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

Autor:	Kim D; Department of Health Services, Policy and Practice, Brown University, Providence, RI 02903, United States., Meyers DJ; Department of Health Services, Policy and Practice, Brown University, Providence, RI 02903, United States., Keohane LM; Department of Health Policy, Vanderbilt University, Nashville, TN 37203, United States., Varma H; Department of Health Services, Policy and Practice, Brown University, Providence, RI 02903, United States., Achola EM; Department of Health Policy, Vanderbilt University, Nashville, TN 37203, United States., Trivedi AN; Department of Health Services, Policy and Practice, Brown University, Providence, RI 02903, United States.; Providence VA Medical Center, Providence, RI 02908, United States.
Jazyk:	angličtina
Zdroj:	Health affairs scholar [Health Aff Sch] 2024 Jun 13; Vol. 2 (6), pp. qxae084. Date of Electronic Publication: 2024 Jun 13 (Print Publication: 2024).
DOI:	10.1093/haschl/qxae084
Abstrakt:	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. Competing Interests: Conflicts of interest Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials. (© The Author(s) 2024. Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc.)
Databáze:	MEDLINE
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