Journal of the American Heart Association · 2026
Health Care Access, Preventive Care, and Affordability Among Rural Adults With Cardiometabolic Conditions: Medicare Advantage Versus Traditional Medicare.
СтатьяСравнительное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chiu Nicholas, Oseran Andrew, Tale Archana P, Wadhera Rishi K
Аннотация
BACKGROUND: Cardiovascular mortality has worsened among rural adults compared with urban counterparts over recent decades. Medicare Advantage (MA) enrollment is increasing in rural areas, yet its impact on access and affordability for high-risk cardiovascular populations remains unclear. This study evaluated differences in health care access, preventive care, and affordability barriers between rural adults with cardiometabolic conditions enrolled in MA versus traditional Medicare.
METHODS: A cross-sectional analysis was performed using 2021 to 2022 Medicare Current Beneficiary Survey data. Multivariable logistic regression was used to estimate adjusted risk differences (aRD) in access, preventive care, and affordability barriers between rural MA and traditional Medicare enrollees, adjusting for sociodemographic characteristics.
RESULTS: The study included 4274 rural beneficiaries with cardiometabolic conditions (weighted population 16 352 800, 53% women). Compared with traditional Medicare, MA enrollees were significantly less likely to miss an annual wellness visit (40.1% versus 50.1%; aRD, -13.4% [95% CI, -17.0% to -9.8%]) or face barriers to preventive care, such as not having annual cholesterol checks (aRD, -3.2% [95% CI, -5.2% to -1.2%]) and influenza vaccinations (aRD, -4.3% [95% CI, -7.8% to -0.7%]). However, MA beneficiaries were more likely to have problems paying medical bills (12.2% versus 6.9%; aRD, 2.5% [95% CI, 0.4%-4.6%]).
CONCLUSIONS: Rural MA beneficiaries with cardiometabolic conditions experienced fewer barriers to preventive care but reported greater difficulty paying medical bills than those in traditional Medicare. As MA expands in rural America, policies are needed to address affordability challenges while preserving access to preventive services.
METHODS: A cross-sectional analysis was performed using 2021 to 2022 Medicare Current Beneficiary Survey data. Multivariable logistic regression was used to estimate adjusted risk differences (aRD) in access, preventive care, and affordability barriers between rural MA and traditional Medicare enrollees, adjusting for sociodemographic characteristics.
RESULTS: The study included 4274 rural beneficiaries with cardiometabolic conditions (weighted population 16 352 800, 53% women). Compared with traditional Medicare, MA enrollees were significantly less likely to miss an annual wellness visit (40.1% versus 50.1%; aRD, -13.4% [95% CI, -17.0% to -9.8%]) or face barriers to preventive care, such as not having annual cholesterol checks (aRD, -3.2% [95% CI, -5.2% to -1.2%]) and influenza vaccinations (aRD, -4.3% [95% CI, -7.8% to -0.7%]). However, MA beneficiaries were more likely to have problems paying medical bills (12.2% versus 6.9%; aRD, 2.5% [95% CI, 0.4%-4.6%]).
CONCLUSIONS: Rural MA beneficiaries with cardiometabolic conditions experienced fewer barriers to preventive care but reported greater difficulty paying medical bills than those in traditional Medicare. As MA expands in rural America, policies are needed to address affordability challenges while preserving access to preventive services.