Evidence map›Paper›PMID 39982721›Full record

ArticleJAMA network open2025

Outcomes for Dual-Eligible Beneficiaries With Dementia in Special Needs Plans and Other Medicare Advantage Plans.

Wendy Xu, Eli Raver, Caroline Carlin, Roger Feldman, Sheldon M Retchin, Jeah Jung

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
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

6 authors.

Wendy XuDivision of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus.
Eli RaverDivision of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus.
Caroline CarlinDepartment of Family Medicine and Community Health, School of Medicine, University of Minnesota, Twin Cities.
Roger FeldmanDivision of Health Policy and Management, School of Public Health, University of Minnesota, Twin Cities.
Sheldon M RetchinDivision of General Internal Medicine, College of Medicine, The Ohio State University, Columbus.
Jeah JungDepartment of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, Virginia.

Funding

Resource Use and Quality of Care in Medicare AdvantageR01AG069352 · NIA · PENNSYLVANIA STATE UNIVERSITY, THE · PI JUNG, JEAH · 2020 to 2023
$2.7M
NIA NIH HHS R01 AG069352
6 · The paper itself

Abstract

Importance: Alzheimer disease and related dementias (ADRD) are especially prevalent among Medicare-Medicaid dual-eligible beneficiaries-the clinical complexity of ADRD amplifies the challenges of managing chronic conditions and accessing care for dual-eligible beneficiaries, and the need to navigate the fragmented Medicare-Medicaid benefits adds to patients' burdens. Little is known about how enrollment in dual-eligible special needs plans (D-SNPs) that coordinate Medicare and Medicaid coverage is associated with health outcomes for dual-eligible beneficiaries with ADRD. Objective: To examine the associations between Medicare Advantage (MA) plan type and adverse medical events among dual-eligible beneficiaries with ADRD. Design, Setting, and Participants: This cross-sectional analysis used MA encounter data from 2016 to 2019. Participants included dual-eligible, community-dwelling Medicare beneficiaries aged 65 years and older with ADRD who enrolled in MA plans in 50 US states and Washington, DC. Data were analyzed from January to November 2024. Exposures: Enrollment in non-D-SNP Medicare Advantage plans and D-SNPs. The exposure variable for additional analyses included enrollment in fully integrated special needs plans (FIDE SNPs). Main Outcomes and Measures: Preventable hospitalizations, 30-day all-cause readmissions, and avoidable emergency department (ED) visits. Results: Analysis included a total of 121 145 patients in non-D-SNP plans with an enrollment of 173 662 patient-years (mean [SD] age, 81.8 [7.8] years; 122 565 female [70.6%]; 6078 Asian [3.5%], 34 150 Black [19.7%], 37 580 Hispanic [21.6%], 95 854 White [55.2%]) and 78 166 patients in D-SNP plans with an enrollment of 122 681 patient-years (mean [SD] age, 80.2 [8.0] years; 87 329 female [71.2%]; 10 530 Asian [8.6%], 33 280 Black [27.1%], 43 294 Hispanic [35.3%], 35 577 White [29.0%]). Dual-eligible enrollees with ADRD had a preventable hospitalization rate of 10.8% (95% CI, 10.3%-11.4%), a 30-day readmission rate of 22.3% (95% CI, 21.6%-22.9%), and an avoidable ED visit rate of 21.1% (95% CI, 20.3-21.9) in D-SNPs. These rates were 11.1% (95% CI, 10.7%-11.5%), 23.6% (95% CI, 22.9%-24.3%), and 20.8% (95% CI, 20.1%-21.6%) in non-D-SNP MA plans. There were no statistical differences in rates of preventable hospitalizations or avoidable ED visits between dual-eligible enrollees with ADRD in D-SNPs and those in non-D-SNP MA plans. Compared with non-D-SNPs, enrollees in FIDE SNPs had lower probabilities of preventable hospitalizations by 1.2 percentage points (95% CI, -2.7 to -0.2 percentage points) and 30-day readmissions by 7.2 percentage points (95% CI, -9.3 to -5.1 percentage points). Conclusions and Relevance: Dual-eligible beneficiaries with ADRD enrolled in D-SNPs and non-D-SNP MA plans had similar rates of adverse events. Dual-eligible beneficiaries with ADRD may benefit from enrollment in more coordinated MA plans, such as FIDE SNPs, by lowering unnecessary hospitalizations.

Indexed as

DementiaDual Medicare Medicaid EligibilityMedicare Part CAgedAged, 80 and overCross-Sectional StudiesFemaleHospitalizationHumansMaleMedicaidMedicareUnited States

Identifiers

PMID39982721
PMCPMC11846004

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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.