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51/100

✓ Peer-reviewed alzhub usefulness score 51 out of 100. Health systems and care delivery

Topic: Risk, prevention and care in population studies

The 32 796 872 Medicare beneficiaries in the cohort had a mean (SD) age of 74.0 (12.5) years and included 18 228 513 females (55.6%). Enrollment in Medicare Advantage among beneficiaries with ADRD increased from 24.7% (95% CI, 24.7%-24.8%) in 2013 to 33.0% (95% CI, 32.9%-33.1%) in 2018, an absolute increase of 8.3 percentage points and a 33.4% relative increase after adjusting for demographic characteristics, comorbid conditions, and utilization and including county fixed effects. Among beneficiaries without ADRD, enrollment in Medicare Advantage increased by 8.2 percentage points from 27.6% (95% CI, 27.6%-27.6%) in 2013 to 35.8% (95% CI, 35.8%-35.8%) in 2018, a 29.7% relative increase over the study period. Beneficiaries with ADRD were 1.4 times as likely to disenroll from their Medicare Advantage contract to traditional Medicare (4.4% vs 3.2% in 2017-2018; P < .001) in adjusted analyses. Regardless of ADRD status, beneficiaries had similar rates of switching to a new Medicare Advantage contract. Differences in contract exit rates were associated with higher rates of disenrollment from Medicare Advantage to traditional Medicare among beneficiaries with ADRD vs those without ADRD (16.3% [95% CI, 16.2%-16.3%] vs 15.1% [95% CI, 15.1%-15.1%]). Beneficiaries with ADRD and dual eligibility for Medicaid enrollment had higher rates of contract exit than those without dual eligibility (19.7% [95% CI, 19.6%-19.7%] vs 14.9% [95% CI, 14.8%-14.9%]), and these differences were even greater than those among beneficiaries without ADRD and with and without dual-eligibility status, respectively (18.3% [95% CI, 18.2%-18.3%] vs 13.8% [95% CI, 13.7%-13.8%]). Conclusions and Relevance: In this cross-sectional study of the Medicare population with acute and postacute care use, beneficiaries with ADRD had increasing enrollment in the Medicare Advantage program, proportional to the growth in overall enrollment, but their disenrollment from Medicare Advantage in the following year remained higher compared with beneficiaries without ADRD. The findings highlight the need to understand the factors associated with higher disenrollment rates and determine whether such rates reflect access or quality challenges for beneficiaries with ADRD.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

James, H. O., Trivedi, A. N., & Meyers, D. J. (2023). Medicare Advantage Enrollment and Disenrollment Among Persons With Alzheimer Disease and Related Dementias. JAMA Health Forum. https://doi.org/10.1001/jamahealthforum.2023.3080

Vancouver

James HO, Trivedi AN, Meyers DJ. Medicare Advantage Enrollment and Disenrollment Among Persons With Alzheimer Disease and Related Dementias. JAMA Health Forum. 2023. doi:10.1001/jamahealthforum.2023.3080. PMID: 37713210.

BibTeX

@article{james2023-37713210,
  author  = {James, Hannah O. and Trivedi, Amal N. and Meyers, David J.},
  title   = {{Medicare Advantage Enrollment and Disenrollment Among Persons With Alzheimer Disease and Related Dementias}},
  journal = {JAMA Health Forum},
  year    = {2023},
  doi     = {10.1001/jamahealthforum.2023.3080},
  pmid    = {37713210},
  url     = {https://doi.org/10.1001/jamahealthforum.2023.3080}
}

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Key findings

The 32 796 872 Medicare beneficiaries in the cohort had a mean (SD) age of 74.0 (12.5) years and included 18 228 513 females (55.6%).
Enrollment in Medicare Advantage among beneficiaries with ADRD increased from 24.7% (95% CI, 24.7%-24.8%) in 2013 to 33.0% (95% CI, 32.9%-33.1%) in 2018, an absolute increase of 8.3 percentage points and a 33.4% relative increase after adjusting for demographic characteristics, comorbid conditions, and utilization and including county fixed effects.
Among beneficiaries without ADRD, enrollment in Medicare Advantage increased by 8.2 percentage points from 27.6% (95% CI, 27.6%-27.6%) in 2013 to 35.8% (95% CI, 35.8%-35.8%) in 2018, a 29.7% relative increase over the study period.
Beneficiaries with ADRD were 1.4 times as likely to disenroll from their Medicare Advantage contract to traditional Medicare (4.4% vs 3.2% in 2017-2018; P < .001) in adjusted analyses.
Regardless of ADRD status, beneficiaries had similar rates of switching to a new Medicare Advantage contract.

Why it matters

This study found that Medicare Advantage enrollment among beneficiaries with Alzheimer disease and related dementias increased from 24.7% in 2013 to 33.0% in 2018. Beneficiaries with dementia were 1.4 times as likely to disenroll from Medicare Advantage to traditional Medicare compared to those without dementia.

Study details

Study designcross-sectional
Participants18
Effect size55.6%; 24.7%; 24.8%
Evidence strengthModerate

How this study scored 51/100

Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (JAMA Health Forum)
Journal's citation record	0 / 4	JAMA Health Forum: journal h-index 60 (OpenAlex, 2026-10-29)
Study design	4 / 12	A snapshot of people at one point in time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	3 / 5	2023 — within 6 year(s) of the newest study here
Sample size	1 / 4	18 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	3 / 7	Cited 26 times (OpenAlex, 2026-10-10)
Citations per year	2 / 5	5.2 citations a year over 5 year(s) since 2023
Impact for its field and year	3 / 6	Cited 5.3× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	2 / 4	Cited 26 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author David J. Meyers: h-index 27 (OpenAlex, whole career)
Institution's track record	1 / 3	Brown University: institution h-index 1,120 (OpenAlex)
Multi-centre collaboration	1 / 3	OpenAlex lists 2 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 37713210)
Free to read	2 / 2	Free to read
Total	51 / 100	—

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