scholarly journals County-Level Variation in Per Capita Spending for Multiple Chronic Conditions Among Fee-for-Service Medicare Beneficiaries, United States, 2014

2016 ◽  
Vol 13 ◽  
Author(s):  
Kevin A. Matthews ◽  
James Holt ◽  
Anne H. Gaglioti ◽  
Kim A. Lochner ◽  
Carla Shoff ◽  
...  
Keyword(s):  
United States ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
County Level ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Level Variation ◽  
Capita Spending ◽  
Per Capita

Association of Medicare Advantage Penetration With Per Capita Spending, Emergency Department Visits, and Readmission Rates Among Fee-for-Service Medicare Beneficiaries With High Comorbidity Burden

2020 ◽  
pp. 107755872095258
Author(s):  
Sungchul Park ◽  
Brent A. Langellier ◽  
Robert E. Burke ◽  
Jose F. Figueroa ◽  
Norma B. Coe
Keyword(s):  
Emergency Department ◽  
Chronic Conditions ◽  
Emergency Department Visits ◽  
Multiple Chronic Conditions ◽  
Fee For Service ◽  
Medicare Advantage ◽  
Readmission Rates ◽  
Comorbidity Burden ◽  
Capita Spending ◽  
Per Capita

Rapid growth of Medicare Advantage (MA) plans has the potential to change clinical practice for both MA and fee-for-service (FFS) beneficiaries, particularly for high-need, high-cost beneficiaries with multiple chronic conditions or a costly single condition. We assessed whether MA growth from 2010 to 2017 spilled over to county-level per capita spending, emergency department visits, and readmission rates among FFS beneficiaries, and how much this varied by the comorbidity burden of the beneficiary. We also examined whether the association between MA growth and per capita spending in FFS varied in beneficiaries with specific chronic conditions. MA growth was associated with decreased FFS spending and emergency department visits only among beneficiaries with six or more chronic conditions. MA growth was associated with decreased FFS spending among beneficiaries with 11 of the 20 chronic conditions. This suggests that MA growth may drive improvements in efficiency of health care delivery for high-need, high-cost beneficiaries.

Abstract P636: Social Determinants of Stroke Hospitalization and Mortality in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Randhir Sagar Yadav ◽  
Durgesh Chaudhary ◽  
Shima Shahjouei ◽  
Jiang Li ◽  
Vida Abedi ◽  
...  
Keyword(s):  
United States ◽  
Income Inequality ◽  
Social Determinants ◽  
Hemorrhagic Stroke ◽  
The United States ◽  
Care Physician ◽  
County Level ◽  
Medicare Beneficiaries ◽  
Level Data ◽  
Control And Prevention

Introduction: Stroke hospitalization and mortality are influenced by various social determinants. This ecological study aimed to determine the associations between social determinants and stroke hospitalization and outcome at county-level in the United States. Methods: County-level data were recorded from the Centers for Disease Control and Prevention as of January 7, 2020. We considered four outcomes: all-age (1) Ischemic and (2) Hemorrhagic stroke Death rates per 100,000 individuals (ID and HD respectively), and (3) Ischemic and (4) Hemorrhagic stroke Hospitalization rate per 1,000 Medicare beneficiaries (IH and HH respectively). Results: Data of 3,225 counties showed IH (12.5 ± 3.4) and ID (22.2 ± 5.1) were more frequent than HH (2.0 ± 0.4) and HD (9.8 ± 2.1). Income inequality as expressed by Gini Index was found to be 44.6% ± 3.6% and unemployment rate was 4.3% ± 1.5%. Only 29.8% of the counties had at least one hospital with neurological services. The uninsured rate was 11.0% ± 4.7% and people living within half a mile of a park was only 18.7% ± 17.6%. Age-adjusted obesity rate was 32.0% ± 4.5%. In regression models, age-adjusted obesity (OR for IH: 1.11; HH: 1.04) and number of hospitals with neurological services (IH: 1.40; HH: 1.50) showed an association with IH and HH. Age-adjusted obesity (ID: 1.16; HD: 1.11), unemployment (ID: 1.21; HD: 1.18) and income inequality (ID: 1.09; HD: 1.11) showed an association with ID and HD. Park access showed inverse associations with all four outcomes. Additionally, population per primary-care physician was associated with HH while number of pharmacy and uninsured rate were associated with ID. All associations and OR had p ≤0.04. Conclusion: Unemployment and income inequality are significantly associated with increased stroke mortality rates.

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

Multiple Chronic Conditions in the United States

10.7249/tl221 ◽  
2017 ◽  
Author(s):  
Christine Buttorff ◽  
Teague Ruder ◽  
Melissa Bauman
Keyword(s):  
United States ◽  
Chronic Conditions ◽  
The United States ◽  
Multiple Chronic Conditions

scholarly journals Racial Disparities in Health Service Utilization Among Medicare Fee-for-Service Beneficiaries Adjusting for Multiple Chronic Conditions

2017 ◽  
Vol 30 (8) ◽  
pp. 1224-1243 ◽  
Author(s):  
Krupa Gandhi ◽  
Eunjung Lim ◽  
James Davis ◽  
John J. Chen
Keyword(s):  
Racial Disparities ◽  
Chronic Conditions ◽  
Skilled Nursing Facility ◽  
Home Health ◽  
Pacific Islanders ◽  
Multiple Chronic Conditions ◽  
Fee For Service ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Racial Disparities In Health

Objective: To examine racial disparities in health services utilization in Hawaii among Medicare fee-for-service beneficiaries aged 65 years and above. Method: All-cause utilization of inpatient, outpatient, emergency, home health agency, and skilled nursing facility admissions were investigated using 2012 Medicare data. For each type of service, multivariable logistic regression model was used to investigate racial disparities adjusting for sociodemographic factors and multiple chronic conditions. Results: Of the 84,212 beneficiaries, 27.8% were White, 27.4% were Asian, 27.3% were Pacific Islanders; 70.3% had two or more chronic conditions and 10.5% had six or more. Compared with Whites, all racial groups experienced underutilization across all types of services. As the number of chronic conditions increased, the utilization of inpatient, home health care, and skilled nursing facility dramatically increased. Discussion: Disparities persist among Asians and Pacific Islanders who encounter the problem of underutilization of various health services compared with Whites.

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