We sought to quantify differences in total and out-of-pocket health care costs associated with treat-and-release emergency department (ED) visits among older adults with traditional Medicare and Medicare Advantage. We conducted a repeated cross-sectional analysis of treat-and-release ED visits using 2015 to 2020 data from the Medicare Current Beneficiary Survey. We measured total and out-of-pocket health care spending during 3 time periods: the 30 days prior to the ED visit, the treat-and-release ED visit itself, and the 30 days after the ED visit. Stratified by traditional Medicare or Medicare Advantage status, we determined median total costs and the proportion of costs that were out-of-pocket. Among the 5,011 ED visits by those enrolled in traditional Medicare, the weighted median total (and % out-of-pocket) costs were $881.95 (13.3%) for the 30 days prior to the ED visit, $419.70 (10.1%) for the ED visit, and $809.00 (13.8%) for the 30 days after the ED visit. For the 2,595 ED visits by those enrolled in Medicare Advantage, the weighted median total (and % out-of-pocket) costs were $484.92 (24.0%) for the 30 days prior to the ED visit, $216.66 (21.9%) for the ED visit, and $439.13 (22.4%) for the 30 days after the ED visit. Older adults insured by Medicare Advantage incur lower total health care costs and face similar overall out-of-pocket expenses in the time period surrounding emergency care. However, a higher proportion of expenses are out-of-pocket compared with those insured by traditional Medicare, providing evidence of greater cost sharing for Medicare Advantage plan enrollees.

中文翻译：

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参加传统医疗保险和医疗保险优势的老年人中与急诊科护理相关的总费用和自付费用


我们试图量化具有传统 Medicare 和 Medicare Advantage 的老年人与治疗和出院急诊室 (ED) 就诊相关的总医疗保健费用和自付费用的差异。我们使用 2015 年至 2020 年医疗保险当前受益人调查的数据，对治疗和出院急诊就诊进行了重复的横断面分析。我们测量了 3 个时间段内的总医疗保健支出和自付费用：急诊就诊前 30 天、急诊就诊后治疗和出院以及急诊就诊后 30 天。根据传统 Medicare 或 Medicare Advantage 状态进行分层，我们确定了总费用中位数以及自付费用的比例。在参加传统 Medicare 的 5,011 次急诊就诊中，急诊就诊前 30 天的加权中位总费用（和自付费用百分比）为 881.95 美元 (13.3%)，急诊就诊的加权中位数为 419.70 美元 (10.1%)急诊就诊后 30 天的费用为 809.00 美元 (13.8%)。对于参加 Medicare Advantage 的患者进行的 2,595 次急诊就诊，急诊就诊前 30 天的加权中位总费用（和自付费用百分比）为 484.92 美元 (24.0%)，急诊就诊为 216.66 美元 (21.9%)急诊就诊后 30 天的费用为 439.13 美元 (22.4%)。参加 Medicare Advantage 的老年人的总医疗保健费用较低，并且在紧急护理期间面临类似的总体自付费用。然而，与传统 Medicare 承保的费用相比，自付费用的比例更高，这证明 Medicare Advantage 计划的参与者可以分摊更多的费用。