ArticleAnnals of internal medicine2025
Prevalence of Chronic Medical Conditions Among Medicare Advantage and Traditional Medicare Beneficiaries.
Article in Annals of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Health Care Access and Affordability for Patients With Heart Failure in Medicare Advantage vs Traditional Medicare.Journal of cardiac failure · 2026Article
- Transcatheter Aortic Valve Replacement (TAVR) in Medicare Advantage and Medicare Fee-for-Service: Differences in Patient Characteristics, Utilization, and Outcomes.Circulation. Population health and outcomes · 2026Article
- Postpandemic Telehealth Use: Patterns and Barriers for Older Adults in the United States, 2024.American journal of public health · 2026Article
- Acute Myocardial Infarction in Medicare Beneficiaries During and After the COVID-19 Pandemic.JAMA network open · 2026Article
- Differences in the Measurement of Comorbidities Based on ICD-10-CM Coding Definitions Using Medicare Advantage Encounter Data and Fee-For-Service Claims.Medical care · 2026Article
- The importance and challenge of comparing stroke care, utilization and outcomes in Medicare Advantage and Fee-for-Service Medicare: a narrative review and vision for the future.Journal of comparative effectiveness research · 2026Review
- Cardiovascular Risk Factor Management in Medicare Advantage and Traditional Medicare.Circulation. Cardiovascular quality and outcomes · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe federal government spends billions of dollars per year on payments to Medicare Advantage (MA) plans based, in part, on beneficiaries' risk scores. Despite this, little is known about the true burden of chronic medical conditions among MA beneficiaries compared with those in fee-for-service (FFS) Medicare.
objectiveTo determine whether the prevalence of chronic medical conditions is higher among MA compared with FFS beneficiaries.
designCross-sectional.
settingPopulation based.
participantsAdults aged 65 years or older enrolled in MA or FFS Medicare. MEASUREMENTS: Using direct physical examination and laboratory data from the National Health and Nutrition Examination Survey (2015 to 2018), we compared the age- and sex-standardized prevalence of obesity, hypertension, hyperlipidemia, diabetes, and chronic kidney disease between MA and FFS beneficiaries.
resultsThe unweighted study population included 2446 respondents corresponding to a weighted total of 45 426 711 adults (34.4% MA, 65.6% FFS Medicare). The prevalence of obesity (41.1% vs. 40.6%; standardized difference [SDiff], 0.48 percentage points [pp] [95% CI, -5.2 to 6.2 pp]), hypertension (70.9% vs. 71.0%; SDiff, -0.05 pp [CI, -5.8 to 5.7 pp]), hyperlipidemia (79.4% vs. 82.3%; SDiff, -2.86 pp [CI, -7.0 to 1.3 pp]), and chronic kidney disease (19.2% vs. 22.8%; SDiff, -3.48 pp [CI, -9.2 to 2.3 pp]) was not higher among MA beneficiaries compared with FFS beneficiaries. However, the prevalence of diabetes was higher in MA (33.3% vs. 26.3%; SDiff, 7.00 pp [CI, 3.3 to 10.7 pp]). LIMITATION: Differences in the severity of specific medical conditions between groups could not be assessed.
conclusionIn this nationally representative study from 2015 to 2018, the prevalence of obesity, hypertension, hyperlipidemia, and chronic kidney disease was not higher among MA compared with FFS beneficiaries; however, the prevalence of diabetes was higher among MA beneficiaries. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute (NHLBI) and American Heart Association (AHA).
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