Resource Use and Quality of Care in Medicare Advantage

项目总结/摘要 医疗保险优势（MA）是传统医疗保险（TM）计划的私人替代方案。马 在过去的十年中，它大幅增长，目前占医疗保险人口的48%。作为 MA在医疗保险中发挥着越来越大的作用，重要的是要评估MA相对于 TM.然而，关于MA如何为严重和昂贵的患者提供护理的证据很少。 条件阿尔茨海默病和相关痴呆症（ADRD）是一种使人衰弱和复杂的疾病。 给患者和社会带来巨大负担。以前的研究报告说， ADRD患者是卫生服务的高使用者，并且增加了不适当护理和不良反应的风险。 健康事件。它还表明白色之间的服务利用和健康结果的差异 和种族/少数民族ADRD患者。然而，现有的ADRD护理工作仅限于 在TM中检查ADRD患者。很少有研究探讨MA如何为ADRD患者提供护理。 鉴于并购的持续增长和不成比例的份额， 种族/少数民族在MA入学。MA中ADRD患者的护理和结局信息 相对于TM，评估MA增长对患者护理的影响至关重要。此外，本发明还提供了一种方法， 关于MA是否缩小了ADRD患者在人种/种族间的护理差异的信息 小组是至关重要的，以得出卫生公平的影响，增长的MA。这项拟议的研究将 为这些重要调查提供第一手证据具体来说，我们将1）比较护理模式 MA和TM之间ADRD患者的结局;（2）审查护理方面的种族/民族差异 MA组ADRD患者相对于TM组的模式和结局。使用全国性的MA和TM声明 数据，我们将研究一系列广泛的卫生服务使用，护理质量和健康结果， 有ADRD的Medicare受益人。 与ADRD的相关性：拟议申请的两个具体目标均侧重于ADRD。

Project Summary/Abstract Medicare Advantage (MA) is a private alternative to the Traditional Medicare (TM) program. MA has substantially grown during the past decade, and it currently enrolls 48% of the Medicare population. As MA plays an increasingly large role in Medicare, it is important to assess MA performance relative to TM. However, evidence is scarce on how MA provides care for patients with serious and costly conditions. Alzheimer’s Disease and Related Dementias (ADRD) are debilitating and complex conditions that bring significant burdens to patients and society. Previous studies report that individuals with ADRD are high users of health services and have increased risk of inappropriate care and adverse health events. It also indicates differences in service utilization and health outcomes between White and racial/ethnic minority patients with ADRD. However, the existing work on ADRD care is limited to examining ADRD patients in TM. Few studies examined how MA provides care for enrollees with ADRD. This is a significant gap in the literature given the continued growth of MA and a disproportionate share of racial/ethnic minority enrollees in MA. Information on care and outcomes of ADRD patients in MA relative to TM is critical to assess implications of the growth of MA for patient care. In addition, information about whether MA narrows disparities in care for ADRD patients across race/ethnicity groups is essential to draw health equity implications of the growth of MA. This proposed study will provide the first evidence on these important inquiries. Specifically, we will 1) compare care patterns and outcomes of ADRD patients between MA and TM.; and 2) examine racial/ethnic disparities in care patterns and outcomes of ADRD patients in MA relative to TM. Using nation-wide MA and TM claims data, we will examine a wide set of health service use, quality of care, and health outcomes relevant to Medicare beneficiaries with ADRD. Relevance to ADRD: Both specific aims of the proposed application focus on ADRD.