Background
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Better Care: by making it easier to get all of your Medicare, Medicaid and Medicare Part D services from a single health plan
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Better Value: through a care team and a care manager that works directly with you or your loved one and providers to make sure you or your loved one get needed health services
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Better Health: through flexible benefits that help you stay at home with family as long as possible [23]
Methods
Data
Statistical analysis
Dependent variables
Independent variables
Factors associated with joining HCP
Factors associated with quitting HCP
Health outcomes following HCP enrollment
Results
Joining or quitting HCP
Overall summary
Variables | Joiner | Quitter | ||||
---|---|---|---|---|---|---|
(1) Joined Prime | (2) Joined Prime | (3) Joined Prime | (4) Quit Prime | (5) Quit Prime | (6) Quit Prime | |
Age | 1.060*** (0.000740) | 1.060*** (0.000763) | 1.061*** (0.000851) | 1.000 (0.00249) | 0.999 (0.00256) | 1.000 (0.00269) |
Female | 0.984 (0.0197) | 0.972 (0.0207) | 0.963* (0.0212) | 1.240*** (0.0562) | 1.223*** (0.0575) | 1.149*** (0.0560) |
Urban | 0.733*** (0.0139) | 0.729*** (0.0145) | 0.748*** (0.0150) | 0.859*** (0.0356) | 0.868*** (0.0369) | 0.875*** (0.0376) |
Black | 1.109*** (0.0220) | 1.083*** (0.0224) | 0.997 (0.0216) | 0.846*** (0.0368) | 0.837*** (0.0373) | 0.864*** (0.0402) |
Other race | 1.503*** (0.0413) | 1.440*** (0.0427) | 1.352*** (0.0406) | 0.666*** (0.0424) | 0.715*** (0.0475) | 0.736*** (0.0494) |
CHARLSON INDEX | 0.938*** (0.00446) | 0.861*** (0.0153) | 1.060*** (0.0107) | 0.940 (0.0366) | ||
Congestive Heart Failure | 0.874*** (0.0330) | 1.028 (0.0837) | ||||
Cardiac Arrhythmias | 0.904*** (0.0253) | 1.029 (0.0612) | ||||
Valvular Disease | 1.431*** (0.0489) | 1.146* (0.0806) | ||||
Pulmonary Circulation Disorders | 0.792*** (0.0460) | 1.056 (0.128) | ||||
Peripheral Vascular Disorders | 1.311*** (0.0515) | 1.266*** (0.104) | ||||
Hypertension, Uncomplicated | 1.422*** (0.0327) | 1.006 (0.0508) | ||||
Paralysis | 0.985 (0.0875) | 1.233 (0.242) | ||||
Other Neurological Disorders | 0.726*** (0.0273) | 1.071 (0.0892) | ||||
Chronic Pulmonary Disease | 1.309*** (0.0388) | 1.239*** (0.0798) | ||||
Diabetes, Uncomplicated | 1.207*** (0.0342) | 1.322*** (0.0807) | ||||
Diabetes, Complicated | 1.196*** (0.0538) | 1.226** (0.121) | ||||
Hypothyroidism | 0.977 (0.0304) | 1.099 (0.0714) | ||||
Renal Failure | 1.121** (0.0602) | 1.395*** (0.152) | ||||
Liver Disease | 1.331*** (0.0777) | 1.203 (0.153) | ||||
Peptic Ulcer Disease Excluding Bleeding | 1.468*** (0.132) | 1.400* (0.257) | ||||
AIDS/HIV | 2.128*** (0.362) | 1.198 (0.481) | ||||
Lymphoma | 1.259* (0.163) | 1.215 (0.339) | ||||
Metastatic Cancer | 1.391** (0.204) | 1.772* (0.558) | ||||
Solid Tumor Without Metastasis | 1.786*** (0.0915) | 1.066 (0.120) | ||||
Rheumatoid Arthritis/Collagen Vascular | 1.115** (0.0577) | 1.401*** (0.149) | ||||
Coagulopathy | 0.811*** (0.0543) | 0.976 (0.143) | ||||
Obesity | 0.837*** (0.0343) | 0.807** (0.0747) | ||||
Weight Loss | 0.812*** (0.0351) | 0.858 (0.0827) | ||||
Fluid and Electrolyte Disorders | 0.699*** (0.0202) | 0.917 (0.0579) | ||||
Blood Loss Anemia | 0.914 (0.0996) | 0.896 (0.216) | ||||
Deficiency Anemia | 0.874*** (0.0407) | 1.018 (0.102) | ||||
Alcohol Abuse | 1.046 (0.0711) | 0.645** (0.114) | ||||
Drug Abuse | 0.755*** (0.0591) | 1.099 (0.192) | ||||
Psychoses | 0.900** (0.0419) | 0.928 (0.0980) | ||||
Depression | (0.0248) | 1.143* (0.0805) | ||||
Hypertension, Complicated | 0.934 (0.0415) | 0.882 (0.0776) | ||||
Constant | 0.00208*** (0.000107) | 0.00250*** (0.000133) | 0.00211*** (0.000126) | 0.333*** (0.0585) | 0.333*** (0.0608) | 0.303*** (0.0584) |
Observations | 198,597 | 170,655 | 170,655 | 13,730 | 12,614 | 12,614 |
Key health outcomes after enrolling in HCP
Variables | Avoidable ED visits | ED charges | ||
---|---|---|---|---|
(1) | (2) | (3) | (4) | |
Post | 0.00844*** (0.000890) | 0.00837*** (0.000889) | 322.1*** (10.17) | 316.7*** (9.999) |
Treatment | −0.00618*** (0.00196) | − 0.00699*** (0.00199) | −10.63 (17.65) | −5.899 (17.40) |
Post X treatment | 0.00673 (0.00465) | 0.00671 (0.00466) | 16.63 (39.78) | 56.39 (38.40) |
Age | −6.38e-05** (2.62e-05) | −7.75e-05*** (2.58e-05) | −12.76*** (0.378) | −13.07*** (0.379) |
Female | − 0.00627*** (0.000892) | − 0.00625*** (0.000903) | −21.70** (9.524) | −27.76*** (9.408) |
Urban | −0.000924 (0.000774) | 0.00255* (0.00147) | 246.8*** (8.714) | 98.32*** (20.29) |
Black | 0.0138*** (0.000809) | 0.0113*** (0.000818) | 107.8*** (9.902) | 39.95*** (9.582) |
Other race | 0.0163*** (0.00192) | 0.0147*** (0.00183) | 103.7*** (13.67) | 50.69*** (13.61) |
CHARLSON INDEX | −0.00210*** (0.000705) | − 0.00215*** (0.000708) | 102.5*** (7.442) | 91.49*** (7.341) |
Congestive Heart Failure | 0.0283*** (0.00175) | 0.0282*** (0.00175) | −50.31*** (17.13) | −20.03 (16.75) |
Cardiac Arrhythmias | 0.0120*** (0.00147) | 0.0118*** (0.00143) | 421.6*** (14.81) | 410.3*** (14.50) |
Valvular Disease | 0.00437*** (0.00156) | 0.00450*** (0.00155) | 97.62*** (19.80) | 78.02*** (19.34) |
Pulmonary Circulation Disorders | −0.00793*** (0.00235) | −0.00827*** (0.00236) | 338.5*** (36.36) | 331.8*** (35.92) |
Peripheral Vascular Disorders | −0.00373** (0.00173) | −0.00360** (0.00175) | −109.5*** (18.44) | −70.24*** (18.12) |
Hypertension, Uncomplicated | −0.00550*** (0.000833) | −0.00543*** (0.000854) | 81.86*** (9.713) | 67.28*** (9.541) |
Paralysis | −0.00320 (0.00252) | − 0.00349 (0.00253) | − 217.1*** (30.07) | −208.2*** (29.61) |
Other Neurological Disorders | −0.0118*** (0.00113) | −0.0118*** (0.00112) | 264.9*** (15.24) | 253.1*** (14.95) |
Chronic Pulmonary Disease | 0.0732*** (0.00128) | 0.0735*** (0.00129) | 117.0*** (12.97) | 127.7*** (12.75) |
Diabetes, Uncomplicated | 0.00198 (0.00128) | 0.00219* (0.00127) | −97.99*** (12.32) | −72.09*** (12.06) |
Diabetes, Complicated | 0.00225 (0.00177) | 0.00186 (0.00178) | 67.25*** (19.73) | 55.87*** (19.39) |
Hypothyroidism | −0.00399*** (0.00111) | − 0.00364*** (0.00111) | −14.52 (13.64) | 5.217 (13.41) |
Renal Failure | −0.00274 (0.00211) | − 0.00240 (0.00212) | −253.4*** (23.85) | −199.1*** (23.48) |
Liver Disease | −0.00112 (0.00198) | −0.000870 (0.00200) | −4.929 (25.74) | 52.61** (25.23) |
Peptic Ulcer Disease Excluding Bleeding | 3.80e-05 (0.00301) | 0.000122 (0.00301) | 679.1*** (62.99) | 683.4*** (62.44) |
AIDS/HIV | 0.00824 (0.00530) | 0.00789 (0.00534) | − 480.7*** (62.79) | − 461.0*** (61.70) |
Lymphoma | −0.0122*** (0.00349) | −0.0126*** (0.00352) | −189.0*** (54.04) | − 154.1*** (53.11) |
Metastatic Cancer | 0.00144 (0.00485) | 0.00159 (0.00489) | − 509.1*** (59.03) | − 436.3*** (58.17) |
Solid Tumor Without Metastasis | −0.00705*** (0.00211) | − 0.00725*** (0.00212) | − 241.3*** (23.76) | −232.8*** (23.46) |
Rheumatoid Arthritis/Collagen Vascular | −0.00850*** (0.00154) | −0.00859*** (0.00154) | 92.71*** (23.76) | 112.1*** (23.34) |
Coagulopathy | −0.00653*** (0.00209) | −0.00644*** (0.00207) | 122.6*** (32.15) | 113.1*** (31.68) |
Obesity | 0.0105*** (0.00127) | 0.0107*** (0.00127) | 107.9*** (15.47) | 110.5*** (15.17) |
Weight Loss | −0.00629*** (0.00149) | −0.00661*** (0.00150) | −63.30*** (20.03) | −59.96*** (19.78) |
Fluid and Electrolyte Disorders | 0.00810*** (0.00127) | 0.00840*** (0.00127) | 562.3*** (14.28) | 549.7*** (14.06) |
Blood Loss Anemia | − 0.00294 (0.00354) | − 0.00289 (0.00354) | 13.07 (59.89) | 0.0154 (58.85) |
Deficiency Anemia | 0.00108 (0.00166) | 0.000522 (0.00166) | 171.1*** (25.74) | 181.0*** (25.37) |
Alcohol Abuse | −0.000863 (0.00238) | −0.00112 (0.00240) | 65.46** (28.96) | 56.10** (28.59) |
Drug Abuse | 0.0121*** (0.00285) | 0.0124*** (0.00285) | 1044*** (33.54) | 1064*** (33.19) |
Psychoses | −0.00443* (0.00229) | − 0.00456** (0.00229) | 232.5*** (19.44) | 223.4*** (19.29) |
Depression | −0.00645*** (0.00107) | −0.00605*** (0.00107) | 241.2*** (12.74) | 259.4*** (12.54) |
Hypertension, Complicated | −0.00166 (0.00166) | − 0.00220 (0.00166) | 8.475 (19.42) | −39.21** (19.36) |
Constant | 0.0119*** (0.00183) | 0.0125*** (0.00424) | 1897*** (20.67) | 1037*** (30.23) |
Observations | 447,867 | 447,851 | 447,867 | 447,851 |
R-squared | 0.022 | 0.023 | 0.061 | 0.092 |
Variables | Avoidable Hospitalization | LOS | Total Charges | SNF placement | ||||
---|---|---|---|---|---|---|---|---|
(1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | |
Post | 0.0144*** (0.00282) | 0.0145*** (0.00282) | − 0.229*** (0.0799) | −0.228*** (0.0799) | 3839*** (429.2) | 3947*** (425.4) | 0.0242*** (0.00242) | 0.0238*** (0.00242) |
Treatment | −0.0202** (0.00864) | −0.0141 (0.00865) | − 0.862*** (0.242) | − 0.955*** (0.244) | − 2651** (1142) | − 3090*** (1144) | −0.148*** (0.00686) | − 0.151*** (0.00686) |
Post X treatment | 0.0410** (0.0169) | 0.0429** (0.0169) | 1.111** (0.464) | 1.183** (0.464) | 555.1 (2251) | 1232 (2233) | 0.00161 (0.0132) | −0.00180 (0.0131) |
Age | 0.00189*** (9.25e-05) | 0.00188*** (9.23e-05) | −0.00395 (0.00262) | − 0.00427 (0.00262) | − 288.1*** (13.83) | − 280.9*** (13.77) | 0.00999*** (7.39e-05) | 0.00996*** (7.39e-05) |
Female | −0.000219 (0.00280) | − 0.000956 (0.00280) | − 0.494*** (0.0828) | − 0.511*** (0.0828) | − 5962*** (444.9) | − 6007*** (442.0) | −0.0100*** (0.00239) | − 0.00991*** (0.00238) |
Urban | −0.0205*** (0.00285) | −0.00817 (0.00587) | 0.321*** (0.0787) | 0.166 (0.177) | 4842*** (405.4) | 1476* (894.4) | 0.0170*** (0.00241) | 0.00633 (0.00570) |
Black | 0.0160*** (0.00284) | 0.0204*** (0.00296) | 0.743*** (0.0841) | 0.360*** (0.0875) | −543.1 (436.2) | − 1075** (457.6) | −0.0448*** (0.00251) | − 0.0403*** (0.00263) |
Other race | 0.0153*** (0.00432) | 0.0200*** (0.00433) | 0.360*** (0.125) | 0.105 (0.126) | − 2025*** (639.8) | − 2436*** (644.3) | − 0.0654*** (0.00324) | − 0.0620*** (0.00328) |
CHARLSON INDEX | −0.0186*** (0.00179) | − 0.0186*** (0.00179) | 0.142*** (0.0516) | 0.131** (0.0517) | 492.7* (265.6) | 514.4* (263.9) | 0.0217*** (0.00159) | 0.0220*** (0.00159) |
Congestive Heart Failure | 0.167*** (0.00403) | 0.165*** (0.00404) | 0.426*** (0.111) | 0.468*** (0.111) | 2853*** (568.9) | 3003*** (565.1) | − 0.00589* (0.00343) | − 0.00788** (0.00343) |
Cardiac Arrhythmias | 0.00692** (0.00316) | 0.00775** (0.00316) | 0.683*** (0.0910) | 0.649*** (0.0911) | 4010*** (479.1) | 4246*** (476.3) | − 0.00259 (0.00264) | − 0.00140 (0.00264) |
Valvular Disease | 0.00399 (0.00423) | 0.00646 (0.00427) | 0.246** (0.112) | 0.158 (0.113) | 7466*** (657.9) | 5418*** (658.6) | −0.0273*** (0.00342) | − 0.0210*** (0.00346) |
Pulmonary Circulation Disorders | 0.00458 (0.00528) | 0.00909* (0.00528) | 1.088*** (0.136) | 1.004*** (0.136) | 4817*** (754.0) | 5205*** (746.7) | 0.0211*** (0.00408) | 0.0187*** (0.00408) |
Peripheral Vascular Disorders | −0.00981** (0.00459) | − 0.00918** (0.00458) | 0.289** (0.127) | 0.302** (0.128) | 8542*** (716.2) | 8862*** (711.6) | −0.0220*** (0.00394) | − 0.0230*** (0.00394) |
Hypertension, Uncomplicated | −0.00244 (0.00291) | − 0.00434 (0.00291) | −1.182*** (0.0902) | −1.141*** (0.0903) | − 4543*** (474.4) | − 4725*** (471.5) | −0.0648*** (0.00265) | − 0.0643*** (0.00266) |
Paralysis | −0.0115* (0.00693) | − 0.0124* (0.00690) | 1.758*** (0.246) | 1.785*** (0.246) | 6502*** (1242) | 6439*** (1235) | 0.0551*** (0.00690) | 0.0553*** (0.00689) |
Other Neurological Disorders | −0.0377*** (0.00330) | −0.0340*** (0.00329) | 1.101*** (0.103) | 1.084*** (0.104) | 4892*** (529.1) | 4664*** (527.5) | 0.112*** (0.00313) | 0.109*** (0.00313) |
Chronic Pulmonary Disease | 0.138*** (0.00340) | 0.136*** (0.00340) | −0.698*** (0.0948) | −0.606*** (0.0949) | − 852.2* (497.6) | − 677.7 (494.4) | − 0.0827*** (0.00286) | − 0.0834*** (0.00286) |
Diabetes, Uncomplicated | 0.0653*** (0.00347) | 0.0656*** (0.00347) | −0.252** (0.101) | −0.249** (0.101) | 1735*** (521.1) | 1165** (517.7) | − 0.0182*** (0.00309) | − 0.0183*** (0.00309) |
Diabetes, Complicated | 0.162*** (0.00514) | 0.161*** (0.00513) | 0.520*** (0.138) | 0.495*** (0.138) | − 1026 (722.3) | −550.3 (717.1) | − 0.0155*** (0.00430) | − 0.0155*** (0.00429) |
Hypothyroidism | −0.0167*** (0.00386) | − 0.0167*** (0.00385) | − 0.188* (0.106) | − 0.142 (0.106) | − 1470*** (536.4) | − 1625*** (531.5) | 0.000919 (0.00335) | 0.000201 (0.00334) |
Renal Failure | 0.0993*** (0.00628) | 0.0979*** (0.00627) | 0.744*** (0.173) | 0.828*** (0.173) | 5868*** (954.6) | 5843*** (949.4) | −0.0295*** (0.00537) | − 0.0297*** (0.00537) |
Liver Disease | −0.00479 (0.00582) | −0.00413 (0.00581) | 0.0679 (0.176) | 0.171 (0.177) | 1089 (946.3) | 2005** (943.8) | − 0.0634*** (0.00441) | −0.0653*** (0.00442) |
Peptic Ulcer Disease Excluding Bleeding | −0.0223*** (0.00845) | − 0.0197** (0.00844) | 0.350 (0.259) | 0.361 (0.259) | 2312 (1616) | 2188 (1611) | −0.0489*** (0.00700) | − 0.0511*** (0.00698) |
AIDS/HIV | 0.0467*** (0.0150) | 0.0495*** (0.0150) | −0.344 (0.485) | − 0.421 (0.485) | 1731 (2776) | 1425 (2761) | − 0.132*** (0.0122) | − 0.132*** (0.0122) |
Lymphoma | 0.0191 (0.0126) | 0.0225* (0.0126) | 1.472*** (0.373) | 1.512*** (0.372) | 9788*** (2084) | 10,119*** (2074) | −0.0813*** (0.0101) | −0.0810*** (0.0100) |
Metastatic Cancer | 0.0446*** (0.0131) | 0.0457*** (0.0131) | −0.519 (0.398) | −0.492 (0.399) | − 3457* (2065) | − 3342 (2049) | −0.177*** (0.0116) | − 0.178*** (0.0116) |
Solid Tumor Without Metastasis | 0.00197 (0.00618) | 0.00247 (0.00618) | 0.101 (0.178) | 0.104 (0.178) | 4479*** (961.6) | 4363*** (952.8) | −0.103*** (0.00516) | −0.104*** (0.00516) |
Rheumatoid Arthritis/Collagen Vascular | −0.0297*** (0.00545) | −0.0287*** (0.00545) | − 0.397*** (0.151) | −0.374** (0.151) | 673.3 (829.7) | 806.4 (824.9) | −0.0225*** (0.00441) | −0.0204*** (0.00441) |
Coagulopathy | −0.0331*** (0.00515) | − 0.0349*** (0.00514) | 0.782*** (0.156) | 0.730*** (0.156) | 6034*** (830.9) | 6450*** (826.5) | −0.00367 (0.00438) | − 0.00422 (0.00438) |
Obesity | −0.0112*** (0.00390) | −0.0112*** (0.00390) | − 0.445*** (0.100) | −0.455*** (0.100) | − 869.6 (553.6) | 90.22 (550.6) | − 0.00462 (0.00285) | − 0.00625** (0.00285) |
Weight Loss | 0.00249 (0.00425) | 0.00491 (0.00425) | 2.612*** (0.136) | 2.569*** (0.136) | 13,957*** (733.5) | 14,321*** (728.8) | 0.0763*** (0.00392) | 0.0773*** (0.00392) |
Fluid and Electrolyte Disorders | 0.0684*** (0.00285) | 0.0649*** (0.00286) | 0.309*** (0.0809) | 0.357*** (0.0810) | −491.2 (425.9) | −690.2 (423.4) | 0.0142*** (0.00241) | 0.0149*** (0.00241) |
Blood Loss Anemia | −0.0704*** (0.00933) | −0.0741*** (0.00932) | 0.448* (0.263) | 0.545** (0.262) | 4827*** (1443) | 4920*** (1425) | 0.00792 (0.00828) | 0.00764 (0.00826) |
Deficiency Anemia | 0.00181 (0.00465) | 0.00234 (0.00463) | 0.263** (0.129) | 0.237* (0.129) | − 737.3 (659.8) | −22.50 (655.8) | 0.0101*** (0.00373) | 0.00913** (0.00373) |
Alcohol Abuse | −0.0465*** (0.00541) | −0.0457*** (0.00540) | −0.533*** (0.170) | −0.576*** (0.170) | − 5492*** (852.2) | − 5410*** (848.0) | −0.0446*** (0.00403) | − 0.0440*** (0.00403) |
Drug Abuse | 0.0249*** (0.00560) | 0.0258*** (0.00559) | 0.101 (0.156) | 0.126 (0.156) | − 4140*** (771.4) | − 3867*** (765.0) | −0.0451*** (0.00318) | −0.0440*** (0.00318) |
Psychoses | −0.0310*** (0.00455) | − 0.0299*** (0.00455) | 2.708*** (0.167) | 2.616*** (0.167) | − 4081*** (674.3) | − 3745*** (672.4) | 0.0630*** (0.00418) | 0.0619*** (0.00418) |
Depression | −0.00661** (0.00328) | −0.00401 (0.00328) | − 0.307*** (0.0923) | −0.274*** (0.0928) | − 3703*** (479.4) | − 3587*** (478.0) | 0.0330*** (0.00270) | 0.0304*** (0.00271) |
Hypertension, Complicated | 0.00145 (0.00536) | 0.00527 (0.00536) | −0.348** (0.141) | −0.414*** (0.142) | − 3307*** (793.5) | − 3350*** (789.7) | −0.0227*** (0.00447) | − 0.0230*** (0.00447) |
Constant | 0.0885*** (0.00658) | 0.0355** (0.0163) | 8.463*** (0.194) | 8.215*** (0.574) | 76,682*** (1067) | 66,435*** (2507) | −0.323*** (0.00504) | −0.364*** (0.0141) |
Observations | 199,649 | 199,643 | 199,649 | 199,643 | 199,649 | 199,643 | 199,649 | 199,643 |
R-squared | 0.073 | 0.078 | 0.015 | 0.018 | 0.019 | 0.036 | 0.123 | 0.127 |