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Chronic disease prevalence and Medicare Advantage market penetration: Findings from the Medical Expenditure Panel Survey
Methods: Data from the 2004-2008 Medical Expenditure Panel Survey (MEPS) Household Component were merged with MA market penetration data from CMS. Drawn from CMS data, the explanatory variable of interest was county-level MA market penetration. The dependent variable in the study, Chronic Disease Severity Index (CDSI), is an aggregate index that considers multiple diagnoses in one outcome measure. It is designed for use with survey or claims-based data, when more direct clinical measures of disease burden are not available. Using respondents’ diagnosis variables in MEPS, the CDSI was constructed to represent beneficiaries' and counties’ overall chronic disease states.
Results: The results indicate strong associations between higher MA market penetration and lower cardiometabolic chronic disease burdens. A one-percentage-point increase in MA market penetration was associated with a 2.43-point decline in CDSI at the end of each MEPS panel (p=0.0017).
Conclusions: Results from this analysis suggest that people living in counties with high MA market penetration rates are less likely to be affected by cardiometabolic chronic diseases than those living in areas of low MA market penetration. Future research will expand our analysis to test different measures of chronic disease severity and to include different MA plan types.
Learning Areas:
Advocacy for health and health educationChronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Public health or related public policy
Learning Objectives:
Explain the differences in chronic disease burdens between areas of high and low Medicare Advantage market penetration.
Keyword(s): Medicare, Chronic Disease Management and Care
Qualified on the content I am responsible for because: Steven Howard's work focuses on the research, development and evaluation of health reform initiatives and novel care delivery models. At the state level, this has included analysis of the development of the Coordinated Care Organization health reform model being implemented by the state of Oregon. His current federal-level research program involves study of the relationships between the market penetration of the Medicare Advantage program and changes in the chronic disease burden at a population level.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.