NBER Center for Aging and Health Research

NBER 老龄化与健康研究中心

• 批准号: 10286675
• 负责人: ANNE CASE
• 金额: $ 9.49万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-08-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10286675
• 关键词: Administrative Supplement; Affect; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Caring; Cognitive; Complex; Decision Making; Development; Drug Prescriptions; Economics; Ecosystem; Effectiveness; Eligibility Determination; Enrollment; Expenditure; Face; Food; Grant; Health; Health Insurance; Health Promotion; Healthcare; Impaired cognition; Income; Incubated; Individual; Insurance; Insurance Carriers; Joints; Lead; Long-Term Care; Long-Term Care Insurance; Managed Competition; Measures; Mediating; Medicaid; Medical; Medical Care Costs; Medicare; Medicare/Medicaid; Methodology; Monitor; Outcome; Patients; Persons; Pilot Projects; Population; Privatization; Process; Public Health; Research; Research Priority; Risk; Role; Services; Structure; Time; Treatment Cost; Visit; Work; beneficiary; caregiving; cost; design; insurance plan; longitudinal database; meetings; mild cognitive impairment; research and development

OTHER PROJECT INFORMATION – Project Summary/Abstract Cognitive Decline and Health Insurance Decisions and Outcomes This administrative supplement application proposes a new Center pilot project, to be conducted as part of the NBER Center for Aging and Health Research. The Center is structured around several high-priority research themes that are incubated and advanced through network meetings and pilot projects. While the NBER Center is not an Alzheimer’s-focused grant, the economics of Alzheimer’s disease has been identified by Center leaders as one of several high-priority themes for new research development. The proposed new pilot study explores how cognitive decline, including the onset and progression of mild cognitive impairment (MCI), Alzheimer’s disease, and related dementias (ADRD) relate to people’s health insurance enrollment decisions and subsequent outcomes. Medicare currently relies on a “managed competition” approach to supplemental insurance for long- term care, prescription drugs, and other coverage not included in traditional Medicare. In this approach, private insurers compete for enrollees within regulated markets. Some people, including those suffering from cognitive decline, may have difficulty navigating such markets, and the enrollment decisions they make may in turn affect other health outcomes. The specific aims of the pilot project are to explore how cognitive decline relates to: (1) the health insurance choice process, including the portfolio of coverage and use of assistance in making enrollment decisions; (2) inertia in insurance plan enrollment, defined as the likelihood of switching to plans that provide greater risk protection or lower costs; and (3) outcomes of Medicare Part D choices, describing how well each person fared under their chosen plan. The study will be conducted using a longitudinal database that tracks the onset and progression of cognitive decline among Medicare beneficiaries; their enrollment in Medigap plans, Medicare Part D prescription drug insurance plans, Medicare Advantage plans, employer-sponsored plans, and plans that provide long-term care coverage, including Medicaid; and many other health and health spending measures. The pilot research would provide the preliminary findings and support the methodological development for a larger R01 proposal that follows directly from the exploratory analyses described here.

其他项目信息-项目概要/摘要 认知衰退与健康保险决策和结果 本行政补充申请提出了一个新的中心试点项目，作为 NBER老龄化与健康研究中心。该中心的结构围绕几个高优先级的研究 通过网络会议和试点项目培育和推进的主题。虽然NBER中心 不是针对阿尔茨海默病的资助，阿尔茨海默病的经济学已由中心领导人确定 作为新研究发展的几个高优先主题之一。拟议的新试点研究探讨了 认知能力下降，包括轻度认知功能障碍（MCI）、阿尔茨海默氏症 疾病和相关痴呆症（ADRD）与人们的健康保险投保决定以及随后的 结果。医疗保险目前长期依赖于一种“有管理的竞争”方法来补充保险- 长期护理、处方药和其他不包括在传统医疗保险中的保险。在这种情况下，私人 保险公司在受监管的市场内竞争投保人。有些人，包括那些患有认知障碍的人， 下降，可能难以驾驭这些市场，他们所做的招生决定可能会反过来影响 其他健康成果。该试点项目的具体目标是探索认知能力下降与以下方面的关系：（1） 健康保险的选择过程，包括保险范围和使用援助的组合， 投保决策;（2）保险计划投保的惯性，定义为转换到 提供更大的风险保护或更低的成本;（3）医疗保险D部分选择的结果，描述如何 每个人都按照自己选择的计划行事。该研究将使用纵向数据库进行， 医疗保险受益人中认知能力下降的发生和进展;他们在Medigap计划中的登记， Medicare Part D处方药保险计划、Medicare Advantage计划、雇主赞助计划，以及 提供长期护理覆盖的计划，包括医疗补助;以及许多其他健康和健康支出 措施试点研究将提供初步调查结果，并支持方法， 开发更大的R 01提案，该提案直接来自此处描述的探索性分析。