PERCEPTIONS OF CARE IN THE MEDICARE PROGRAM: AN ANALYSIS COMPARING EXPERIENCES OF CARE OF MEDICARE BENEFICIARIES WITH A DIAGNOSIS OF DIABETES ENROLLED IN TRADITIONAL MEDICARE AND MEDICARE ADVANTAGE

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Date
2015-04-09
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Publisher
Johns Hopkins University
Abstract
Background: The Medicare program offers two main insurance options: Traditional Fee-For-Service (FFS) Medicare and Medicare Advantage (MA). The primary purpose of the two options is to provide healthcare choices to Medicare beneficiaries; however, their structural and cost differences could result in quite different experiences for beneficiaries obtaining care within each option. This research will look at differences in experiences of care between beneficiaries that are enrolled in MA and FFS with a diagnosis of diabetes. Methods: This study utilizes data collected in the 2009 Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) survey. The 2009 MCAHPS survey includes a nationally representative sample of Medicare beneficiaries who were surveyed about different aspects of the health care experiences. This study will focus on Medicare beneficiaries who reported their doctor telling them they have diabetes. The study will utilize Univariate and Multivariable logistic regression models to examine the relationship of experience of care outcomes between beneficiaries in FFS and MA programs taking into account demographic and health characteristics of diabetic beneficiaries. Results: Results show that Medicare beneficiaries who are White are more likely to report positive experiences for all the outcome variables in the analyses with and without taking demographic and health variables into account. Enrollees with more than a high school education report better experience with understanding a doctor’s explanation than those with a high school education or less; older enrollees that are 65 and older report better experiences for all outcome variables than enrollees who are younger than 65. There is not a statistically significant difference in the way that males and females report experiences of care for the outcome variables. Conclusion: This is the first time a study has been done looking at experiences of care for Medicare beneficiaries with a diagnosis of diabetes enrolled in MA and FFS Medicare options. The information generated by this research will be valuable to policy makers, quality improvement organizations, and other stakeholders as they explore and refine quality improvement strategies for patient experience of care, specifically for patient with chronic conditions like diabetes, across the Medicare program.
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Keywords
Medicare, Fee-for-Service, Medicare Advantage, CAHPS, MCAHPS, Diabetes
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