Medicare Advantage and its Impact on Oral Health Equity among Older Adults

医疗保险优势及其对老年人口腔健康公平的影响

• 批准号: 10661151
• 负责人: DARIEN JEROME Weatherspoon
• 金额: $ 19.31万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-16 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10661151
• 关键词: Accounting; African American; Age; Alternative Health; Behavioral Model; Black race; Characteristics; Chronic Disease; Congresses; County; Data; Dental; Dental Care; Dental caries; Dentition; Disparity; Elderly; Eligibility Determination; Emergency Situation; Enrollment; Equity; Ethnic Origin; Face; Fee-for-Service Plans; Goals; Health; Health Services; Health trends; Healthcare; Hearing; High Prevalence; Hispanic; Hospitals; Income; Individual; Insurance; Intervention; Low income; Marketing; Measures; Medical; Medicare; Minority; Mouth Diseases; Oral health; Penetration; Periodontal Diseases; Personal Satisfaction; Pharmaceutical Preparations; Policies; Population; Predisposition; Preventive; Privatization; Provider; Race; Research; Retirement; Socioeconomic Status; Time; Tooth Loss; Tooth structure; Underserved Population; United States; Vision; Xerostomia; beneficiary; community intervention; community-level factor; demographics; economic disparity; edentulism; ethnic minority; experience; health care availability; health care service; health disparity; health equity; health plan; health service use; improved; low socioeconomic status; novel; programs; racial minority; satisfaction; socioeconomic disadvantage

Project Summary/Abstract Despite the great need for oral healthcare access, many older adults rely on traditional fee -for-service (FFS) Medicare, which does not provide routine dental benefits. The need for oral healthcare services is especially critical for older adults who are racial/ethnic minorities and those who are economically-disadvantaged, as these groups display significantly poorer oral health than their counterparts. Medicare Advantage (MA) health plans are available to U.S. seniors as an alternative to FFS Medicare health plans. MA plans offer access to more comprehensive dental benefits than traditional FFS Medicare, and individuals from underserved backgrounds are enrolling in MA at higher rates than other demographics. Therefore, MA coverage could help facilitate oral health equity among the Medicare-eligible older adult population. Our analyses in this timely, exploratory study will help to determine if there is in fact equity in access to and utilization of oral health services among all demographics of MA enrollees. We will conduct the following aims: Aim 1. Estimate whether traditionally underserved groups, compared to their counterparts, are less likely to have dental coverage in their Medicare Advantage (MA) plans; are less likely to use dental services if covered; and are more likely to receive emergency dental care and receive dental care in a non-dental setting if using covered dental services; Aim 2. Estimate disparities in MA dental coverage, MA covered dental use conditional on MA dental coverage, and emergency dental care and type of dental setting conditional on MA covered dental use after controlling for community-level factors, including among others: county-level measures for the penetration of MA coverage among eligibles, the concentration of MA dental coverage among MA enrollees by race/ethnicity and income, and the market supply of dental providers. The study results will be directly relevant to current, national-level policy decisions around how to improve oral health access to the Medicare population, particularly among underserved groups.

项目摘要/摘要 尽管非常需要口腔医疗保健访问，但许多老年人依靠传统费用服务（FFS） Medicare，不提供常规的牙科福利。尤其是对口腔医疗服务的需求 对于种族/少数族裔和经济偏爱的老年人至关重要，如 这些组的口腔健康表现出明显差的口腔健康。 Medicare Advantage（MA）健康 美国老年人可以使用计划，以替代FFS Medicare健康计划。 MA计划可访问 比传统的FFS Medicare更全面的牙科福利，以及服务不足的人 与其他人口统计相比，背景以高率招收MA。因此，MA覆盖范围可能会有所帮助 促进符合医疗保险资格的老年人的口腔健康平衡。我们及时的分析 探索性研究将有助于确定实际上是否有获得和利用口腔健康的权益 MA参与者的所有人口统计。我们将执行以下目标：目标1。估计 与同行相比，传统上服务不足的群体是否不太可能 他们的Medicare Advantage（MA）计划的牙科覆盖范围；如果 覆盖；并且更有可能接受紧急牙科护理并在非牙科中接受牙科护理 设置如果使用覆盖的牙科服务；目标2。马萨诸塞州牙科的估计差异，马萨诸塞州 有条件的牙齿覆盖有条件，以及紧急牙科护理和牙科类型 控制社区级别的因素，包括 除其他外：县级的措施渗透了MA覆盖范围， 通过种族/种族和收入，MA参与者之间的MA牙科覆盖率集中 牙科提供者的市场供应。研究结果将与当前的国家级政策直接相关 围绕如何改善对医疗保险人群的口腔健康的决定，尤其是在 服务不足的组。