The Impact of Poverty on Health-Related Outcomes: Data Released on the Medicare-Medicaid Population

The Impact of Poverty on Health-Related Outcomes: Data Released on the Medicare-Medicaid Population

The U.S. Office of Minority Health (OMH) released last Tuesday new public files on Socio-demographic and Health Characteristics of Medicare Beneficiaries Living in the Community by Dual Eligible Status in 2021. The data file provides aggregated demographic information with correlations to health status and chronic conditions, activities of daily living, mental health, and oral health data from Medicare-Medicaid beneficiaries.

This report is a sign of continued federal efforts to release valuable information regarding the social factors impacting healthcare for the Medicare population, which can help inform future policy and practice decisions. The data set from 2021 reveals some interesting details about the uniqueness of the dual-enrolled Medicare-Medicaid beneficiaries and their care delivery needs, compared to those who are not dual-eligible. 

Overall, we learned that 26 percent of dual-enrolled members speak another language than English at home, compared to only 9 percent of the population that is Medicare-only. We also learned that over 40 percent of this population was classified as having fair or poor health, compared to only 18 percent of the Medicare-only group. When it comes to activities of daily living, those who were dually enrolled had greater difficulty with walking, bathing, getting out of bed, and dressing themselves than their counterparts, suggesting a greater need for additional supportive services. This also suggests further concerns regarding the progressive nature of poverty and one’s health status.

In looking at how Medicare beneficiaries were functioning in social domains, the impact of poverty was overwhelming in showing a significant decline in access to basic resources for those below the poverty line. A total of 42 percent of those who are 0-138 percent of the federal poverty level do not drive or have given up driving altogether.

This subgroup was also more likely to decrease meal size or skip meals altogether due to lack of access to food, reported at 40 percent. This group was more likely to have trouble staying up-to-date with their preventative healthcare and annual age-related vaccines, such as pneumonia, shingles, and flu. In looking at the neighborhood domain, this population was more likely to either be living alone or in an “other” type setting, likely a placement facility.

They were also significantly more likely to reside in a “disadvantaged” neighborhood, according to the Wisconsin Atlas neighborhood indicator. Not only does this population struggle with social domains, but they are also more likely to have four or more chronic conditions. 

I think this report confirms some of the information we have already seen in our hospitals and EDs: that our patients are increasingly more socially and medically complex. Although details were listed in the report regarding patient data, at this time there were not further suggestions for care delivery models; however, I think we have already seen the release of additional funding support for care navigation and provider time to care for this population.

I would imagine that we will continue to see additional resources as we prepare to support the growing number of seniors in our Medicare population who will fall into the dual-enrolled group, as the data confirms their needs are significantly more complex and resource-limited.

2024-poverty-awareness-infographic.pdf (cms.gov)

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Tiffany Ferguson, LMSW, CMAC, ACM

Tiffany Ferguson is CEO of Phoenix Medical Management, Inc., the care management company. Tiffany serves on the ACPA Observation Subcommittee. Tiffany is a contributor to RACmonitor, Case Management Monthly, and commentator for Finally Friday. After practicing as a hospital social worker, she went on to serve as Director of Case Management and quickly assumed responsibilities in system level leadership roles for Health and Care Management and c-level responsibility for a large employed medical group. Tiffany received her MSW at UCLA. She is a licensed social worker, ACM, and CMAC certified.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
Mastering Healthcare Refunds: Navigating Compliance with Confidence

Mastering Healthcare Refunds: Navigating Compliance with Confidence

Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.

February 29, 2024
Mastering Medicare Notices: Your Essential Guide to the MOON and Beyond

Mastering Medicare Notices: Your Essential Guide to the MOON and Beyond

Hospital staff continue to grapple with the complexities of Medicare notices.  In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, will present the latest requirements for preparation and delivery of CMS-mandated forms, including the Advance Beneficiary Notice (ABN), Hospital-Issued Notices of Noncoverage (HINNs), Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON), and practical solutions through foolproof workflows and compliance auditing.

January 25, 2024
OBGYN ICD-10-CM/PCS Coding: Mastering Complex Guidelines and Compliance

OBGYN ICD-10-CM/PCS Coding: Mastering Complex Guidelines and Compliance

Dive into the complexities of Obstetrics and Gynecology coding, addressing challenges from antepartum to postpartum care. Learn to decode intricate guidelines, tackle claim denials, and safeguard your practice’s financial health. Uncover the secrets to compliant coding, reducing errors, and optimizing reimbursement. With practical exercises and expert insights, this webcast empowers coders, auditors, and healthcare professionals to elevate their OBGYN coding prowess.

February 28, 2024
Unlocking Clinical Documentation Excellence: Empowering CDISs & Coders

Unlocking Clinical Documentation Excellence: How to Engage the Provider

Uncover effective techniques to foster provider understanding of CDI, empower CDISs and coders to customize their queries for enhanced effectiveness, and learn to engage adult learners, leveraging their experiences for superior learning outcomes. Elevate your CDI expertise, leading to fewer coding errors, reduced claim denials, and minimized audit issues.

December 14, 2023
Coding for Spinal Procedures: A 2-Part Webcast Series

Coding for Spinal Procedures: A 2-Part Webcast Series

This exclusive ICD10monitor webcast series will help you acquire the critical knowledge you need to completely and accurately assign ICD-10-PCS and CPT® codes for spinal fusion and other common spinal procedures.

October 26, 2023

Trending News

It’s Heart Month! Use code HEART24 at checkout to receive 20% off your cardiology products. Click here to view our suite of Cardiology products!