Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemic
BackgroundThe objective of this study was to examine differences in availability and use of telehealth services among Medicare enrollees according to Alzheimer’s disease and related dementias (ADRD) status and enrollment in Medicare Advantage (MA) versus Traditional Medicare (TM) during the period s...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-02-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1346293/full |
| _version_ | 1827340952006557696 |
|---|---|
| author | Nianyang Wang Melvin Seale Jie Chen |
| author_facet | Nianyang Wang Melvin Seale Jie Chen |
| author_sort | Nianyang Wang |
| collection | DOAJ |
| description | BackgroundThe objective of this study was to examine differences in availability and use of telehealth services among Medicare enrollees according to Alzheimer’s disease and related dementias (ADRD) status and enrollment in Medicare Advantage (MA) versus Traditional Medicare (TM) during the period surrounding the COVID-19 pandemic.MethodsThis was a retrospective cross-sectional analysis of data from community-dwelling MA and TM enrollees with and without ADRD from the Medicare Current Beneficiary Survey (MCBS) Fall 2020 and Winter 2021 COVID-19 Supplement Public Use Files. We examined self-reported availability of telehealth service before and during the COVID-19 pandemic and use of telehealth services during COVID-19. We analyzed marginal effects under multivariable logistic regression.ResultsThere were 13,700 beneficiaries with full-year enrollment in MA (6,046) or TM (7,724), 518 with ADRD and 13,252 without ADRD. Telehealth availability during COVID-19 was positively associated with having a higher income (2.81 pp. [percentage points]; 95% CI: 0.57, 5.06), having internet access (7.81 pp.; 95% CI: 4.96, 10.66), and owning telehealth-related technology (3.86; 95% CI: 1.36, 6.37); it was negatively associated with being of Black Non-Hispanic ethnicity (−8.51 pp.; 95% CI: −12.31, −4.71) and living in a non-metro area (−8.94 pp.; 95% CI: −13.29, −4.59). Telehealth availability before COVID-19 was positively associated with being of Black Non-Hispanic ethnicity (9.34 pp.; 95% CI: 3.74, 14.94) and with enrollment in MA (4.72 pp.; 95% CI: 1.63, 7.82); it was negatively associated having dual-eligibility (−5.59 pp.; 95% CI: −9.91, −1.26). Telehealth use was positively associated with being of Black Non-Hispanic ethnicity (6.47 pp.; 95% CI: 2.92, 10.01); it was negatively associated with falling into the age group of 75+ years (−4.98 pp.; 95% CI: −7.27, −2.69) and with being female (−4.98 pp.; 95% CI: −7.27, −2.69).ConclusionTelehealth services were available to and used by Medicare enrollees with ADRD to a similar extent compared to their non-ADRD counterparts. Telehealth services were available to MA enrollees to a greater extent before COVID-19 but not during COVID-19, and this group did not use telehealth services more than TM enrollees during COVID-19. |
| first_indexed | 2024-03-07T21:28:50Z |
| format | Article |
| id | doaj.art-8b62a0d0d178467e84c235469582022f |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-07T21:28:50Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-8b62a0d0d178467e84c235469582022f2024-02-27T04:13:55ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-02-011210.3389/fpubh.2024.13462931346293Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemicNianyang WangMelvin SealeJie ChenBackgroundThe objective of this study was to examine differences in availability and use of telehealth services among Medicare enrollees according to Alzheimer’s disease and related dementias (ADRD) status and enrollment in Medicare Advantage (MA) versus Traditional Medicare (TM) during the period surrounding the COVID-19 pandemic.MethodsThis was a retrospective cross-sectional analysis of data from community-dwelling MA and TM enrollees with and without ADRD from the Medicare Current Beneficiary Survey (MCBS) Fall 2020 and Winter 2021 COVID-19 Supplement Public Use Files. We examined self-reported availability of telehealth service before and during the COVID-19 pandemic and use of telehealth services during COVID-19. We analyzed marginal effects under multivariable logistic regression.ResultsThere were 13,700 beneficiaries with full-year enrollment in MA (6,046) or TM (7,724), 518 with ADRD and 13,252 without ADRD. Telehealth availability during COVID-19 was positively associated with having a higher income (2.81 pp. [percentage points]; 95% CI: 0.57, 5.06), having internet access (7.81 pp.; 95% CI: 4.96, 10.66), and owning telehealth-related technology (3.86; 95% CI: 1.36, 6.37); it was negatively associated with being of Black Non-Hispanic ethnicity (−8.51 pp.; 95% CI: −12.31, −4.71) and living in a non-metro area (−8.94 pp.; 95% CI: −13.29, −4.59). Telehealth availability before COVID-19 was positively associated with being of Black Non-Hispanic ethnicity (9.34 pp.; 95% CI: 3.74, 14.94) and with enrollment in MA (4.72 pp.; 95% CI: 1.63, 7.82); it was negatively associated having dual-eligibility (−5.59 pp.; 95% CI: −9.91, −1.26). Telehealth use was positively associated with being of Black Non-Hispanic ethnicity (6.47 pp.; 95% CI: 2.92, 10.01); it was negatively associated with falling into the age group of 75+ years (−4.98 pp.; 95% CI: −7.27, −2.69) and with being female (−4.98 pp.; 95% CI: −7.27, −2.69).ConclusionTelehealth services were available to and used by Medicare enrollees with ADRD to a similar extent compared to their non-ADRD counterparts. Telehealth services were available to MA enrollees to a greater extent before COVID-19 but not during COVID-19, and this group did not use telehealth services more than TM enrollees during COVID-19.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1346293/fulltelehealthAlzheimer’s disease and related dementiasMedicare advantageCOVID-19racial disparities |
| spellingShingle | Nianyang Wang Melvin Seale Jie Chen Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemic Frontiers in Public Health telehealth Alzheimer’s disease and related dementias Medicare advantage COVID-19 racial disparities |
| title | Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemic |
| title_full | Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemic |
| title_fullStr | Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemic |
| title_full_unstemmed | Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemic |
| title_short | Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemic |
| title_sort | availability and use of telehealth services among patients with adrd enrolled in traditional medicare vs medicare advantage during the covid 19 pandemic |
| topic | telehealth Alzheimer’s disease and related dementias Medicare advantage COVID-19 racial disparities |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1346293/full |
| work_keys_str_mv | AT nianyangwang availabilityanduseoftelehealthservicesamongpatientswithadrdenrolledintraditionalmedicarevsmedicareadvantageduringthecovid19pandemic AT melvinseale availabilityanduseoftelehealthservicesamongpatientswithadrdenrolledintraditionalmedicarevsmedicareadvantageduringthecovid19pandemic AT jiechen availabilityanduseoftelehealthservicesamongpatientswithadrdenrolledintraditionalmedicarevsmedicareadvantageduringthecovid19pandemic |