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      CARE EXPERIENCES AMONG DUALLY ENROLLED OLDER ADULTS WITH CANCER: SEER-CAHPS, 2005-2013

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          Abstract

          Purpose:

          Given associations between poverty and poorer outcomes among older adults with cancer, we sought to understand the effects of dual enrollment in Medicare and Medicaid – as a marker of poverty – on self-reported care experiences among seniors diagnosed with cancer.

          Methods:

          Retrospective, observational study using cancer registry, Medicare claims, and care experience survey data (Surveillance, Epidemiology, and End Results [SEER] - Consumer Assessment of Healthcare Providers and Systems [CAHPS ®]) for a national sample of fee-for-service (FFS) and Medicare Advantage (MA) enrollees aged 65 or older. We included people with one incident primary, malignant cancer diagnosed between 2005 and 2011, surveyed within 2 years after diagnosis (n=9,800; 995 dual enrollees). Medicare CAHPS measures included 5 global ratings and 3 composite scores.

          Results:

          After adjustment for potential confounders, people with cancer histories who were dually enrolled were significantly more likely to report better experiences than nonduals on 2 measures (Medicare/their health plan: adjusted odds ratio [aOR]: 0.68, 95% confidence interval [CI]: 0.53–0.87; prescription drug plan [PDP]: aOR: 0.54, 95% CI: 0.40–0.73).

          Conclusions:

          Dual enrollees with cancer reported better experiences than Medicare-only enrollees in terms of their health plan (Medicare FFS or Medicare Advantage) and their PDP. Better ratings among dually enrolled beneficiaries suggest possible divergence between health outcomes and care experiences, warranting additional investigation.

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          Author and article information

          Journal
          9100846
          1173
          Cancer Causes Control
          Cancer Causes Control
          Cancer causes & control : CCC
          0957-5243
          1573-7225
          29 September 2019
          17 August 2019
          October 2019
          01 October 2020
          : 30
          : 10
          : 1137-1144
          Affiliations
          [1. ]RTI International, 307 Waverley Oaks Rd, Suite 101, Waltham, MA 02452
          [2. ]University of Massachusetts Medical School, 55 Lake Ave. North, Worcester, MA 01655
          [3. ]Temple University, 1301 Cecil B. Moore Ave., Philadelphia, PA 19122
          [4. ]Outcomes Research Branch, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850
          Author notes
          [* ]Corresponding author; tel: 781-434-1757; llines@ 123456rti.org .
          Author information
          http://orcid.org/0000-0002-9202-3466
          http://orcid.org/0000-0001-8514-6313
          http://orcid.org/0000-0003-2503-2191
          Article
          PMC6786484 PMC6786484 6786484 nihpa1051501
          10.1007/s10552-019-01218-7
          6786484
          31422490
          5ba021fe-0b65-41d4-86ff-10ed27f3c995
          History
          Categories
          Article

          patient experience,Medicaid,poverty,cancer,dual eligible,Medicare

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