Impact of Managed Care on the Treatment, Costs, and Outcomes of Fee‐for‐Service Medicare Patients with Acute Myocardial Infarction
Key result
High-HMO penetration markets were associated with lower rates of revascularization and cardiac catheterization for Medicare fee-for-service AMI patients compared to low-penetration markets.
Why the study?
Does market-level managed care activity affect the treatment, costs, and outcomes of Medicare fee-for-service patients with acute myocardial infarction?
Population
Medicare fee-for-service beneficiaries aged 65 and older discharged from nonrural acute-care hospitals with…
Comparison
High market-area managed care penetration and… vs Low market-area managed care penetration and…
Design
Cohort
Authors
Discussion
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Member takes
Implication
May indicate market spillovers reducing procedures for Medicare AMI patients; leaves open effects on outcomes and appropriateness.
Study Design
Type
Observational
Multicenter
Yes
Structured PICO
Does market-level managed care activity affect the treatment, costs, and outcomes of Medicare fee-for-service patients with acute myocardial infarction?
P
Population
Medicare fee-for-service patients aged 65 and older admitted with a confirmed AMI to a nonrural hospital between 1994 and 1995.
E
Exposure
High market-area managed care (HMO) penetration and competition
C
Comparator
Low market-area managed care (HMO) penetration and competition
O
Outcome
Patient treatment (rates of revascularization and cardiac catheterization), costs, and outcomes
Market-level managed care penetration and competition significantly influence the rates of invasive cardiac procedures and costs for fee-for-service Medicare patients with AMI.
Cite This Study
Bundorf et al. (2004) conducted an observational in Acute myocardial infarction. Market-area managed care penetration and competition vs. Low-penetration and low-competition markets was evaluated on Rates of revascularization, cardiac catheterization, treatment costs, and outcomes. High-HMO penetration markets were associated with lower rates of revascularization and cardiac catheterization for Medicare fee-for-service AMI patients compared to low-penetration markets.