TY - JOUR
T1 - Care experiences among dually enrolled older adults with cancer
T2 - SEER-CAHPS, 2005–2013
AU - Lines, Lisa M.
AU - Cohen, Julia
AU - Halpern, Michael T.
AU - Smith, Ashley Wilder
AU - Kent, Erin E.
N1 - Funding Information:
Funding for this research was provided to LML, JC, and MTH under National Cancer Institute Contract #HHSN-261–2015-00132U.
Publisher Copyright:
© 2019, Springer Nature Switzerland AG.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - 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.
AB - 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.
KW - Cancer
KW - Dual eligible
KW - Medicaid
KW - Medicare
KW - Patient experience
KW - Poverty
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U2 - 10.1007/s10552-019-01218-7
DO - 10.1007/s10552-019-01218-7
M3 - Article
C2 - 31422490
AN - SCOPUS:85071109955
VL - 30
SP - 1137
EP - 1144
JO - Cancer Causes and Control
JF - Cancer Causes and Control
SN - 0957-5243
IS - 10
ER -