Daeho Kim, David J Meyers, L. Keohane, Hiren Varma, Emma M Achola, Amal N Trivedi
{"title":"Medicare Advantage Enrollment and Outcomes of Post-Acute Nursing Home Care Among Patients with Dementia","authors":"Daeho Kim, David J Meyers, L. Keohane, Hiren Varma, Emma M Achola, Amal N Trivedi","doi":"10.1093/haschl/qxae084","DOIUrl":null,"url":null,"abstract":"\n Enrollment in Medicare Advantage (MA) has been rapidly growing. We examine whether MA enrollment affects the outcomes of post-acute nursing home care among patients with Alzheimer’s Disease and Related Dementias (ADRD). We exploit year-to-year changes in MA penetration rates within counties from 2012 through 2019. After adjusting for patient-level characteristics and county fixed effects, we find that MA enrollment was not associated with days spent at home, nursing home days, likelihood of becoming a long-stay resident, hospital days, hospital readmission, or 1-year mortality. There was a modest increase in successful discharge to community by 0.73 percentage points (relative increase of 2.4%) associated with a 10-percentage point increase in MA enrollment. The results are consistent among racial/ethnic subgroups and dual-eligible patients. These findings suggest an imperative need to monitor and improve quality of managed care among enrollees with ADRD.","PeriodicalId":502462,"journal":{"name":"Health Affairs Scholar","volume":"38 7","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Affairs Scholar","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/haschl/qxae084","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Enrollment in Medicare Advantage (MA) has been rapidly growing. We examine whether MA enrollment affects the outcomes of post-acute nursing home care among patients with Alzheimer’s Disease and Related Dementias (ADRD). We exploit year-to-year changes in MA penetration rates within counties from 2012 through 2019. After adjusting for patient-level characteristics and county fixed effects, we find that MA enrollment was not associated with days spent at home, nursing home days, likelihood of becoming a long-stay resident, hospital days, hospital readmission, or 1-year mortality. There was a modest increase in successful discharge to community by 0.73 percentage points (relative increase of 2.4%) associated with a 10-percentage point increase in MA enrollment. The results are consistent among racial/ethnic subgroups and dual-eligible patients. These findings suggest an imperative need to monitor and improve quality of managed care among enrollees with ADRD.
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