دورية أكاديمية
Telehealth Infrastructure, Accountable Care Organization, and Medicare Payment for Patients with Alzheimer's Disease and Related Dementia Living in Socially Vulnerable Areas.
| العنوان: | Telehealth Infrastructure, Accountable Care Organization, and Medicare Payment for Patients with Alzheimer's Disease and Related Dementia Living in Socially Vulnerable Areas. |
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| المؤلفون: | Chen J; Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, Maryland, USA.; Department of Health Policy and Management, The Hospital And Public health interdisciPlinarY research (HAPPY) Lab, School of Public Health, University of Maryland, College Park, Maryland, USA., Maguire TK; Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, Maryland, USA.; Department of Health Policy and Management, The Hospital And Public health interdisciPlinarY research (HAPPY) Lab, School of Public Health, University of Maryland, College Park, Maryland, USA., Qi Wang M; Department of Health Policy and Management, The Hospital And Public health interdisciPlinarY research (HAPPY) Lab, School of Public Health, University of Maryland, College Park, Maryland, USA.; Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, USA. |
| المصدر: | Telemedicine journal and e-health : the official journal of the American Telemedicine Association [Telemed J E Health] 2024 Aug; Vol. 30 (8), pp. 2148-2156. Date of Electronic Publication: 2024 May 16. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 100959949 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3669 (Electronic) Linking ISSN: 15305627 NLM ISO Abbreviation: Telemed J E Health Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c2000- |
| مواضيع طبية MeSH: | Accountable Care Organizations*/economics , Accountable Care Organizations*/statistics & numerical data , Medicare*/economics , Alzheimer Disease*/economics , Alzheimer Disease*/therapy , Telemedicine*/economics , Telemedicine*/organization & administration , Dementia*/therapy , Dementia*/economics, Humans ; United States ; Aged ; Male ; Female ; Cross-Sectional Studies ; Aged, 80 and over ; Vulnerable Populations ; Fee-for-Service Plans |
| مستخلص: | Background: Structural social determinants of health have an accumulated negative impact on physical and mental health. Evidence is needed to understand whether emerging health information technology and innovative payment models can help address such structural social determinants for patients with complex health needs, such as Alzheimer's disease and related dementias (ADRD). Objective: This study aimed to test whether telehealth for care coordination and Accountable Care Organization (ACO) enrollment for residents in the most disadvantaged areas, particularly those with ADRD, was associated with reduced Medicare payment. Methods: The study used the merged data set of 2020 Centers for Medicare and Medicaid Services Medicare inpatient claims data, the Medicare Beneficiary Summary File, the Medicare Shared Savings Program ACO, the Center for Medicare and Medicaid Service's Social Vulnerability Index (SVI), and the American Hospital Annual Survey. Our study focused on community-dwelling Medicare fee-for-service beneficiaries aged 65 years and up. Cross-sectional analyses and generalized linear models (GLM) were implemented. Analyses were implemented from November 2023 to February 2024. Results: Medicare fee-for-service beneficiaries residing in SVI Q4 (i.e., the most vulnerable areas) reported significantly higher total Medicare costs and were least likely to be treated in hospitals that provided telehealth post-discharge services or have ACO affiliation. Meanwhile, the proportion of the population with ADRD was the highest in SVI Q4 compared with other SVI levels. The GLM regression results showed that hospital telehealth post-discharge infrastructure, patient ACO affiliation, SVI Q4, and ADRD were significantly associated with higher Medicare payments. However, coefficients of interaction terms among these factors were significantly negative. For example, the average interaction effect of telehealth post-discharge and ACO, SVI Q4, and ADRD on Medicare payment was -$1,766.2 (95% confidence interval: -$2,576.4 to -$976). Conclusions: Our results suggested that the combination of telehealth post-discharge and ACO financial incentives that promote care coordination is promising to reduce the Medicare cost burden among patients with ADRD living in socially vulnerable areas. |
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| معلومات مُعتمدة: | R01 AG062315 United States AG NIA NIH HHS; RF1 AG083175 United States AG NIA NIH HHS |
| فهرسة مساهمة: | Keywords: Accountable Care Organization; Alzheimer's disease and related dementias; Medicare; care coordination; health information technology; social vulnerability; structural social determinants of health; telehealth; telemedicine |
| تواريخ الأحداث: | Date Created: 20240516 Date Completed: 20240812 Latest Revision: 20240912 |
| رمز التحديث: | 20240912 |
| مُعرف محوري في PubMed: | PMC11386988 |
| DOI: | 10.1089/tmj.2024.0119 |
| PMID: | 38754136 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1556-3669 |
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| DOI: | 10.1089/tmj.2024.0119 |