(P20-096-24) Comparing Malnutrition Risk and Burden among Medicare Fee-for-Service (FFS) Versus Medicare Advantage (MA) Patients in US Hospitals

Objectives: Malnutrition can be a very costly disease that is highly treatable but leads to poor health outcomes if left untreated. The diagnosis rates of hospital malnutrition in the United States (6-9%), while improving over recent years, remain well-below expected rates (30-50%) per published literature. We assessed the incidence rate and burden of malnutrition among older adults (65 years and older) compared by their insurance status: Medicare Fee-for-Service (FFS) versus Medicare Advantage (MA).

Methods: MEDPAR data from 70,855,014 patients receiving care in US hospitals between 2017-2021 were included in the analysis. Sociodemographic and clinical outcomes were compared between 45,889,069 FFS patients vs. 24,965,945 MA patients.

Results: In general, FFS and MA patients were primarily female (52.9% vs. 53.3%, respectively), white (80.4% vs. 75.1%, respectively) and with a mean age of 72.6 years (both groups). Malnutrition diagnosis was reported in 8.6% of FFS patients and 8.1% of MA patients. Mean length of hospital stay for malnourished FFS patients was 9.3 (± 0.1) days, which equated to a mean total spending of $105,925 (± $11,285). Mean length of hospital stay for malnourished MA patients was 9.7 (± 0.45) days, which equated to a mean total spending of $110,389 (± $12,415); thus, demonstrating very slight but not-statistically significant differences between groups on both length of stay and total spending (p >0.05).

Conclusions: These findings demonstrate that malnutrition diagnoses remain largely unidentified, with malnutrition posing significant clinical and economic burden to both FFS and MA patients. Malnourished FFS and MA patient groups are comparable regarding sociodemographic characteristics and are equally likely to suffer from prolonged and costly hospitalizations. Similar attention should be spent on addressing and reducing malnutrition risk among both patient populations regardless of insurance status. Cost-effective nutrition interventions that focus on screening, assessment, diagnosis, and treatment plans can help alleviate malnutrition burden in US hospitals, thus improving patient outcomes and reducing healthcare costs.

Funding Sources: This study was supported by Abbott.