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POLICY SERIES: INEQUITABLE IMPACTS OF POLICY AND PAYMENT CHANGES ON CARE USE AND OUTCOMES FOR OLDER ADULTS WITH HIGH CARE NEEDS
Jason R. Falvey, Amit Kumar. Innovation in Aging, 2024-12-01
Topic: Risk, prevention and care in population studies
Abstract Over the past decade, the CMS has introduced numerous value-based policy initiatives. While these changes aim to reduce cost of care, they often have disparate effects on patient care and clinical outcomes particularly among minority communities and older adults with high-needs. The first presentation explores the disproportionate impacts of Medicare Advantage (MA) penetration among skilled nursing facility (SNF) users across various racial and ethnic identities, shedding light on the disparities perpetuated within the healthcare system. Another will then examine the ramifications of the Patient-Driven Groupings Model (PDGM) on older adults with dementia receiving home care, scrutinizing the changes in care and potential impacts on outcomes associated with this shift. Following this, the discussion shifts to the inequitable access to adult day services in urban areas, particularly highlighting the barriers faced by many older adults seeking non-institutional long-term care options that are growing in number around the country. Last, the symposium will discuss findings from qualitative work exploring how neighborhood disadvantage affects community mobility and successful aging in place among older adults recovering from lower extremity surgery, and the structural inequities experienced by this population with changes to home health care benefits. We will specifically highlight factors such as community cohesion and exposures to violent crime as key deterrents for recovery among older adults living with new mobility disability. Overall, this symposium will stimulate current debate on merits and demerits of various federal policies and growth of MA plans for older adults with high-needs.
Key findings
- Another will then examine the ramifications of the Patient-Driven Groupings Model (PDGM) on older adults with dementia receiving home care, scrutinizing the changes in care and potential impacts on outcomes associated with this shift.
- Overall, this symposium will stimulate current debate on merits and demerits of various federal policies and growth of MA plans for older adults with high-needs.
Why it matters
This symposium summary describes planned talks on how Medicare policy and payment changes affect older adults with high care needs, including those with dementia receiving home care. It presents no results on treating, curing, or preventing Alzheimer's disease.
Study details
- Evidence strengthLow
How this study scored 27/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 26 of the 97 points we could judge it on, which is 27 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 0 / 6 | Cited 0.0× 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 | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Amit Kumar: h-index 16 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 26 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 26 of the 97 points we could judge it on is 27 out of 100. |
| Total | 27 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Falvey, J. R., & Kumar, A. (2024). POLICY SERIES: INEQUITABLE IMPACTS OF POLICY AND PAYMENT CHANGES ON CARE USE AND OUTCOMES FOR OLDER ADULTS WITH HIGH CARE NEEDS. Innovation in Aging. https://doi.org/10.1093/geroni/igae098.0073
Vancouver
Falvey JR, Kumar A. POLICY SERIES: INEQUITABLE IMPACTS OF POLICY AND PAYMENT CHANGES ON CARE USE AND OUTCOMES FOR OLDER ADULTS WITH HIGH CARE NEEDS. Innovation in Aging. 2024. doi:10.1093/geroni/igae098.0073.
BibTeX
@article{falvey2024-66ec12f8,
author = {Falvey, Jason R. and Kumar, Amit},
title = {{POLICY SERIES: INEQUITABLE IMPACTS OF POLICY AND PAYMENT CHANGES ON CARE USE AND OUTCOMES FOR OLDER ADULTS WITH HIGH CARE NEEDS}},
journal = {Innovation in Aging},
year = {2024},
doi = {10.1093/geroni/igae098.0073},
url = {https://doi.org/10.1093/geroni/igae098.0073}
}
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