrolled in MA, hospice use would have been 6.1% higher (95% confidence interval, CI, 3.4%−8.8%) 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%−13.3%) versus without dementia (2.5% higher, 95% CI 1.2% lower–6.1% higher). 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).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Ankuda, C. K., McKendrick, K., & Aldridge, M. (2026). How Would Hospice Use Differ if Every Medicare Beneficiary Were in Medicare Advantage? Journal of Palliative Medicine. https://doi.org/10.1177/10966218261464669
Vancouver
Ankuda CK, McKendrick K, Aldridge M. How Would Hospice Use Differ if Every Medicare Beneficiary Were in Medicare Advantage? Journal of Palliative Medicine. 2026. doi:10.1177/10966218261464669. PMID: 42363745.
BibTeX
@article{ankuda2026-42363745,
author = {Ankuda, Claire K. and McKendrick, Karen and Aldridge, Melissa},
title = {{How Would Hospice Use Differ if Every Medicare Beneficiary Were in Medicare Advantage?}},
journal = {Journal of Palliative Medicine},
year = {2026},
doi = {10.1177/10966218261464669},
pmid = {42363745},
url = {https://doi.org/10.1177/10966218261464669}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- 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 TM decedents had been enrolled in MA, hospice use would have been 6.1% higher (95% confidence interval, CI, 3.4%−8.8%) 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%−13.3%) versus without dementia (2.5% higher, 95% CI 1.2% lower–6.1% higher).
- Relative to TM, hospice use is highest among MA beneficiaries with higher education and specific serious illnesses.
Why it matters
This study estimated how hospice use would differ if all Medicare beneficiaries were in Medicare Advantage. It found hospice use would be higher, especially among those with dementia, which concerns end-of-life care patterns rather than treating, curing or preventing Alzheimer's disease.
Study details
- Study designcohort study
- Effect size35.3%; 6.1%; 3.4%
- Evidence strengthModerate
How this study scored 41/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 39 of the 96 points we could judge it on, which is 41 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Palliative Medicine) |
| Journal's citation record | 1 / 4 | Journal of Palliative Medicine: journal h-index 134 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Melissa Aldridge holds only 7 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 1 / 3 | Icahn School of Medicine at Mount Sinai: institution h-index 1,331 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42363745) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 39 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 39 of the 96 points we could judge it on is 41 out of 100. |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
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