Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Complex choices in Medicare Advantage program may overwhelm seniors, study finds

18.08.2011
In health care, more choice may not always lead to better choices, particularly for the elderly.

In a new study, researchers from Harvard Medical School's Department of Health Care Policy found that the large variety of managed care plans offered by the Medicare Advantage program may be counter-productive.

Elderly patients, particularly those with low cognitive ability, often make poor decisions—or no decisions at all—when faced with an overwhelming number of complex insurance choices. Ironically, those with impaired cognition may benefit most from the more generous coverage often offered by Medicare Advantage plans.

"We are providing the most complex insurance choices to the very population that is least equipped to make these high-stakes decisions," says J. Michael McWilliams, assistant professor of health care policy and medicine at Harvard Medical School and a practicing general internist in the Division of General Medicine at Brigham and Women's Hospital. "Most other Americans choose from just a few health plans, but elderly Medicare beneficiaries often have to sift through dozens of options."

The study will appear online August 18 in the journal Health Affairs. It will also appear in the September print edition of Health Affairs.

The Medicare Modernization Act of 2003 initiated a series of payment increases to the Medicare Advantage program. These payment hikes dramatically increased the number of private plans participating in the program and encouraged plans to compete for enrollees by offering lower premiums and more generous benefits, such as prescription drug coverage.

In order to examine the effects of these expanded choices and benefits of enrollment in Medicare Advantage versus traditional Medicare, McWilliams and his team looked at 21,815 enrollment decisions from 2004 to 2007 made by 6,672 participants in a national longitudinal survey, and compared enrollment decisions between participants with different cognition levels and different plan offerings in their area.

The researchers found that, on average, an increase in the number of plans was associated with increased Medicare Advantage enrollment, provided the number of available plan options was fewer than 15. When the number of options surpassed 30, as it did in 25 percent of U.S. counties, such increases were actually associated with decreased enrollment. More importantly, beneficiaries with low cognitive function were substantially less likely than their peers with high cognitive function to appreciate the advantages offered by these plans, choosing to remain in the traditional Medicare program instead.

The authors suggest the reason for lower enrollment could be that beneficiaries became overwhelmed and chose traditional Medicare by default. Furthermore, elderly Medicare beneficiaries with limited cognitive abilities may have difficulty identifying the most valuable option from a complex set of Medicare alternatives. This is particularly concerning given the high and rising prevalence of cognitive impairment and dementia in the aging Medicare population.

The findings also have important policy implications as health insurance exchanges are established under the recent national health reform legislation, the Affordable Care Act. These exchanges, the authors say, could be helpful to seniors and the Medicare program if expanded to handle enrollment in Medicare Advantage plans.

"Efforts to limit choice and guide seniors to the most valuable options could especially benefit those with cognitive impairments, who without more help appear to be leaving money on the table," McWilliams said. "Better enrollment decisions could in turn strengthen competition by rewarding high-value plans with more enrollees."

This research was funded by the Beeson Career Development Award Program, National Institute on Aging and American Federation for Aging Research.

Full citation

Health Affairs, online release August 18, 2011
"Cognitive Functioning and Choice between Traditional Medicare and Medicare Advantage"

McWilliams JM (1,2), Afendulis CC (1), McGuire TG (1), Landon BE (1,3)

1- Department of Health Care Policy, Harvard Medical School, Boston, MA.
2- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA.

3- Division of General Internal Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA

Harvard Medical School http://hms.harvard.edu has more than 7,500 full-time faculty working in 11 academic departments located at the School's Boston campus or in one of 47 hospital-based clinical departments at 17 Harvard-affiliated teaching hospitals and research institutes. Those affiliates include Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Cambridge Health Alliance, Children's Hospital Boston, Dana-Farber Cancer Institute, Forsyth Institute, Harvard Pilgrim Health Care, Hebrew SeniorLife, Joslin Diabetes Center, Judge Baker Children's Center, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, McLean Hospital, Mount Auburn Hospital, Schepens Eye Research Institute, Spaulding Rehabilitation Hospital, and VA Boston Healthcare System.

David Cameron | EurekAlert!
Further information:
http://www.hms.harvard.edu

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Fighting drug resistant tuberculosis – InfectoGnostics meets MYCO-NET² partners in Peru

28.04.2017 | Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

 
Latest News

Wireless power can drive tiny electronic devices in the GI tract

28.04.2017 | Medical Engineering

Ice cave in Transylvania yields window into region's past

28.04.2017 | Earth Sciences

Nose2Brain – Better Therapy for Multiple Sclerosis

28.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>