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The impact of Medicare Advantage on Health Care, Management of Comorbid Conditions, and Potentially Inappropriate Medication Use, for Beneficiaries with Alzheimer's Disease and Its Related Dementias

Award Number: R01AG079216
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

Group Awards By Issue Date FY or Funding FY:

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Project Summary / Abstract Over 6 million adults in the U.S. are living with Alzheimer's Disease and Alzheimer's Disease Related Dementias (ADRD), a population estimated to double by 2050. Medicare costs associated with individuals with AD/ADRD are more than three times higher than for those without and the total Medicare spending for beneficiaries with AD/ADRD is projected to reach $584 billion in 2050. People with ADRD are also characterized by higher complexity of comorbid conditions and coordination of care. There is evidence of potentially inappropriate or suboptimal care for individuals with ADRD. Medicare Advantage (MA) provides a potential opportunity to improve the efficiency and quality of treatment for individuals with ADRD. Because MA plans receive capitated monthly payments from Medicare, they have strong financial incentive to manage chronic conditions and avoid unnecessary health care use. However, MA plans' incentives to control costs could also lead to reduction in beneficial care for enrollees with AD/ADRD. Prior research suggest that MA enrollment is associated with lower healthcare utilization for ADRD individuals, but the results were based on cross-sectional comparisons in self-reported outcomes between MA and TM, which could have biased estimates if MA enrollees differed from TM enrollees in unobserved ways. With the growing share of Medicare beneficiaries enrolled in MA, it is important to understand the causal effects of MA coverage on health care use and outcomes for beneficiaries with ADRD. Our proposed project will use plausibly exogenous variation in MA enrollment in seven states that shifted public retiree health benefits from TM with supplemental plans to mandatory MA plans (or in one state, from a mandatory MA plan to TM coverage) in 2016-2019. We will use these natural experiments, along with comprehensive Medicare data for TM and MA enrollees, to estimate the causal effects of MA coverage on health care use, management of comorbid conditions, potentially inappropriate medication use and polypharmacy, and institutionalization for individuals with ADRD. These results will provide insights on the relative benefits and harms of MA enrollment for this vulnerable population and contribute important evidence to policymakers weighing broader expansions of Medicare Advantage.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $595,825 )
2024	2024	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST FL 3	LOS ANGELES	CA	90089	LOS ANGELES	USA	Aging Research	000	3	4/17/2024	NON-COMPETING CONTINUATION	$595,825
														Subtotal = $595,825

Issue Date FY: 2023 ( Subtotal = $619,047 )
2023	2023	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST	LOS ANGELES	CA	90089	LOS ANGELES	USA	Aging Research	001	2	4/19/2023	NON-COMPETING CONTINUATION	$619,047
2023	2022	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST	LOS ANGELES	CA	90089	LOS ANGELES	USA	Aging Research	000	1	11/22/2022	NEW	$0
														Subtotal = $619,047

Issue Date FY: 2022 ( Subtotal = $665,619 )
2022	2022	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST FL 3	LOS ANGELES	CA	90007	LOS ANGELES	USA	Aging Research	000	1	8/25/2022	NEW	$665,619
														Subtotal = $665,619

Grand Total All Awards = $1,880,491

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The impact of Medicare Advantage on Health Care, Management of Comorbid Conditions, and Potentially Inappropriate Medication Use, for Beneficiaries with Alzheimer's Disease and Its Related Dementias

Award Number: R01AG079216

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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