Cardiovascular Risk Factor Management in Medicare Advantage and Traditional Medicare

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Cardiovascular disease is a leading cause of death among Medicare beneficiaries.
• Management of modifiable cardiovascular risk factors remains suboptimal.
• Medicare Advantage (MA) enrollment is increasing, necessitating an understanding of its quality of care.

Purpose of the Study:

• To compare cardiovascular risk factor management between Medicare Advantage (MA) and traditional Medicare (TM) beneficiaries.
• To evaluate treatment and control rates for hypertension, diabetes, and hyperlipidemia in MA versus TM enrollees.
• To assess the quality of care for cardiovascular risk factors in an expanding MA population.

Main Methods:

• Linked National Health and Nutrition Examination Survey (2015-2018) data with Medicare enrollment data.
• Calculated age- and sex-standardized differences in treatment and control rates for hypertension, diabetes, and hyperlipidemia.
• Utilized National Health and Nutrition Examination Survey weights for nationally representative estimates in adults aged 65+.

Main Results:

• Analyzed 45,426,712 adults (34.4% MA, 65.6% TM).
• Found no significant differences in treatment rates for hypertension, hyperlipidemia, or diabetes between MA and TM beneficiaries.
• Observed similar control rates for hypertension, hyperlipidemia, and diabetes across both MA and TM groups.

Conclusions:

• Treatment and control rates for key cardiovascular risk factors are comparable between MA and TM beneficiaries.
• Despite increased MA enrollment, quality of cardiovascular risk factor management appears consistent across MA and TM.
• Further research may explore reasons for suboptimal risk factor management across all Medicare beneficiaries.