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Published, Version of Record (VoR)CC BY-NC-ND V4.0, Open
Journal article
Health Care Utilization, Care Satisfaction, and Health Status for Medicare Advantage and Traditional Medicare Beneficiaries With and Without Alzheimer Disease and Related Dementias
JAMA network open, v 3(3), pp e201809-e201809
02 Mar 2020
PMID: 32227181
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Compared with traditional Medicare (TM) fee-for-service plans, Medicare Advantage (MA) plans may provide more-efficient care for beneficiaries with Alzheimer disease and related dementias (ADRD) without compromising care quality.
To determine differences in health care utilization, care satisfaction, and health status for MA and TM beneficiaries with and without ADRD.
A cohort study was conducted of MA and TM beneficiaries with and without ADRD from all publicly available years of the Medicare Current Beneficiary Survey between 2010 and 2016. To address advantageous selection into MA plans, county-level MA enrollment rate was used as an instrument. Data were analyzed between July 2019 and December 2019.
Enrollment in MA.
Self-reported health care utilization, care satisfaction, and health status.
The sample included 47 100 Medicare beneficiaries (25 900 women [54.9%]; mean [SD] age, 72.2 [11.4] years). Compared with TM beneficiaries with ADRD, MA beneficiaries with ADRD had lower utilization across the board, including a mean of -22.3 medical practitioner visits (95% CI, -24.9 to -19.8 medical practitioner visits), -2.3 outpatient hospital visits (95% CI, -3.6 to -1.1 outpatient hospital visits), -0.2 inpatient hospital admissions (95% CI, -0.3 to -0.1 inpatient hospital admissions), and -0.1 long-term care facility stays (95% CI, -0.2 to -0.1 long-term care facility stays). A similar trend was observed among beneficiaries without ADRD, but the difference was greater between MA and TM beneficiaries with ADRD than between MA and TM beneficiaries without ADRD (mean, -15.0 medical practitioner visits [95% CI, -18.7 to -11.3 medical practitioner visits], -1.7 outpatient hospital visits [95% CI, -3.0 to -0.3 outpatient hospital visits], and -0.1 inpatient hospital admissions [95% CI, -1.0 to 0.0 inpatient hospital admissions]). Overall, no or negligible differences were detected in care satisfaction and health status between MA and TM beneficiaries with and without ADRD.
Compared with TM beneficiaries, MA beneficiaries had lower health care utilization without compromising care satisfaction and health status. This difference was more pronounced among beneficiaries with ADRD. These findings suggest that MA plans may be delivering health care more efficiently than TM, especially for beneficiaries with ADRD.
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Details
- Title
- Health Care Utilization, Care Satisfaction, and Health Status for Medicare Advantage and Traditional Medicare Beneficiaries With and Without Alzheimer Disease and Related Dementias
- Creators
- Sungchul Park - Drexel UniversityLindsay White - RTI InternationalPaul Fishman - Department of Health ServicesEric B Larson - Kaiser Permanente Washington Health Research InstituteNorma B Coe - University of Pennsylvania
- Publication Details
- JAMA network open, v 3(3), pp e201809-e201809
- Publisher
- American Medical Association
- Grant note
- P30 AG012836 / NIA NIH HHS R01 AG049815 / NIA NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:000523670800004
- Scopus ID
- 2-s2.0-85082581435
- Other Identifier
- 991019167815404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Medicine, General & Internal