Evidence map›Paper›PMID 39418023›Full record

ArticleJAMA network open2024

Vertical Integration and Care Experiences Among Medicare Advantage Beneficiaries.

Geronimo Bejarano, Andrew Ryan, Amal Trivedi, David J Meyers

Abstract read
In one paragraph

Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Geronimo BejaranoDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
Andrew RyanDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
Amal TrivediDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
David J MeyersDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.

Funding

TRAINing in Aging Health & Health Services for Alzheimer's Disease and Related Dementias (TRAIN-ADRD)T32AG023482 · NIA · BROWN UNIVERSITY · PI Vincent Mor, Theresa I. Shireman · 2004 to 2026
$3.0M
NIA NIH HHS T32 AG023482
6 · The paper itself

Abstract

Importance: Medicare Advantage (MA) beneficiaries are increasingly enrolling in integrated MA plans. Legacy-integrated plans share unique features that may differ from newer integrated MA plans. It is unclear whether integrated and legacy-integrated MA plans are associated with a better beneficiary care experience compared with non-legacy-integrated and nonintegrated MA plans. Objective: To assess whether enrollment in integrated, legacy-integrated, non-legacy-integrated, and nonintegrated MA plans is associated with better beneficiary care experiences. Design, Setting, and Participants: This cross-sectional study included MA beneficiaries who responded to Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys conducted annually between 2015 and 2019. Data analysis was performed between October 1, 2023, and July 31, 2024. Exposure: Medicare Advantage plan integration status, categorized as integrated, legacy-integrated, non-legacy-integrated, and nonintegrated. Main Outcomes and Measures: The CAHPS surveys assessed 9 care experience measures. To assess differences in care experience measures, mixed linear regression analyses were performed, adjusting for demographic characteristics, plan random effects, and state fixed effects. Results: The sample consisted of 857 695 respondents. Their mean (SD) age was 72.6 (10.3) years, and 58.1% were women. A total of 12.7% of respondents were Black, 10.7% were Hispanic, and 71.0% were White. Compared with respondents in nonintegrated MA plans, respondents in integrated MA plans were younger (mean [SD] age, 72.7 [10.3] vs 72.2 [10.3] years, respectively) and were less likely to be Black (13.1% vs 11.2%, respectively), female (58.4% vs 57.2%, respectively), and partially dual eligible (8.7% vs 6.2%, respectively). Integrated MA plans were associated with meaningfully better mean ratings only of customer service (1.6 points [95% CI, 1.1-2.1]) and health plan (1.0 points [95% CI, 0.6-1.5]) compared with nonintegrated MA plans. Legacy-integrated MA plans were associated with meaningfully better mean ratings of drug plan (3.7 points [95% CI, 2.4-5.0]), health plan (3.1 points [95% CI, 1.7-4.5]), customer service (2.8 points [95% CI, 1.3-4.4]), getting appointments and care quickly (2.6 points [95% CI, 1.2-4.0]), health care quality (1.9 points [95% CI, 1.0-2.7]), physicians who communicate well (1.1 points [95% CI, 0.4-1.8]), and care coordination (1.1 points [95% CI, 0.4-1.9]) compared with nonintegrated MA plans. Conclusions and Relevance: In this study, integrated MA plans were not associated with better beneficiary care experiences compared with nonintegrated MA plans. Legacy-integrated MA plans were associated with higher ratings on all care experience measures compared with both non-legacy-integrated and nonintegrated MA plans. Monitoring of integrated MA plans is needed to assess whether they are adding meaningful value to MA beneficiaries and to determine their effects on the health care system.

Indexed as

Medicare Part CAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleMiddle AgedPatient SatisfactionUnited States

Identifiers

PMID39418023
PMCPMC11581604

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.