Retrospective cohort study of quality, cost, and timeliness of cancer treatment in Medicare Advantage and traditional Medicare

Use of Medicare Advantage (MA) insurance has been associated with lower cancer treatment costs than traditional Medicare (TM). Whether there are differences in guideline-concordant care or treatment costs for beneficiaries insured under MA versus TM is unknown. A retrospective cohort study included 35 245 patients (median age, 74 years; IQR 70-79; 63.2% male) with a new cancer diagnosis from 2016 through 2019 with either MA (31%) or TM (69%). The median time to treatment initiation was 36 (IQR 20-60) days for MA versus 35 (19-59) days for TM. The unadjusted mean treatment cost was $29 252 (SD $80 391) for MA and $ 40 874 ($106 205) for TM. MA beneficiaries had a likelihood of optimal treatment similar to TM beneficiaries (aRR 0.99; 95% CI 0.97-1.02), and MA was associated with lower treatment cost (adjusted cost ratio 0.94; 95% CI 0.91-0.97). Mean savings within this patient cohort was -$931 (95% CI -$1244 to -$615). The authors conclude that in this cohort study of Medicare beneficiaries with cancer, MA beneficiaries had lower estimated treatment costs and similar likelihood of receiving optimal treatment compared with TM beneficiaries.