A large cross-sectional study of Medicare Advantage (MA) plan beneficiaries found that more than one fifth of participants are homebound or semi-homebound, which is a powerful independent predictor of hospitalization and healthcare utilization. As MA becomes the majority payer source for Medicare beneficiaries, attention to providing appropriate care delivery to this high-need, high-cost population is warranted, according to the authors.

Researchers surveyed more than 514,000 Humana MA beneficiaries to determine the prevalence, characteristics, predictors, health service use, and mortality outcomes of homebound beneficiaries. The data showed that the overall prevalence of homebound status was 22%.

Compared to those who were not homebound, participants who were homebound or semi-homebound were more likely to be older than 85, female, and low-income, and factors associated with homebound status included dementia and moderate-severe frailty. Homebound status was associated with increased odds of emergency department visits, inpatient hospital admissions, skilled nursing facility admissions and mortality. In fact, homebound status was a more powerful predictor of hospitalization than any sociodemographic variable or measure of morbidity burden except level of frailty.

Similarly, homebound status was the strongest predictor of skilled-nursing facility admission other than frailty and having an abnormal gait. According to the study authors, these findings can be used to inform strategic initiatives to identify and manage care for homebound beneficiaries.

To read the abstract of the study,  published in Annals of Internal Medicine, click here