Using Medicare Enrollment Data to Identify Beneficiaries in Assisted Living

Temkin‐Greener, Helena; Mao, Yunjiao; Li, Yue; McGarry, Brian E.

doi:10.1016/j.jamda.2022.01.062

Cited by 19 publications

(17 citation statements)

References 16 publications

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“…Residents' characteristics, for example, socio‐demographics and chronic conditions, were obtained from the Medicare Beneficiary Summary File (MBSF). AL location (urban/rural) and bed size information were obtained from the national directory of AL communities 20 …”

Section: Methodsmentioning

confidence: 99%

“…We used a previously described method to identify Medicare fee-for-service (FFS) beneficiaries residing in ALs, by matching their residential 9-digit zip codes to the zip codes of ALs. 20 We restricted the sample to residents who entered AL between January and December of 2018 (i.e., new residents). We excluded those who were enrolled in Medicare Advantage (MA) plans in any month of the…”

Section: Data and Samplementioning

confidence: 99%

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Are online reviews of assisted living communities associated with patient‐centered outcomes?

Mao

McGarry

et al. 2022

J American Geriatrics Society

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Background: Existing literature on online reviews of healthcare providers generally portrays online reviews as a useful way to disseminate information on quality. However, it remains unknown whether online reviews for assisted living (AL) communities reflect AL care quality. This study examined the association between AL online review ratings and residents' home time, a patient-centered outcome.Methods: Medicare beneficiaries who entered AL communities in 2018 were identified. The main outcome is resident home time in the year following AL admission, calculated as the percentage of time spent at home (i.e., not in institutional care setting) per day being alive. Additional outcomes are the percentage of time spent in emergency room, inpatient hospital, nursing home, and inpatient hospice. AL online Google reviews for 2013-2017 were linked to 2018-2019 Medicare data. AL average rating score (ranging 1-5) and rating status (no-rating, low-rating, and high-rating) were generated using Google reviews. Linear regression models and propensity score weighting were used to examine the association between online reviews and outcomes. The study sample included 59,831 residents in 12,143 ALs.Results: Residents were predominately older (average 81.2 years), non-Hispanic White (90.4%), and female (62.9%), with 17% being dually eligible for Medicare and Medicaid. From 2013 to 2017, ALs received an average rating of 4.1 on Google, with a standard deviation of 1.1. Each one-unit increase in the AL's average online rating was associated with an increase in residents' riskadjusted home time by 0.33 percentage points (p < 0.001). Compared with residents in ALs without ratings, residents in high-rated ALs (average rating ≥4.4) had a 0.64 pp (p < 0.001) increase in home time.Conclusions: Higher online rating scores were positively associated with residents' home time, while the absence of ratings was associated with reduced home time. Our results suggest that online reviews may be a quality signal with respect to home time.

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Section: Methodsmentioning

confidence: 99%

Section: Data and Samplementioning

confidence: 99%

Are online reviews of assisted living communities associated with patient‐centered outcomes?

Mao

McGarry

et al. 2022

J American Geriatrics Society

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“…59 About 35% of Medicare beneficiaries residing in AL are enrolled in Medicare Advantage (MA) plans. 60 Their enrollment opens an opportunity, especially for larger AL communities, to partner with existing MA plans or develop their own plans such as to provide onsite medical services. 37 Increased care coordination and monitoring may translate into fewer hospitalizations, thus delaying or preventing individuals from moving to a higher level of care.…”

Section: Potential Solutionsmentioning

confidence: 99%

The Imperative to Reimagine Assisted Living

Zimmerman

Carder

Schwartz

et al. 2022

Journal of the American Medical Directors Association

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“…A national inventory of ALCs that we previously constructed based on data obtained from state licensing agencies was linked to the COVID-19 state reports using facility names and addresses. 22 Employing a previously developed methodology, 23 we identified Medicare beneficiaries who resided in ALCs in calendar year 2018 (CY2018). We then used the Master Beneficiary Summary File (MBSF) to characterize ALCs based on the following factors: average resident age, proportion of race and ethnic minorities and the dual-eligible status for Medicare and Medicaid, proportion of males, and residents with chronic conditions.…”

Section: Datamentioning

confidence: 99%

“…Following prior studies, 26,32 we chose the median value of 55 as the cutoff point. Using 9-digit ZIP codes, 23 we linked the ALCs to the most proximate ADIs.…”

Section: Key Independent Variablesmentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) in assisted living communities: Neighborhood deprivation and state social distancing policies matter

Guo

Temkin‐Greener

2022

Infect. Control Hosp. Epidemiol.

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BACKGROUND: Residents of long-term care facilities face significantly greater risk of contracting or dying from COVID-19. However, little is known about COVID-19 in assisted living communities (ALCs) and the potential determinants of its spread. We examined the association between COVID-19 cases in ALCs and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency. METHODS: We conducted longitudinal analyses employing data on confirmed COVID-19 cases in ALCs within 5 states. Outcome was weekly cumulative number of COVID-19 cases in ALCs. Covariates were ALC characteristics, area deprivation index, and state COVID-19 policy stringency. Multivariate two-part models were used to determine the associations between independent variables and the likelihood of an outbreak and the overall count of cases. RESULTS: In our study sample, 201 ALCs (7.04%) reported 1 or more COVID-19 cases as of August 17th, 2020. A higher percentage of minority residents was associated with an increased likelihood of ALC reporting at least one COVID-19 case (OR=1.06, P=0.032). Conditional on having at least one case, ALCs in states with stricter social distancing policies had lower case count (IRR=0.98, P<0.001). Greater neighborhood deprivation was associated with higher case count (IRR=1.36, P=0.049). CONCLUSION: ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies tended to have more COVID-19 cases.

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Using Medicare Enrollment Data to Identify Beneficiaries in Assisted Living

Cited by 19 publications

References 16 publications

Are online reviews of assisted living communities associated with patient‐centered outcomes?

Are online reviews of assisted living communities associated with patient‐centered outcomes?

The Imperative to Reimagine Assisted Living

Coronavirus disease 2019 (COVID-19) in assisted living communities: Neighborhood deprivation and state social distancing policies matter

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