CHARLOTTESVILLE, VA (CVILLE RIGHT NOW) – Backed by a grant from the American Heart Association, a University of Virginia neurologist is preparing to launch a three-year study on differences in stroke care of patients covered under Medicare and Medicare Advantage.

Dr. Jonathan Crowe, funded by a $231,000 AHA Career Development Award will research the differences in care for stroke patients on traditional Medicare Parts A, B, and D and those enrolled in an Advantage plan.

“Our national stroke guidelines through the American Heart Association recommend that stroke patients who have access to an inpatient rehabilitation facility or a skilled nursing facility, that they go to the more intensive stroke rehab care at an inpatient rehabilitation facility rather than a skilled nursing facility where they get less intensive care,” Crowe told Cville Right Now. “And we’ve got outcomes that shows that their outcomes are better at the more intensive rehab facilities.”

Those patients have better functional recovery, are less likely to return to the hospital, and he said, “There even seems to be benefits for survival over time.”

Crowe believes Medicare “fee for service” patients are more likely to receive intensive rehab than Advantage patients because Medicare Advantage uses measures to control spending, including prior authorization requirements and narrower networks.

“The American Heart Association actually released a policy statement almost a year ago in July where they raised concerns that this could be happening,” Crowe said. “What we’re going to do is analyze American Heart Association and American Stroke Association data to try and understand whether there are differences in both the care and the outcomes that stroke patients get where they’re in the hospital at places like UVA and hospitals across the United States.”

Crowe and his team plan to interview stroke survivors and their families as part of the research.

“We also want to understand what are the implications for stroke patients who are on these different types of Medicare plans when they’re sent to different types of recovery care, or rehabilitation care, after a stroke hospitalization at UVA and other hospitals across the country,” he said. “So we’re going to interview stroke survivors and their families to really try to understand what are their perceptions about the what they say are the impacts that their Medicare insurance has had on their stroke recovery.”

Crowe hopes his work will ultimately answer important questions such as whether Medicare Advantage patients are receiving less stroke rehabilitation than patients on traditional Medicare. This type of information, he says, is key to informing federal policy discussions that will shape future stroke care for Medicare recipients.

“Our hope is that we can use this information to improve stroke outcomes and stroke care across the United States,” Crowe said. “We believe that this is an important opportunity for research to make a meaningful difference in the lives of patients and their families.”

Crowe plans to publish the findings after the three years in medical journals, and hopes to convey their findings to policymakers.