Variations in Medicare Advantage Switching Rates among African American and Hispanic Medicare Beneficiaries with Alzheimer's Disease and Related Dementias, by Sex and Dual Eligibility

Maricruz Rivera-Hernandez, David J. Meyers, Daeho Kim, Sungchul Park, Amal N. Trivedi

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: The objective of this study was to identify rates of switching to Medicare Advantage (MA) among fee-for-service (FFS) Medicare beneficiaries with Alzheimer's disease and related dementias (ADRD) by race/ethnicity and whether these rates vary by sex and dual-eligibility status for Medicare and Medicaid. Methods: Data came from the Medicare Master Beneficiary Summary File from 2017 to 2018. The outcome of interest for this study was switching from FFS to MA during any month in 2018. The primary independent variable was race/ethnicity including non-Hispanic White, non-Hispanic African American, and Hispanic beneficiaries. Two interaction terms among race/ethnicity and dual eligibility, and race/ethnicity and sex were included. The model adjusted for age, year of ADRD diagnosis, the number of chronic/disabling conditions, total health care costs, and ZIP code fixed effects. Results: The study included 2,284,175 FFS Medicare beneficiaries with an ADRD diagnosis in 2017. Among dual-eligible beneficiaries, adjusted rates of switching were higher among African American (1.91 percentage points [p.p.], 95% confidence interval [CI]: 1.68-2.15) and Hispanic beneficiaries (1.36 p.p., 95% CI: 1.07-1.64) compared to non-Hispanic White beneficiaries. Among males, adjusted rates were higher among African American (3.28 p.p., 95% CI: 2.97-3.59) and Hispanic beneficiaries (2.14 p.p., 95% CI: 1.86-2.41) compared to non-Hispanic White beneficiaries. Discussion: Among persons with ADRD, African American and Hispanic beneficiaries are more likely than White beneficiaries to switch from FFS to MA. This finding underscores the need to monitor the quality and equity of access and care for these populations.

Original languageEnglish
Pages (from-to)E279-E287
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Volume77
Issue number12
DOIs
StatePublished - 1 Dec 2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.

Keywords

  • Dementia
  • Health care costs
  • Health insurance
  • Racial disparities

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