Lianlian Lei1, Julie Pw Bynum2, Donovan T Maust3. 1. Department of Psychiatry, University of Michigan(LL, DTM). Electronic address: leilian@med.umich.edu. 2. Department of Internal Medicine, University of Michigan (JPWB); Institute for Healthcare Policy and Innovation, University of Michigan (JPWB, DTM). 3. Department of Psychiatry, University of Michigan(LL, DTM); Institute for Healthcare Policy and Innovation, University of Michigan (JPWB, DTM); Center for Clinical Management Research, VA Ann Arbor Healthcare System (DTM).
Abstract
OBJECTIVE: To examine whether prescription fills of opioids and central nervous system (CNS) depressants are lower in Medicare Advantage (MA) plans, which aim to provide more coordinated and integrated care, than fee-for-service (FFS) Medicare. METHODS: Data from the 2015 National Health and Aging Trends Study linked with Medicare claims. Community-dwelling adults ≥65 enrolled in Medicare Part D were included (n = 5,652). Prescription fills of opioids, antipsychotics, benzodiazepines, gabapentinoids, and co-prescriptions of opioids with the other medications in MA versus FFS Medicare were examined using multivariate logistic models. Propensity score weighting was applied to account for differences in characteristics between MA and FFS beneficiaries. RESULTS: MA enrollees were less likely to fill prescriptions for benzodiazepines (15.6% versus 19.0%; marginal difference: -3.4%, t = -2.54, df = 56, p = 0.01), and co-prescriptions of opioids and gabapentinoids (5.1% versus 6.7%; marginal difference: -1.6%, t = -2.07, df = 56, p = 0.04) than FFS beneficiaries. There were no significant differences among the other prescription outcomes. CONCLUSIONS: MA was associated with slightly lower likelihood of receiving opioids and some CNS depressants.
OBJECTIVE: To examine whether prescription fills of opioids and central nervous system (CNS) depressants are lower in Medicare Advantage (MA) plans, which aim to provide more coordinated and integrated care, than fee-for-service (FFS) Medicare. METHODS: Data from the 2015 National Health and Aging Trends Study linked with Medicare claims. Community-dwelling adults ≥65 enrolled in Medicare Part D were included (n = 5,652). Prescription fills of opioids, antipsychotics, benzodiazepines, gabapentinoids, and co-prescriptions of opioids with the other medications in MA versus FFS Medicare were examined using multivariate logistic models. Propensity score weighting was applied to account for differences in characteristics between MA and FFS beneficiaries. RESULTS: MA enrollees were less likely to fill prescriptions for benzodiazepines (15.6% versus 19.0%; marginal difference: -3.4%, t = -2.54, df = 56, p = 0.01), and co-prescriptions of opioids and gabapentinoids (5.1% versus 6.7%; marginal difference: -1.6%, t = -2.07, df = 56, p = 0.04) than FFS beneficiaries. There were no significant differences among the other prescription outcomes. CONCLUSIONS: MA was associated with slightly lower likelihood of receiving opioids and some CNS depressants.
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