Out-Of-Network Utilization and Plan Selection Among Medicare Advantage Cost Plan Enrollees.

Objective: To understand how Medicare Advantage (MA) networks impact utilization patterns and plan choices, using the 2019 discontinuation of MA 1876 Cost plans as a natural experiment.

Study Setting And Design: We study 1876 Cost plans, MA plans for which out-of-network care is covered through traditional Medicare (TM) and many of which CMS discontinued in 2019. We characterize the proportion of Cost plan enrollees who utilized out-of-network care in 2018 from different types of medical specialties.

Enrollment in Medicare is associated with fewer outpatient mental healthcare visits among those with mental health symptoms.

Objective: To test whether enrolling in traditional Medicare (TM) or Medicare Advantage (MA) at age 65 reduces mental healthcare utilization among individuals with mental health symptoms and low or moderate family incomes.

Study Setting And Design: We employ a fuzzy regression discontinuity design, comparing the likelihood of having an outpatient mental health visit or a psychotropic drug fill among individuals younger than or older than the age 65 Medicare eligibility threshold.

Data Sources And Analytic Sample: We analyze 2014-2021 Medical Expenditure Panel Survey data.

Neighbourhood walkability and transportation and leisure physical activity by residency status: A cross-sectional analysis of nationally representative Canadian data.

Objective: We aimed to 1) estimate the differences in transportation (TPA) and leisure physical activity (LPA) participation and duration between Canadian-born and immigrant adults, and 2) examine whether associations between neighbourhood walkability and physical activity differ by residency status.

Methods: We linked Canadian Community Health Survey (CCHS; 2017-2018) with Canadian Active Living Environment (2016) data. Participants were urban Canadian-born or immigrant adults (recent: <10 years, established: ≥10 years).

How Specialized Are Special Needs Plans? Evidence From Provider Networks.

Enrollment in Medicare Advantage (MA) Dual-Eligible Special Needs Plans (D-SNPs) among individuals dually eligible for Medicare and Medicaid has more than tripled over the past decade. Little is known about whether D-SNP plan design differs from standard MA plan design nor whether this design reflects the needs of dual-eligible enrollees. We characterize the degree to which D-SNPs specialize in an important plan design dimension-provider networks.

Recent cohorts aging into Medicare use more counseling and psychotherapy than past cohorts.

Objectives: Despite recent policy interest in improving access to mental health care in Medicare, little is known about how demand for care will change among the Medicare population as newer cohorts age into the program. We documented the growing rate of counseling and psychotherapy use in the decade prior to turning age 65 years among subsequent cohorts aging into Medicare. We characterized how this growth varied across demographic groups, income levels, and mental and physical health status.