Self-reported CAHPS Quality Measures by Medicare Beneficiary Social Vulnerability Index
Author(s)
Teagan Maguire, MS1, Jie Chen, PhD2;
1University of Maryland at College Park, College Park, MD, USA, 2University of Maryland, Professor and Chair, College Park, MD, USA
1University of Maryland at College Park, College Park, MD, USA, 2University of Maryland, Professor and Chair, College Park, MD, USA
OBJECTIVES: Self-reported healthcare quality often reflects older adults’ health experiences and is associated with improved clinical outcomes. This study aims to examine variations in patient-reported satisfaction measures based on the Social Vulnerability Index (SVI).
METHODS: We investigated the relationship between SVI and patient-reported healthcare quality among Medicare Fee-for-Service (FFS) and Medicare Advantage and Prescription Drug Plan (MA/PDP) beneficiaries. Data from the 2018, 2019, 2021, and 2022 Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys were linked with SVI data. Outcome variables included four patient-reported satisfaction measures: overall quality of health care, quality of the personal provider, and ease of obtaining needed medical care and prescribed medications.
RESULTS: Logistic regression analyses showed that higher SVI (greater social vulnerability) was associated with lower patient-reported quality measures. Compared to FFS beneficiaries in the least vulnerable areas (SVI1), beneficiaries in the most vulnerable areas (SVI4) had the lowest odds of rating health care above the median (OR = 0.85, 95% CI 0.82-0.88), followed by SVI3 (OR = 0.91, 95% CI 0.88-0.94) and SVI2 (OR = 0.94, 95% CI 0.91-0.97). Similarly, FFS beneficiaries in SVI4 had significantly lower odds of reporting high-quality health care as measured by the CAHPS score (OR = 0.90, 95% CI 0.87-0.93). The odds of attaining needed health care and prescribed medications were also lower for SVI4 beneficiaries (OR = 0.87, 95% CI 0.84-0.89, and OR = 0.87, 95% CI 0.83-0.90, respectively). Significant racial and ethnic disparities were also observed. Asian FFS beneficiaries reported lower quality across all measures compared to White beneficiaries. Results were consistent among MA/PDP beneficiaries.
CONCLUSIONS: Findings highlight significant disparities in self-reported healthcare quality among socially vulnerable and minority populations. Addressing these disparities is critical to improving health care experiences and outcomes for individuals who live in unsevered areas.
METHODS: We investigated the relationship between SVI and patient-reported healthcare quality among Medicare Fee-for-Service (FFS) and Medicare Advantage and Prescription Drug Plan (MA/PDP) beneficiaries. Data from the 2018, 2019, 2021, and 2022 Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys were linked with SVI data. Outcome variables included four patient-reported satisfaction measures: overall quality of health care, quality of the personal provider, and ease of obtaining needed medical care and prescribed medications.
RESULTS: Logistic regression analyses showed that higher SVI (greater social vulnerability) was associated with lower patient-reported quality measures. Compared to FFS beneficiaries in the least vulnerable areas (SVI1), beneficiaries in the most vulnerable areas (SVI4) had the lowest odds of rating health care above the median (OR = 0.85, 95% CI 0.82-0.88), followed by SVI3 (OR = 0.91, 95% CI 0.88-0.94) and SVI2 (OR = 0.94, 95% CI 0.91-0.97). Similarly, FFS beneficiaries in SVI4 had significantly lower odds of reporting high-quality health care as measured by the CAHPS score (OR = 0.90, 95% CI 0.87-0.93). The odds of attaining needed health care and prescribed medications were also lower for SVI4 beneficiaries (OR = 0.87, 95% CI 0.84-0.89, and OR = 0.87, 95% CI 0.83-0.90, respectively). Significant racial and ethnic disparities were also observed. Asian FFS beneficiaries reported lower quality across all measures compared to White beneficiaries. Results were consistent among MA/PDP beneficiaries.
CONCLUSIONS: Findings highlight significant disparities in self-reported healthcare quality among socially vulnerable and minority populations. Addressing these disparities is critical to improving health care experiences and outcomes for individuals who live in unsevered areas.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD36
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas