Differences in spending for diabetes and multiple chronic conditions in Michigan Medicare beneficiaries

2020 ◽  
Vol 26 (11) ◽  
pp. e362-e368
Keyword(s):  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Medicare Beneficiaries

scholarly journals A cluster-based approach for integrating clinical management of Medicare beneficiaries with multiple chronic conditions

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0217696 ◽  
Author(s):  
Brent M. Egan ◽  
Susan E. Sutherland ◽  
Peter L. Tilkemeier ◽  
Robert A. Davis ◽  
Valinda Rutledge ◽  
...  
Keyword(s):  
Clinical Management ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Medicare Beneficiaries

scholarly journals Emergency Department and Inpatient Utilization among U.S. Older Adults with Multiple Chronic Conditions: A Post-Reform Update

2020 ◽  
Author(s):  
SangNam Ahn ◽  
Mustafa Hussein ◽  
Asos Mahmood ◽  
Matthew Lee Smith
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Low Income ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Multiple Chronic Conditions ◽  
Medicare Beneficiaries ◽  
Percentage Points ◽  
Ed Visits

Abstract Background. The Affordable Care Act (ACA) was enacted to enhance access to care primarily among nonelderly and low-income populations; however, several provisions addressed key determinants of emergency department (ED) and inpatient visits among Medicare beneficiaries over age 65 years. We take stock of the overall changes in these visits among older Medicare beneficiaries, focusing on those with multiple chronic conditions (MCCs), and provide a nationally representative post-reform update. Methods. We analyzed a sample of 32,919 older adults (65+) on Medicare from the 2006-2015 Medical Expenditure Panel Survey (MEPS). Using a survey-weighted two-part model, we examined changes in ED visits, inpatient visits, and length of stay (LOS) by MCC status, before (2006-2010), during (2011-2013), and after the ACA (2014-2015). Results. Prior to the ACA, 18.1% of Medicare older adults had ≥1 ED visit, whereas 17.1% had ≥1 inpatient visits, with an average of 5.1 nights/visit. Following ACA reforms, among those with 2+ chronic conditions, the rate of ever having an ED visit increased by 4.3 percentage points [95% confidence intervals [CI]: 2.5, 6.1, p < 0.01], whereas the rate of inpatient visits decreased by 1.4 percentage points [95%CI: -2.9, 0.2, p < 0.1], after multivariable adjustment. Conclusions. We found sizable increases in ED visits and nontrivial decreases in inpatient visits among older Medicare beneficiaries with MCCs, underscoring the continuing need for improving access to and quality of care among older adults with MCCs to decrease reliance on the ED and reduce preventable hospitalizations.

scholarly journals Emergency Department and Inpatient Utilization among U.S. Older Adults with Multiple Chronic Conditions: A Post-Reform Update

2019 ◽  
Author(s):  
SangNam Ahn ◽  
Mustafa Hussein ◽  
Asos Mahmood ◽  
Matthew Lee Smith
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Low Income ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Multiple Chronic Conditions ◽  
Medicare Beneficiaries ◽  
Percentage Points ◽  
Ed Visits

Abstract Background The Affordable Care Act (ACA) was enacted to enhance access to care primarily among nonelderly and low-income populations; however, several provisions addressed key determinants of emergency department (ED) and inpatient visits among Medicare beneficiaries over age 65 years. We take stock of the overall changes in these visits among older Medicare beneficiaries, focusing on those with multiple chronic conditions (MCCs), and provide a nationally representative post-reform update. Methods We analyzed a sample of 32,919 older adults (65+) on Medicare from the 2006-2015 Medical Expenditure Panel Survey (MEPS). Using survey-weighted logistic regression, we examined changes in ED visits, inpatient visits, and length of stay (LOS) by MCC status, before (2006-2010), during (2011-2013), and after the ACA (2014-2015). Results Prior to the ACA, 18.1% of Medicare older adults had ≥1 ED visit, whereas 17.1% had ≥1 inpatient visits, with an average of 5.1 nights/visit. Following ACA reforms, among those with 2+ chronic conditions, the rate of ever having an ED visit increased by 4.3 percentage points [95% confidence intervals [CI]: 2.5, 6.1, p < 0.01], whereas the rate of inpatient visits decreased by 1.4 percentage points [95%CI: -2.9, 0.2, p < 0.1], after multivariable adjustment. Conclusions We found sizable increases in ED visits and nontrivial decreases in inpatient visits among older Medicare beneficiaries with MCCs, underscoring the continuing need for improving access to and quality of care among older adults with MCCs to decrease reliance on the ED and reduce preventable hospitalizations.

scholarly journals Race Disparities in the Use of Prevention, Screening, and Monitoring Services in Michigan Medicare Beneficiaries With Type 2 Diabetes and Combinations of Multiple Chronic Conditions

2020 ◽  
Vol 38 (4) ◽  
pp. 363-370
Author(s):  
John Michael Clements ◽  
Brady Thomas West ◽  
Batoul Harissa ◽  
Nolan Hayden ◽  
Mishaal Mustafa Khan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Medicare Beneficiaries ◽  
Race Disparities

scholarly journals Emergency Department and Inpatient Utilization among U.S. Older Adults with Multiple Chronic Conditions: A Post-Reform Update

2019 ◽  
Author(s):  
SangNam Ahn ◽  
Mustafa Hussein ◽  
Asos Mahmood ◽  
Matthew Lee Smith
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Low Income ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Multiple Chronic Conditions ◽  
Medicare Beneficiaries ◽  
Percentage Points ◽  
Ed Visits

Abstract Background. The Affordable Care Act (ACA) was enacted to enhance access to care primarily among nonelderly and low-income populations; however, several provisions addressed key determinants of emergency department (ED) and inpatient visits among Medicare beneficiaries over age 65 years. We take stock of the overall changes in these visits among older Medicare beneficiaries, focusing on those with multiple chronic conditions (MCCs), and provide a nationally representative post-reform update. Methods. We analyzed a sample of 32,919 older adults (65+) on Medicare from the 2006-2015 Medical Expenditure Panel Survey (MEPS). Using a survey-weighted two-part model, we examined changes in ED visits, inpatient visits, and length of stay (LOS) by MCC status, before (2006-2010), during (2011-2013), and after the ACA (2014-2015). Results. Prior to the ACA, 18.1% of Medicare older adults had ≥1 ED visit, whereas 17.1% had ≥1 inpatient visits, with an average of 5.1 nights/visit. Following ACA reforms, among those with 2+ chronic conditions, the rate of ever having an ED visit increased by 4.3 percentage points [95% confidence intervals [CI]: 2.5, 6.1, p < 0.01], whereas the rate of inpatient visits decreased by 1.4 percentage points [95%CI: -2.9, 0.2, p < 0.1], after multivariable adjustment. Conclusions. We found sizable increases in ED visits and nontrivial decreases in inpatient visits among older Medicare beneficiaries with MCCs, underscoring the continuing need for improving access to and quality of care among older adults with MCCs to decrease reliance on the ED and reduce preventable hospitalizations.

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