Scientists from the University of Pittsburgh found that diabetes patients on Medicare Advantage plans are more likely to have worse health.
While these patients are more likely to receive preventive treatments, they were less likely to be prescribed newer, more expensive medications and were more likely to have higher blood pressure and worse blood glucose control than patients on Medicare Fee-For-Service plans.
The research is published in Diabetes Care and was conducted by Utibe Essien et al.
Diabetes is reported in 1 in 5 Medicare beneficiaries age 65 and older and is associated with over 60% higher out-of-pocket prescription costs compared to those without diabetes.
In the study, researchers used data from more than 5,000 clinicians who participate in The Diabetes Collaborative Registry to study nearly 350,000 patients with Type 2 diabetes, aged 65 or older, on Medicare Advantage or Medicare Fee-For-Service plans.
The team found that patients with Medicare Advantage were more likely to receive preventive treatments, such as tobacco cessation, foot care and other screenings.
However, patients on Medicare Advantage plans were also more likely to have higher blood pressure and poorer diabetes control and were less likely to receive newer, evidence-based medications than their counterparts on Medicare Fee-For-Service plans.
Medicare Advantage uses a variety of strategies to mitigate the cost of care, including limiting access to newer and more expensive medications.
Older generic diabetes medications, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), were appropriately prescribed to the Medicare Advantage beneficiaries.
But when it came to newer, more expensive medications, such as glucagon-like peptide-1 receptor agonists (GLP-1RA) or sodium/glucose cotransporter-2 inhibitors (SGLT2i), there is a clear drop in Medicare Advantage enrollees getting those medications.
The study raises a red flag that—despite improving access to preventive care—the rapid growth in Medicare Advantage enrollees may foreshadow a trend toward poorer health outcomes and disparities in care.
The researchers hope that these findings can help fine-tune the Medicare Advantage program, allowing patients to access the care and treatments they need while keeping costs and health care utilization low.
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