Medicare Advantage enrollment and outcomes of post-acute nursing home care among patients with dementia

被引：0

作者：

Kim, Daeho ^{[1
]}

Meyers, David J. ^{[1
]}

Keohane, Laura M. ^{[2
]}

Varma, Hiren ^{[1
]}

Achola, Emma M. ^{[2
]}

Trivedi, Amal N. ^{[1
,3
]}

机构：

[1] Brown Univ, Dept Hlth Serv Policy & Practice, Providence, RI 02903 USA

[2] Vanderbilt Univ, Dept Hlth Policy, Nashville, TN 37203 USA

[3] Providence VA Med Ctr, Providence, RI 02908 USA

来源：

HEALTH AFFAIRS SCHOLAR | 2024年 / 2卷 / 06期

关键词：

Medicare Advantage; post-acute care; dementia; FAVORABLE SELECTION; ENROLLEES; NETWORKS; ILLNESS; BURDEN; RISK;

D O I：

10.1093/haschl/qxae084

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Enrollment in Medicare Advantage (MA) has been rapidly growing. We examined whether MA enrollment affects the outcomes of post-acute nursing home care among patients with Alzheimer's disease and related dementias (ADRD). We exploited 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 found 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 the 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.

引用

页数：6