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Variations in Medicare Advantage Switching Rates Among African American and Hispanic Medicare Beneficiaries With Alzheimer's Disease and Related Dementias, by Sex and Dual Eligibility
Journal article   Open access   Peer reviewed

Variations in Medicare Advantage Switching Rates Among African American and Hispanic Medicare Beneficiaries With Alzheimer's Disease and Related Dementias, by Sex and Dual Eligibility

Maricruz Rivera-Hernandez, David J. Meyers, Daeho Kim, Sungchul Park and Amal N. Trivedi
The journals of gerontology. Series B, Psychological sciences and social sciences
08 Sep 2022
PMID: 36075080
url
https://doi.org/10.1093/geronb/gbac132View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Geriatrics & Gerontology Gerontology Life Sciences & Biomedicine Psychology Psychology, Multidisciplinary Science & Technology Social Sciences
Objectives The objective of this study was to identify rates of switching to Medicare Advantage (MA) among fee-for-service (FFS) Medicare beneficiaries with Alzheimer's disease and related dementias (ADRD) by race/ethnicity and whether these rates vary by sex and dual-eligibility status for Medicare and Medicaid. Methods Data came from the Medicare Master Beneficiary Summary File from 2017 to 2018. The outcome of interest for this study was switching from FFS to MA during any month in 2018. The primary independent variable was race/ethnicity including non-Hispanic White, non-Hispanic African American, and Hispanic beneficiaries. Two interaction terms among race/ethnicity and dual eligibility, and race/ethnicity and sex were included. The model adjusted for age, year of ADRD diagnosis, the number of chronic/disabling conditions, total health care costs, and ZIP code fixed effects. Results The study included 2,284,175 FFS Medicare beneficiaries with an ADRD diagnosis in 2017. Among dual-eligible beneficiaries, adjusted rates of switching were higher among African American (1.91 percentage points [p.p.], 95% confidence interval [CI]: 1.68-2.15) and Hispanic beneficiaries (1.36 p.p., 95% CI: 1.07-1.64) compared to non-Hispanic White beneficiaries. Among males, adjusted rates were higher among African American (3.28 p.p., 95% CI: 2.97-3.59) and Hispanic beneficiaries (2.14 p.p., 95% CI: 1.86-2.41) compared to non-Hispanic White beneficiaries. Discussion Among persons with ADRD, African American and Hispanic beneficiaries are more likely than White beneficiaries to switch from FFS to MA. This finding underscores the need to monitor the quality and equity of access and care for these populations.

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4 citations in Scopus

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Geriatrics & Gerontology
Gerontology
Psychology
Psychology, Multidisciplinary
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