Evaluating Medicare Performance: Perceptions of Performance Pre- and Post- ACA

Ashleigh Chinelo Oguagha, Nickesha Joan Lambert

Abstract


Medicare is a national single-payer system that provides health coverage for the elderly, disabled, and terminally ill in the United States. Rising enrollment, costs, and decreases in financing options may affect the way Medicare performs. This study aimed to investigate participants’ perceptions of Medicare performance before and after the Affordable Care Act. A 3-part questionnaire was created and validated for use in this study. Respondents affiliated with several social work agencies were invited via email to participate in this study. 287 out of 519 invited questionnaires were used in data analyses. 27.5% of respondents reported being currently enrolled in Medicare, while 33.2% reported lifetime enrollment. Overall, retired/disabled, elderly and low-income participants reported currently or ever using Medicare. One’s perception of Medicare performance was determined by their status as a Medicare beneficiary. Medicare service efficacy was rated more positively over-time by current and life-time enrollees; additionally, Medicare performance was determined to be better in 2013 than in 2009. Ultimately, this study showed that health service and financial fairness factors are indicative of Medicare performance. Additional research should explore possible implications for the healthcare field as well as formulate a broad range of possible management and/or improvement strategies. Lastly, differences in performance across years can inform decision-makers and bolster the fundamental foundation of health policies at the state and national level.


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References


Braithwaite, J., Hibbert, P., Blakely, B., Plumb, J., Hannaford, N., Long, J. C., & Marks, D. (2017). Health system frameworks and performance indicators in eight countries: a comparative international analysis. SAGE open medicine, 5

Centers for Disease Control and Prevention. (2019). Chronic Diseases in America. National Center for Chronic Disease Prevention and Health Promotion. Retrieved February 2020 from https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm

Centers for Medicare and Medicaid Services. (2008). Medicare & You 2009. U.S. Department of Health and Human Services. Available at https://q1medicare.com/pics/ContentPics/MedicareAndYou2009_10050.pdf&sa=U&ved=2ahUKEwizpMmJnJPoAhVByoUKHd8bAtYQFjAEegQIARAB&usg=AOvVaw13fzjWd3GL3zNYzUaXriF2

Dalen, J., Waterbrook, K. & Alpert, J. (2015). Why do so many Americans oppose the Affordable Care Act?. The American Journal of Medicine, 128(8), 807-810.

Fowler, E. F., Baum, L. M., Barry, C. L., Niederdeppe, J., & Gollust, S. E. (2017). Media messages and perceptions of the Affordable Care Act during the early phase of implementation. Journal of Health Politics, Policy and Law, 42(1), 167-195.

Gordon, P. R., Gray, L., Hollingsworth, A., Shapiro, E. C., & Dalen, J. E. (2017). Opposition to Obamacare: a closer look. Academic Medicine, 92(9), 1241-1247.

Henseler, J. (2017). Partial least squares path modeling. In Advanced methods for modeling markets (pp. 361-381). Springer, Cham.

Jacobson, G., Neuman, T. & Musumeci, M. (2017). What could a Medicaid per capita cap mean for low-income people on Medicare?. Menlo Park, CA: Kaiser Family Foundation

Jencks, S., Huff., E., & Cuerdon. (2003). Change in the quality of care delivered to Medicare Beneficiaries, 1998-1999 to 2000-2001. JAMA, 289(3), 305-312.

Kessell, E., Pegany, V., Keolanui, B., Fulton, B. D., Scheffler, R. M., & Shortell, S. M. (2015). Review of Medicare, Medicaid, and commercial quality of care measures: considerations for assessing accountable care organizations. Journal of Health Politics, Policy and Law, 40(4), 761-796.

Martin, A. B., Lassman, D., Washington, B., Catlin, A., & National Health Expenditure Accounts Team. (2012). Growth in US health spending remained slow in 2010; health share of gross domestic product was unchanged from 2009. Health Affairs, 31(1), 208-219.

Medicare.gov. (n.d.). The Official U.S. Government Site for Medicare Family of Sites. Retrieved December 2018, from https://www.medicare.gov/

National Health Council (2014). About Chronic Diseases. Retrieved February 2020 from https://nationalhealthcouncil.org/wp-content/uploads/2019/12/AboutChronicDisease.pdf

Office of the Actuary. (2018, February). CMS Office of the Actuary releases 2017-2026 Projections of National Health Expenditures. Centers for Medicare & Medicaid Services. Retrieved January 2020 from https://www.cms.gov/newsroom/press-releases/cms-office-actuary-releases-2017-2026-projections-national-health-expenditures

Phellas, C., Bloch, A., & Seale, C. (2011). Structured methods: Interviews, questionnaires and observation. Researching Society and Culture, 3, 181-205

Safran, D. G., Wilson, I. B., Rogers, W. H., Montgometery, J.E., & Chang, H. (2002). Primary care quality in the Medicare program: Comparing the performance of Medicare health maintenance organizations and traditional fee-for-service Medicare. Archives of Internal Medicine, 16(2), 757-765

Silvers, J. B. (2013). The affordable care act: Objectives and likely results in an imperfect world. Annals of Family Medicine, 11(5), 402-405

Thorpe, K., Ogden, L., & Galactionova (2010). Chronic conditions account for rise in Medicare spending from 1987 to 2006. Health Affairs, 29(4), 718-724

U.S. Bureau of the Census. (2018). United States Census Bureau Family of Sites. Retrieved January 2020 from https://www.census.gov

Zuckerman, R., Sheingold, D., Orav, E., Ruther, J., & Epstein. (2016). Readmissions, observation, and the hospital readmissions reduction program. New England Journal of Medicine, 374(16), 1543-1551.




DOI: https://doi.org/10.5430/wjss.v7n2p28

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World Journal of Social Science     ISSN 2329-9347 (Print)  ISSN 2329-9355 (Online)

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