This project will use data from the Medicare Current Beneficiary Survey (MCBS) to study how the structure of the Medicare managed care market affects economic and clinical outcomes among chronically ill elderly persons. Specifically, the project will use the MCBS to: (1) determine how Medicare market structure affects insurance choice, health status and out-of-pocket expenses for the chronically ill in Medicare; (2) determine how thee effects vary by type of chronic condition or disease progression; and (3) forecast how changes in Medicare market structure might affect the chronically ill in Medicare. Several of the project analyses will be highly innovative. For instance, the project will assess the impact of market structure on transitions among fee-for-free service (FFS) Medicare without supplemental insurance, FFS Medicare with private supplemental insurance, and HMO coverage. The project also will assess how incident chronic conditions or worsening conditions (i.e., health shocks) affect beneficiaries choices between FFS and HMOs.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Program Projects (P01)
Project #
5P01HS010770-03
Application #
6602716
Study Section
Special Emphasis Panel (ZHS1)
Project Start
2002-07-01
Project End
2003-06-30
Budget Start
Budget End
Support Year
3
Fiscal Year
2002
Total Cost
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Escarce, Jose J; Kapur, Kanika (2009) Do patients bypass rural hospitals? Determinants of inpatient hospital choice in rural California. J Health Care Poor Underserved 20:625-44
Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, Jose J (2009) Community demographics and access to health care among U.S. Hispanics. Health Serv Res 44:1542-62
Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, Jose J (2008) Individuals'use of care while uninsured: effects of time since episode inception and episode length. J Natl Med Assoc 100:1394-404
Bao, Yuhua; Fox, Sarah A; Escarce, Jose J (2007) Socioeconomic and racial/ethnic differences in the discussion of cancer screening: ""between-"" versus ""within-"" physician differences. Health Serv Res 42:950-70
Kapur, Kanika; Rogowski, Jeannette A; Freedman, Vicki A et al. (2006) Socioeconomic status and medical care expenditures in Medicare managed care. J Health Care Poor Underserved 17:876-98