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Opioid and CNS-Depressant Medication Prescribing among Older Adults Enrolled in Medicare Advantage Versus Fee-for-Service Medicare.

Lei L, Bynum JP, Maust DT. Opioid and CNS-Depressant Medication Prescribing among Older Adults Enrolled in Medicare Advantage Versus Fee-for-Service Medicare. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2022 Feb 1; 30(2):249-255.

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Abstract:

OBJECTIVE: To examine whether prescription fills of opioids and central nervous system (CNS) depressants are lower in Medicare Advantage (MA) plans, which aim to provide more coordinated and integrated care, than fee-for-service (FFS) Medicare. METHODS: Data from the 2015 National Health and Aging Trends Study linked with Medicare claims. Community-dwelling adults = 65 enrolled in Medicare Part D were included (n  =  5,652). Prescription fills of opioids, antipsychotics, benzodiazepines, gabapentinoids, and co-prescriptions of opioids with the other medications in MA versus FFS Medicare were examined using multivariate logistic models. Propensity score weighting was applied to account for differences in characteristics between MA and FFS beneficiaries. RESULTS: MA enrollees were less likely to fill prescriptions for benzodiazepines (15.6% versus 19.0%; marginal difference: -3.4%, t  =  -2.54, df  =  56, p  =  0.01), and co-prescriptions of opioids and gabapentinoids (5.1% versus 6.7%; marginal difference: -1.6%, t  =  -2.07, df  =  56, p  =  0.04) than FFS beneficiaries. There were no significant differences among the other prescription outcomes. CONCLUSIONS: MA was associated with slightly lower likelihood of receiving opioids and some CNS depressants.





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