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Financial Hardship Among Traditional Medicare and Medicare Advantage Enrollees With and Without Food Insecurity
Journal article   Open access   Peer reviewed

Financial Hardship Among Traditional Medicare and Medicare Advantage Enrollees With and Without Food Insecurity

Sungchul Park and Seth A Berkowitz
Journal of general internal medicine : JGIM
16 May 2024
DOI: https://doi.org/10.1007/s11606-024-08798-4
PMID: 38755470
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1007/s11606-024-08798-4View
Published, Version of Record (VoR) Open

Abstract

medicare Advantage traditional Medicare food insecurity financial hardship
Compared to traditional Medicare (TM), Medicare Advantage (MA) plans impose out-of-pocket cost limits and offer extra benefits, potentially providing financial relief for MA enrollees, especially for those with food insecurity. To examine whether the prevalence of food insecurity differs between TM and MA enrollees at baseline and then examine whether MA enrollment in a baseline year is associated with less financial hardships in the following year, relative to TM enrollment, especially for those experiencing food insecurity. We conducted a retrospective longitudinal cohort study. Our analysis included 2807 Medicare beneficiaries (weighted sample size, 23,963,947) who maintained continuous enrollment in either TM or MA in both 2020 and 2021 from the Medical Expenditure Panel Survey. We assessed outcomes related to financial hardships in health care and non-health care domains (measured in 2021). Our primary independent variables were food insecurity and MA enrollment (measured in 2020). The point estimate of food insecurity prevalence was greater among MA enrollees than TM enrollees, but the difference was not statistically significant (1.1 percentage points [95% CI, - 1.0, 3.4]). Furthermore, there is evidence that compared to TM enrollment, MA enrollment did not mitigate the risk of financial hardship, particularly for food-insecure enrollees. Rather, food-secure MA enrollees faced greater financial hardship in the following year than food-secure TM enrollees (11.2% [8.9-13.6] and 7.6% [6.9-8.3] for problems paying medical bills and 5.5% [4.6-6.4] and 2.8% [2.1-3.6] for paying medical bills over time). Moreover, the point estimate of financial hardship was higher among food-insecure MA enrollees than food-insecure TM enrollees (21.5% [5.4-37.5] and 11.2% [4.1-18.4] and 23.7% [9.6-37.9] and 6.9% [0.5-13.3]) despite the lack of statistical significance. These findings suggest that the promise of financial protection offered by MA plans has not been fully realized, particularly for those with food insecurity.

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4 citations in Web of Science
4 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Domestic collaboration
International collaboration
Web of Science research areas
Health Care Sciences & Services
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