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Excess CMS morbidity and FEMA declarations: Phenome Wide Association Study of Generalized Linear Model interactions
1Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, 8600 Rockville Pike, Bethesda, MD 20894, USA.
Informatics in Medicine Unlocked
|December 19, 2025
Summary
Disaster types influence healthcare utilization, with Federal Emergency Management Agency (FEMA) events affecting Centers for Medicare and Medicaid Services (CMS) service use. Specific disaster exposures can accelerate or impede seeking certain types of care.
Area of Science:
- Public Health
- Health Services Research
- Disaster Medicine
Background:
- The relationship between disaster types and clinical health outcomes is not well understood.
- The Federal Emergency Management Agency (FEMA) coordinates disaster response, while the Centers for Medicare and Medicaid Services (CMS) covers healthcare services.
- Existing data lacks clarity on how specific disaster types correlate with healthcare service utilization patterns.
Purpose of the Study:
- To investigate the associations between disaster types and clinical morbidity using CMS service utilization data.
- To analyze the impact of different disaster incident types (e.g., hurricanes, fires, terrorism) on specific CMS health phenotypes.
- To quantify the relationship between FEMA disaster declarations and CMS service utilization.
Main Methods:
- Utilized FEMA API for disaster declarations and CMS Chronic Conditions Warehouse for claims data.
- Merged FEMA and CMS data by county and month to create a detailed utilization model.
- Employed a generalized linear model to predict per-member, per-month, per-county attack rates and analyzed phenotype-disaster type interactions.
Main Results:
- Identified statistically significant associations and disassociations between specific disaster types and healthcare phenotypes.
- Observed consistent relationships between disaster types and phenotypes across various historical disaster declarations.
- Demonstrated that disaster declarations have distinct impacts on the utilization of different healthcare services.
Conclusions:
- CMS beneficiaries' healthcare-seeking behavior is statistically linked to disaster incident types.
- Federal Emergency Management Agency (FEMA) disaster exposure can both encourage and discourage specific healthcare service utilization, notably impacting STD care access.
- Future research should incorporate temporal and spatial factors like lag, lead, distance, and duration to refine association detection.
Keywords:
Covid-19Emergency Preparedness and ResponseMachine LearningMedicaidMedicarePheWASSexually Transmitted InfectionsWildfire SmokeMore Related Videos
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