998 results match your criteria beneficiary survey

Five-year impact of Medicare Part D coverage gap reform on drug expenditures and utilization.

Health Serv Res 2021 Apr 18. Epub 2021 Apr 18.

Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin, USA.

Objective: To estimate the impact of the Medicare Part D coverage gap reform under the Affordable Care Act (ACA) on the utilization of and expenditures for prescription drugs within the first five years of the policy's implementation.

Data Sources: 2008-2015 Medicare Current Beneficiary Survey (MCBS).

Study Design: We used a difference-in-differences approach to estimate the year-by-year changes in prescription drug use and expenditures before (2006-2010) and after (2011-2015) the ACA's Part D coverage gap reform between Part D beneficiaries not receiving the Low-Income Subsidy (LIS) and those receiving the LIS. Read More

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Healthcare governance during humanitarian responses: a survey of current practice among international humanitarian actors.

Confl Health 2021 Apr 10;15(1):25. Epub 2021 Apr 10.

Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

Background: Large international humanitarian actors support and directly deliver health services for millions of people in crises annually, and wield considerable power to decide which health services to provide, how and to whom, across a vast spectrum of health areas. Despite decades of reform aiming to improve accountability in the sector, public health practice among humanitarian actors is not heavily scrutinized in either the countries where they are headquartered or those where they provide healthcare. We surveyed current healthcare governance practice among large international humanitarian actors to better understand what organisations are doing to ensure oversight and accountability for health services in humanitarian responses. Read More

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Service Availability in Assisted Living and Other Community-Based Residential Settings at the End of Life.

J Palliat Med 2021 Apr 7. Epub 2021 Apr 7.

Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Community-based residential settings (e.g., assisted living facilities and retirement communities), are increasing, where vulnerable older adults are living as they age and die. Read More

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Influenza vaccination rates and location for receiving the influenza vaccination among older adult Medicare beneficiaries.

J Am Pharm Assoc (2003) 2021 Feb 27. Epub 2021 Feb 27.

Objectives: The objectives of this study were to (1) assess the trends in older adult influenza vaccination rates and (2) locations at which U.S. older adults received influenza vaccinations for the 2008-2009 to 2017-2018 influenza seasons, and (3) compare the estimates of influenza vaccination rates and locations with the estimates from other sources reported previously. Read More

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February 2021

Hearing Loss and Home Health: An Unmet Need and an Opportunity for Action.

Home Healthc Now 2021 Mar-Apr 01;39(2):72-80

The purpose of this study was to identify unmet hearing care needs among older adults receiving home healthcare as a potential method to reach a population unserved by clinic-based care. Cross-sectional analyses were used to identify hearing loss and hearing aid use among beneficiaries enrolled in home care, using data from the nationally representative 2017 Medicare Current Beneficiary Survey (MCBS). Survey participants who reported enrollment in home healthcare services in 2017 (n = 3,183,693) were included for the purposes of analyses. Read More

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Special Report from the CDC Antidepressant subclass use and fall risk in community-dwelling older Americans.

J Safety Res 2021 02 13;76:332-340. Epub 2020 Dec 13.

Larner College of Medicine, University of Vermont, Burlington, VT, USA.

Introduction: Falls among older adults are a significant health concern affecting more than a quarter of older adults (age 65+). Certain fall risk factors, such as medication use, increase fall risk among older adults (age 65+).

Aim: The aim of this study is to examine the association between antidepressant-medication subclass use and self-reported falls in community-dwelling older adults. Read More

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February 2021

Rural Enrollees In Medicare Advantage Have Substantial Rates Of Switching To Traditional Medicare.

Health Aff (Millwood) 2021 Mar;40(3):469-477

Brent A. Langellier is an assistant professor in the Department of Health Management and Policy at the Drexel Dornsife School of Public Health.

Medicare beneficiaries in rural areas may face challenges to gaining access to care, particularly if enrolled in Medicare Advantage (MA) plans with limited benefits and restrictive provider networks. These barriers to care may, in turn, increase switching to traditional fee-for-service Medicare among rural MA enrollees. Using 2010-16 Medicare Current Beneficiary Survey data, we found that switching from traditional Medicare to Medicare Advantage was uncommon among enrollees, both rural (1. Read More

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Societal Cost of Opioid Use in Symptomatic Knee Osteoarthritis Patients in the United States.

Arthritis Care Res (Hoboken) 2021 Feb 24. Epub 2021 Feb 24.

Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.

Background: Symptomatic knee osteoarthritis (SKOA) is a chronic, disabling condition, requiring long-term pain management; over 800,000 SKOA patients in the USA use opioids chronically. We aim to characterize the societal economic burden of opioid use in this population.

Methods: We used the Osteoarthritis Policy Model, a validated computer simulation of SKOA, to estimate the opioid-related lifetime and annual cost generated by the USA SKOA population. Read More

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February 2021

Differences in patient perceptions of integrated care among black, hispanic, and white Medicare beneficiaries.

Health Serv Res 2021 Feb 11. Epub 2021 Feb 11.

Stanford University School of Medicine, Stanford, California, USA.

Objective: This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities.

Data Source: Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year.

Study Design: We used 4-point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. Read More

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February 2021

Association of self-reported hearing loss severity and healthcare utilization outcomes among Medicare beneficiaries.

Am J Otolaryngol 2021 Feb 2;42(4):102943. Epub 2021 Feb 2.

Department of Otolaryngology- Head and Neck Surgery, Stanford University School of Medicine, United States of America. Electronic address:

Purpose: Understanding health utilization trends in the elderly population is pivotal for Medicare and policymakers. This study evaluates the association between hearing status and health utilization outcomes in a representative sample of elderly Medicare beneficiaries.

Materials And Methods: We employed the 2017 Medicare Current Beneficiary Survey (MCBS), which includes self-reported hearing loss data and weighted health utilization information. Read More

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February 2021

Asthma-chronic obstructive pulmonary disease overlap and cost-related medication non-adherence among older adults in the United States.

J Asthma 2021 Jan 19:1-15. Epub 2021 Jan 19.

School of Pharmacy, West Virginia University, Morgantown, WV, USA.

Background: Cost-related medication non-adherence (CRN) can negatively impact health outcomes in older adults with asthma and chronic obstructive pulmonary disease (COPD) overlap (ACO) by reducing access and adherence to essential medications. The objective of this study is to examine the association of ACO to any CRN and specific forms of CRN among a nationally representative sample of older (age ≥ 65 years) adults.

Methods: We adopted a cross-sectional study design using data from pooled cross-sectional Medicare Current Beneficiary Surveys (MCBS) (2006-2013) and linked fee-for-service Medicare claims. Read More

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January 2021

Productive Activities But Not Paid Work Relate to Well-Being in Older Adults.

Res Gerontol Nurs 2021 Jan 14;14(1):24-32. Epub 2020 Dec 14.

Productive activity engagement may positively contribute to the subjective well-being (SWB) of older adults during retirement. The current study explored the relationships between paid work and productive activities and SWB in Medicare beneficiary older adults predominantly living in the community. The 2015-2016 data (N = 2,916) from the National Health and Aging Trends Study were used. Read More

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January 2021

Cost-related Medication Nonadherence and Its Risk Factors Among Medicare Beneficiaries.

Med Care 2021 01;59(1):13-21

School of Pharmacy, Northeastern University.

Background: Unaffordability of medications is a barrier to effective treatment. Cost-related nonadherence (CRN) is a crucial, widely used measure of medications access.

Objectives: Our study examines the current national prevalence of and risk factors for CRN (eg, not filling, skipping or reducing doses) and companion measures in the US Medicare population. Read More

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January 2021

Patient Experiences of Integrated Care in Medicare Accountable Care Organizations and Medicare Advantage Versus Traditional Fee-for-Service.

Med Care 2021 Mar;59(3):195-201

Stanford University School of Medicine, Stanford, CA.

Background: Health insurance design can influence the extent to which clinical care is well-coordinated. Through alternative payment models, Medicare Advantage (MA) and Accountable Care Organizations (ACOs) have the potential to improve integration relative to traditional fee-for-service (FFS) Medicare.

Objective: To characterize patient experiences of integrated care within Medicare and identify whether MA or ACO beneficiaries perceive greater integration than FFS beneficiaries. Read More

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Association of Neighborhood Deprivation Index With Success in Cancer Care Crowdfunding.

JAMA Netw Open 2020 12 1;3(12):e2026946. Epub 2020 Dec 1.

Department of Medicine, Columbia University Irving Medical Center, New York, New York.

Importance: Financial toxicity resulting from cancer care poses a substantial public health concern, leading some patients to turn to online crowdfunding. However, the practice may exacerbate existing socioeconomic cancer disparities by privileging those with access to interpersonal wealth and digital media literacy.

Objective: To test the hypotheses that higher county-level socioeconomic status and the presence (vs absence) of text indicators of beneficiary worth in campaign descriptions are associated with amount raised from cancer crowdfunding. Read More

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December 2020

Contact by Collection Agencies for Medical Debt: Rural-Urban Differences Among Older and Younger Medicare Beneficiaries.

J Appl Gerontol 2020 Dec 2:733464820975902. Epub 2020 Dec 2.

University of Minnesota School of Public Health, Minneapolis, USA.

Geographic disparities in health and health care are increasingly well-documented, as are financial barriers to accessing care. Still, less is known about whether Medicare beneficiaries differ in their ability to pay for care by rurality. Using data from the 2016 Medicare Current Beneficiary Survey ( = 12,688 U. Read More

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December 2020

Public health insurance and birth outcomes: evidence from Punjab, Pakistan.

Health Policy Plan 2021 Mar;36(1):1-13

School of Public Policy, Oregon State University, Corvallis, OR 97330, USA.

Public health insurance targeted towards low-income households has gained traction in many developing countries. However, there is limited evidence as to the effectiveness of these programs in countries where institutional constraints may limit participation by the eligible population. This paper evaluates a recent health insurance initiative introduced in Pakistan and discusses whether eligibility for the programme improves maternal health seeking behaviour. Read More

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Screening Mammography Utilization Among Female Medicare Beneficiaries and Breast Cancer Survivors in 2002-2016.

J Womens Health (Larchmt) 2020 Nov 18. Epub 2020 Nov 18.

Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, Alabama, USA.

The use of screening mammography varies by patient characteristics. This study examined the annual mammography utilization trends among female Medicare beneficiaries and breast cancer survivors, overall and by beneficiary characteristics. This retrospective, serial cross-sectional study used the 2002-2016 Medicare Current Beneficiary Survey (MCBS), including fee-for-service female Medicare beneficiaries who resided in community settings and who completed the survey ( = 53,788, weighted  = 206,259,890). Read More

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November 2020

Assessment of Sensory Impairment and Health Care Satisfaction Among Medicare Beneficiaries.

JAMA Netw Open 2020 11 2;3(11):e2025522. Epub 2020 Nov 2.

Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Importance: Satisfaction with care is associated with improved quality of care and health outcomes. Sensory impairment can be a barrier to effective communication and access to care, and this may result in reduced satisfaction with care.

Objective: This study examined the association between sensory impairment and health care satisfaction among Medicare beneficiaries. Read More

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November 2020

Organizational integration, practice capabilities, and outcomes in clinically complex medicare beneficiaries.

Health Serv Res 2020 12 26;55 Suppl 3:1085-1097. Epub 2020 Oct 26.

Geisel School of Medicine, The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA.

Objective: To assess the association between clinical integration and financial integration, quality-focused care delivery processes, and beneficiary utilization and outcomes.

Data Sources: Multiphysician practices in the 2017-2018 National Survey of Healthcare Organizations and Systems (response rate 47%) and 2017 Medicare claims data.

Study Design: Cross-sectional study of Medicare beneficiaries attributed to physician practices, focusing on two domains of integration: clinical (coordination of patient services, use of protocols, individual clinician measures, access to information) and financial (financial management and planning across operating units). Read More

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December 2020

Discrepancies between Perceived and Physiological Fall Risks and Repeated Falls among Community-Dwelling Medicare Beneficiaries Aged 65 Years and Older.

Clin Gerontol 2020 Oct 22:1-13. Epub 2020 Oct 22.

College of Sciences, Department of Sociology, University of Central Florida , Orlando, Florida, USA.

Objectives: This study examined the associations of discrepancies between perceived and physiological fall risks with repeated falls.

Methods: We analyzed the 2016 Medicare Current Beneficiary Survey of 2,487 Medicare beneficiaries aged ≥ 65 years with ≥ 1 fall. The outcome variable was repeated falls (≥ 2 falls), the key independent variable was a categorical variable of discrepancies between perceived (fear of falling) and physiological fall risks (physiological limitations), assessed using multivariate logistic regression. Read More

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October 2020

Factors Associated With Avoiding Health Care Among Community-Dwelling Medicare Beneficiaries With Type 2 Diabetes.

Prev Chronic Dis 2020 10 15;17:E128. Epub 2020 Oct 15.

Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University.

Introduction: Health care avoidance by Medicare beneficiaries with chronic conditions such as type 2 diabetes can result in adverse health and economic outcomes. The objective of this study was to describe factors associated with choices to avoid health care among Medicare beneficiaries with type 2 diabetes.

Methods: We used a survey-weighted logistic model and the nationally representative 2016 Medicare Current Beneficiary Survey to analyze data on 1,782 Medicare beneficiaries aged ≥65 with type 2 diabetes, to examine associations between Medicare beneficiaries' decisions to avoid health care and multiple factors (eg, dissatisfaction with information given by providers, health problems that should have been discussed with providers but were not, worry about health more than other people their age). Read More

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October 2020

Midwifery and Birth Centers Under State Medicaid Programs: Current Limits to Beneficiary Access to a High-Value Model of Care.

Milbank Q 2020 12 15;98(4):1091-1113. Epub 2020 Sep 15.

The Urban Institute, Health Policy Center.

Policy Points Birth center services must be covered under Medicaid per federal mandate, but reimbursement and other policy barriers prevent birth centers from serving more Medicaid patients. Midwifery care provided through birth centers improves maternal and infant outcomes and lowers costs for Medicaid beneficiaries. Birth centers offer an array of birth options and have resources to care for patients with medical and psychosocial risks. Read More

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December 2020

Differences in Health Care Utilization, Process of Diabetes Care, Care Satisfaction, and Health Status in Patients With Diabetes in Medicare Advantage Versus Traditional Medicare.

Med Care 2020 11;58(11):1004-1012

Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Objective: The objective of this study was to determine differences in health care utilization, process of diabetes care, care satisfaction, and health status for Medicare Advantage (MA) and traditional Medicare (TM) beneficiaries with and without diabetes.

Methods: Using the 2010-2016 Medicare Current Beneficiary Survey, we identified MA and TM beneficiaries with and without diabetes. To address the endogenous plan choice between MA and TM, we used an instrumental variable approach. Read More

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November 2020

Association of Electronic Health Record Use Above Meaningful Use Thresholds With Hospital Quality and Safety Outcomes.

JAMA Netw Open 2020 09 1;3(9):e2012529. Epub 2020 Sep 1.

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Importance: By 2018, Medicare spent more than $30 billion to incentivize the adoption of electronic health records (EHRs), based partially on the belief that EHRs would improve health care quality and safety. In a time when most hospitals are well past minimum meaningful use (MU) requirements, examining whether EHR implementation beyond the minimum threshold is associated with increased quality and safety may guide the future focus of EHR development and incentive structures.

Objective: To determine whether EHR implementation above MU performance thresholds is associated with changes in hospital patient satisfaction, efficiency, and safety. Read More

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September 2020

Hospitalization Risk Among Older Adults with Sensory Impairments: Development of a Prognostic Model.

J Am Geriatr Soc 2020 11 27;68(11):2650-2655. Epub 2020 Aug 27.

Department of Medicine, Duke University School of Medicine, Durham, North Carolina.

Objectives: To develop a prognostic model for hospital admissions over a 1-year period among community-dwelling older adults with self-reported hearing and/or vision impairments based on readily obtainable clinical predictors.

Design: Retrospective cohort study.

Setting: Medicare Current Beneficiary Survey from 1999 to 2006. Read More

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November 2020

Development of a Predictive Algorithm to Identify Adults With Mobility Limitations Using VA Health Care Administrative Data.

Med Care Res Rev 2020 Aug 26:1077558720950880. Epub 2020 Aug 26.

College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.

An estimated 31.5 million Americans have a mobility limitation. Health care administrative data could be a valuable resource for research on this population but methods for cohort identification are lacking. Read More

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Part D coverage gap reform: trends in drug use and expenditures.

Am J Manag Care 2020 08;26(8):349-356

University of Wisconsin-Madison School of Pharmacy, 777 Highland Ave, Madison, WI 53705-2222. Email:

Objectives: This study analyzed annual trends in the distribution of beneficiaries entering each benefit phase and the utilization of and expenditures for prescription drugs among Medicare Part D beneficiaries from 2008 to 2015.

Study Design: Retrospective, repeated cross-sectional analysis using Medicare Current Beneficiary Survey data.

Methods: The study population included elderly Part D beneficiaries without a low-income subsidy, with continuous enrollment in a Part D plan, and with at least 1 prescription fill for a given year. Read More

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Medicaid managed care in Iowa: Experiences of older adults and people with disabilities.

Disabil Health J 2021 Jan 30;14(1):100975. Epub 2020 Jul 30.

Department of Health Management and Policy, University of Iowa, United States.

Background: A growing number of states are turning to managed care arrangements to provide care to senior and disabled Medicaid beneficiaries. Despite their complex care needs, very little is known about the experience of these individuals in managed care.

Objective: To document experiences of a sample of aged and disabled Medicaid beneficiaries receiving long-term services and supports through managed care in Iowa and to assess whether these experiences changed over time. Read More

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January 2021