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February 26, 2026JAMA Network OpenOpen Access

Association of Dual Eligibility and Medicare Type With Quality of Postacute Care After Stroke

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Authors

AKAmol KarmarkarLCLin-Na ChouTJTarang Jain

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Overview

A retrospective cohort study investigates postacute care quality for dual-eligible beneficiaries after stroke, suggesting disparities exist depending on Medicare enrollment type.

Key Points

  • To evaluate differences in postacute care quality after stroke among dual-eligible beneficiaries in Medicare Advantage versus fee-for-service plans.
  • Analyzed a 20% random sample of Medicare data
  • Included beneficiaries aged 65 and older hospitalized for ischemic stroke
  • Categorized care types as inpatient rehabilitation facilities, skilled nursing facilities, and home health care
  • Utilized the CMS 5-star rating system for quality assessment
  • 39.4% were discharged to inpatient rehabilitation facilities, 36.9% to skilled nursing facilities, and 23.8% to home health care.
  • Dual-eligible beneficiaries in both FFS and MA plans showed lower odds of being discharged to high-quality SNFs and HH agencies compared to non–dual-eligible FFS beneficiaries.
  • No significant differences in the quality of IRFs used across groups.

Cite This Study

Karmarkar et al. (2026) studied this question.

synapsesocial.com/papers/699fe33695ddcd3a253e6ec5https://doi.org/10.1001/jamanetworkopen.2026.0095
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Abstract DP338: Medicare Advantage seems to promote less intensive post-acute care utilization after stroke than Traditional Medicare2026
  2. 2Outcomes after ischemic stroke for dual-eligible Medicare-Medicaid beneficiaries in the United States2023 · 7 citations
  3. 3The importance and challenge of comparing stroke care, utilization and outcomes in Medicare Advantage and Fee-for-Service Medicare: a narrative review and vision for the future2026 · 1 citations
  4. 4Abstract A122: Payer-Based Disparities in Post-Acute Stroke Care: An Analysis of Discharge Patterns for Medicare Advantage vs. Traditional Medicare Beneficiaries2026
  5. 5Association of Dual Eligibility for Medicare and Medicaid With Heart Failure Quality and Outcomes Among Get With The Guidelines–Heart Failure Hospitals2021 · 27 citations