Lisa M Lines1,2, Julia Cohen3, Michael T Halpern4, Ashley Wilder Smith4, Erin E Kent5. 1. RTI International, 307 Waverley Oaks Rd, Suite 101, Waltham, MA, 02452, USA. llines@rti.org. 2. University of Massachusetts Medical School, 55 Lake Ave. North, Worcester, MA, 01655, USA. llines@rti.org. 3. RTI International, 307 Waverley Oaks Rd, Suite 101, Waltham, MA, 02452, USA. 4. Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr., Room 3E4342, Bethesda, MD, 20892-9762, USA. 5. Gillings School of Public Health, University of North Carolina - Chapel Hill, 135 Dauer Dr., Chapel Hill, NC, 27559, USA.
Abstract
PURPOSE: Given the associations between poverty and poorer outcomes among older adults with cancer, we sought to understand the effects of dual enrollment in Medicare and Medicaid-as a marker of poverty-on self-reported care experiences among seniors diagnosed with cancer. METHODS: Retrospective, observational study using cancer registry, Medicare claims, and care experience survey data (Surveillance, Epidemiology, and End Results [SEER]-Consumer Assessment of Healthcare Providers and Systems [CAHPS®]) for a national sample of fee-for-service (FFS) and Medicare Advantage (MA) enrollees aged 65 or older. We included people with one incident primary, malignant cancer diagnosed between 2005 and 2011, surveyed within 2 years after diagnosis (n = 9,800; 995 dual enrollees). Medicare CAHPS measures included 5 global ratings and 3 composite scores. RESULTS: After adjustment for potential confounders, people with cancer histories who were dually enrolled were significantly more likely to report better experiences than non-duals on 2 measures (Medicare/their health plan: adjusted odds ratio [aOR]: 0.68, 95% confidence interval [CI] 0.53-0.87; prescription drug plan [PDP]: aOR: 0.54, 95% CI 0.40-0.73). CONCLUSIONS: Dual enrollees with cancer reported better experiences than Medicare-only enrollees in terms of their health plan (Medicare FFS or Medicare Advantage) and their PDP. Better ratings among dually enrolled beneficiaries suggest possible divergence between health outcomes and care experiences, warranting additional investigation.
PURPOSE: Given the associations between poverty and poorer outcomes among older adults with cancer, we sought to understand the effects of dual enrollment in Medicare and Medicaid-as a marker of poverty-on self-reported care experiences among seniors diagnosed with cancer. METHODS: Retrospective, observational study using cancer registry, Medicare claims, and care experience survey data (Surveillance, Epidemiology, and End Results [SEER]-Consumer Assessment of Healthcare Providers and Systems [CAHPS®]) for a national sample of fee-for-service (FFS) and Medicare Advantage (MA) enrollees aged 65 or older. We included people with one incident primary, malignant cancer diagnosed between 2005 and 2011, surveyed within 2 years after diagnosis (n = 9,800; 995 dual enrollees). Medicare CAHPS measures included 5 global ratings and 3 composite scores. RESULTS: After adjustment for potential confounders, people with cancer histories who were dually enrolled were significantly more likely to report better experiences than non-duals on 2 measures (Medicare/their health plan: adjusted odds ratio [aOR]: 0.68, 95% confidence interval [CI] 0.53-0.87; prescription drug plan [PDP]: aOR: 0.54, 95% CI 0.40-0.73). CONCLUSIONS: Dual enrollees with cancer reported better experiences than Medicare-only enrollees in terms of their health plan (Medicare FFS or Medicare Advantage) and their PDP. Better ratings among dually enrolled beneficiaries suggest possible divergence between health outcomes and care experiences, warranting additional investigation.
Authors: Marc N Elliott; Amelia M Haviland; David E Kanouse; Katrin Hambarsoomian; Ron D Hays Journal: Health Serv Res Date: 2008-11-24 Impact factor: 3.402
Authors: Neetu Chawla; Matthew Urato; Anita Ambs; Nicola Schussler; Ron D Hays; Steven B Clauser; Alan M Zaslavsky; Kayo Walsh; Margot Schwartz; Michael Halpern; Sarah Gaillot; Elizabeth H Goldstein; Neeraj K Arora Journal: J Gen Intern Med Date: 2015-01-14 Impact factor: 6.473
Authors: Steven C Martino; Marc N Elliott; Paul D Cleary; David E Kanouse; Julie A Brown; Karen L Spritzer; Amy Heller; Ron D Hays Journal: Health Care Financ Rev Date: 2009
Authors: Lisa M Lines; Julia Cohen; Justin Kirschner; Daniel H Barch; Michael T Halpern; Erin E Kent; Michelle A Mollica; Ashley Wilder Smith Journal: J Geriatr Oncol Date: 2022-03-07 Impact factor: 3.929
Authors: Lisa D DiMartino; Justin Kirschner; George L Jackson; Michelle A Mollica; Lisa M Lines Journal: Cancer Causes Control Date: 2021-05-27 Impact factor: 2.532