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No Considerable Changes in Use of High-Value and Low-Value Care Services for Medicare Eligibility and Enrollment at 65 Years
Findings from a recent study suggest that while Medicare eligibility and enrollment at age 65 years led to increased utilization of some high-value and low-value care services, there were no changes in the utilization of most other services offered (Health Serv Res. 2022; 10.1111/1475-6773.14065. doi:10.1111/1475-6773.14065).
Utilizing the data from the 2002-2019 Medical Expenditure Panel Survey, researchers, Sungchul Park, MD, Department of Health Policy and Management, College of Health Science, Korea University, BK21 FOUR R&E Center for Learning Health Systems, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Republic of Korea, and colleagues sought to assess the effects of Medicare eligibility and enrollment in the use of high-value and low-value care services.
The primary outcomes included use of high-value care services (eight services) and low-value care services (seven services).
Researchers performed a regression discontinuity analysis and to assess the effects of Medicare enrollment, they utilized the discontinuity in the probability of having Medicare coverage around the age eligibility cutoff and conducted an instrumental variable analysis.
Results revealed that Medicare eligibility and enrollment led to statistically significant increases in the usage of only two high-value services: cholesterol measurement [2.1 percentage points (95%: 0.4-3.7) (2.2% relative change) and 2.4 percentage points (95%: 0.4-4.4)] and receipt of the influenza vaccine [3.0 percentage points (95%: 0.3-5.6) (6.0% relative change) and 3.6 percentage points (95%: 0.4-6.8)]. Medicare eligibility and enrollment led to statistically significant increases in the use of two low-value services: antibiotics for acute upper respiratory infection [6.9 percentage points (95% CI: 0.8-13.0) (24.0% relative change) and 8.2 percentage points (95% CI: 0.8-15.5)] and radiographs for back pain [4.6 percentage points (95% CI: 0.1-9.2) (36.8% relative change) and 6.2 percentage points (95% CI: 0.1-12.3)]. However, there was no significant change in the use of other high-value and low-value care services.
The authors concluded, “Medicare eligibility and enrollment at age 65 years led to increases in the use of some high-value and low-value care services, but there were no changes in the use of the majority of other services,” adding, “Policymakers should consider refining the Medicare program to enhance the value of care delivered.”
