Journal article
Effect of Medicare Advantage on health care use and care dissatisfaction in mental illness
Health services research, v 57(4), pp 820-829
17 Feb 2022
PMID: 35124801
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective To examine the effects of Medicare Advantage (MA) enrollment on health care use and dissatisfaction with care received among Medicare beneficiaries with mental illness. Data Sources I identified traditional Medicare (TM) and MA beneficiaries with mental illness using the Medicare Current Beneficiary Survey for 2012-2016. Study Design I included two types of outcomes: four measures of health care use and 10 measures of care dissatisfaction. My primary independent variable was enrollment in TM versus MA. To address selective enrollment into MA, I used an instrumental variable (IV) approach. Following prior research, I decomposed the MA benchmark into exogenous and endogenous components and then used the exogenous component as my instrument. Data Collection/Extraction Methods Not Applicable. Principal Findings IV analyses showed that compared with TM enrollment, MA enrollment significantly decreased outpatient hospital visits and medical provider visits by 6.73 (95% CI: -12.10 to -1.36) and 36.48 (95% CI: -52.67 to -20.28). However, there were no significant changes in inpatient hospital admissions and prescription drug purchases. Compared with TM enrollment, MA enrollment significantly increased dissatisfaction with out-of-pocket expenses by 25.51 percentage points (95% CI: 0.43 to 50.60). However, there were no significant changes in other measures of care dissatisfaction in terms of access to care, quality of care, and prescription medication. Conclusions These findings suggest that MA enrollment may lead to low health care use among those with mental illness, indicating efficient care delivery. Also, MA enrollment may not preclude those with mental illness from accessing needed care. However, high dissatisfaction with out-of-pocket expenses among MA beneficiaries may imply the use of out-of-network providers. Further research is warranted to investigate whether high dissatisfaction with out-of-pocket expenses may be attributable to MA's narrow networks for mental services.
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Details
- Title
- Effect of Medicare Advantage on health care use and care dissatisfaction in mental illness
- Creators
- Sungchul Park - Drexel University
- Publication Details
- Health services research, v 57(4), pp 820-829
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- R01 AG049815 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:000756490900001
- Scopus ID
- 2-s2.0-85124836730
- Other Identifier
- 991019167584804721
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- Web of Science research areas
- Health Care Sciences & Services
- Health Policy & Services