Details:

Alternative Title:
Ann Intern Med
Publisher's site:
http://dx.doi.org/10.7326/M21-1588
Personal Author:
Berkowitz, Seth A. ; Palakshappa, Deepak ; Rigdon, Joseph ; Seligman, Hilary K. ; Basu, Sanjay ;
Berkowitz, Seth A. ; Palakshappa, Deepak ; Rigdon, Joseph ; Seligman, Hilary K. ; Basu, Sanjay ; Less -
Description:
Background: Older adults dually eligible for Medicare and Medicaid have particularly high food insecurity prevalence and healthcare use. Objective: We sought to determine whether Supplemental Nutrition Assistance Program (SNAP) participation, which reduces food insecurity, is associated with lower healthcare use and cost for older adults dually eligible for Medicare and Medicaid. Design: Incident user retrospective cohort study. We assessed the association between SNAP participation and healthcare use and cost using outcome regression, supplemented by entropy balancing, matching, and instrumental variable analyses. Setting: North Carolina, September 2016 through July 2020. Participants: Older adults (age ≥65 years) dually enrolled in Medicare and Medicaid but initially not enrolled in SNAP. Measurements: Inpatient admissions (primary outcome), emergency department visits, long-term care admissions, and Medicaid expenditures. Results: Of 115,868 individuals included, 5093 (4.4%) enrolled in SNAP. Mean follow-up was approximately 22 months. In outcome regression analyses, SNAP enrollment was associated, per 1000 person-years, with fewer inpatient hospitalizations (−24.6, 95% confidence interval [CI] −40.6 to −8.7), emergency department visits (−192.7, 95%CI −231.1 to −154.4), long-term care admissions (−65.2, 95%CI −77.5 to −52.9), and $2360 (95%CI −2649 to −2071) fewer dollars in Medicaid payments per person per year. Results were similar in entropy balancing, matching, and instrumental variable analyses. Limitations: Single state; no Medicare claims data available; possible residual confounding. Conclusions: SNAP participation was associated with fewer inpatient admissions and lower healthcare costs for older adults dually eligible for Medicare and Medicaid. Funding Source: National Institutes of Health
Subject:
[+]
Aged
Article
Delivery Of Healthcare
Dual Medicaid Medicare Eligibility
Emergency Service, Hospital
Female
Food Assistance
Food Insecurity
Healthcare Costs
Healthcare Utilization
Health Expenditures
Health Services Research
Hospitalization
Humans
Long-Term Care
Male
Medicaid
Medicare
North Carolina
Retrospective Studies
Socioeconomic Factors
Supplemental Nutrition Assistance Program
United States

Source:
Ann Intern Med. 174(12):1674-1682 ;
Pubmed ID:
34662150
Pubmed Central ID:
PMC8893035
Document Type:
Journal Article ;
Funding:
K23 DK109200/DK/NIDDK NIH HHSUnited States/ ; K23 HL146902/HL/NHLBI NIH HHSUnited States/ ; P30 DK092924/DK/NIDDK NIH HHSUnited States/ ; UR6 DP000498/DP/NCCDPHP CDC HHSUnited States/ ;
K23 DK109200/DK/NIDDK NIH HHSUnited States/ ; K23 HL146902/HL/NHLBI NIH HHSUnited States/ ; P30 DK092924/DK/NIDDK NIH HHSUnited States/ ; UR6 DP000498/DP/NCCDPHP CDC HHSUnited States/ ; Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:a585fd3f9fd57cd64693e0e5a7df98efe10e04cc53ba0b7a8efa241024730e90
File Type:

Supporting Files

• 	nihms-1780821.nxml	xml
  	NIHMS1780821-supplement-Appendix.docx	docx
  	NIHMS1780821-supplement-Supplement.docx	docx

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