Socioeconomic factors associated with uptake and satisfaction with a post‐hospitalization meals benefit in Medicare Advantage

Background Kaiser Permanente Southern California began offering a 4‐week supplemental benefit of home‐delivered meals to Medicare Advantage members after discharge from a hospitalization for heart failure and other medical conditions in 2021. The purpose of this study is to explore the associations...

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Veröffentlicht in:Journal of the American Geriatrics Society (JAGS) 2024-08, Vol.72 (8), p.2460-2470
Hauptverfasser: Richards, Anna L., Vallejo, Jessica, Duan, Lewei, Dinsdale, Mary P., Akiyama‐Ciganek, Jaime, Arakelian, Annet, Lee, Janet S., Shen, Ernest, Nguyen, Huong Q.
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container_end_page 2470
container_issue 8
container_start_page 2460
container_title Journal of the American Geriatrics Society (JAGS)
container_volume 72
creator Richards, Anna L.
Vallejo, Jessica
Duan, Lewei
Dinsdale, Mary P.
Akiyama‐Ciganek, Jaime
Arakelian, Annet
Lee, Janet S.
Shen, Ernest
Nguyen, Huong Q.
description Background Kaiser Permanente Southern California began offering a 4‐week supplemental benefit of home‐delivered meals to Medicare Advantage members after discharge from a hospitalization for heart failure and other medical conditions in 2021. The purpose of this study is to explore the associations between socioeconomic disadvantage and food insecurity with patient uptake of and satisfaction with the meals. Methods Data for this cross‐sectional study were drawn from survey and electronic medical record data for members referred for the meals benefit (n = 6169) and linked to a hospitalization encounter (n = 2254) between January and December 2021. Uptake was assessed using vendor records; measures of socioeconomic status included the neighborhood deprivation index (NDI) and prior receipt of medical financial assistance (MFA) from the health system. Patients were invited to complete an email or phone survey about their satisfaction with the meals and food insecurity. Multivariable log‐binomial regression models were used to examine the association between socioeconomic disadvantage and food insecurity with meals uptake and satisfaction. Results Sixty‐two percent of patients referred for the benefit accepted the meals (mean age: 79 ± 9, 59% people of color). While there was no significant relationship between NDI and meals uptake (RR: 0.99, 95% CI: 0.92–1.07, p = 0.77), patients who received prior MFA were more likely to accept the meals (RR: 1.09, 95% CI: 1.02–1.16, p 
doi_str_mv 10.1111/jgs.18907
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The purpose of this study is to explore the associations between socioeconomic disadvantage and food insecurity with patient uptake of and satisfaction with the meals. Methods Data for this cross‐sectional study were drawn from survey and electronic medical record data for members referred for the meals benefit (n = 6169) and linked to a hospitalization encounter (n = 2254) between January and December 2021. Uptake was assessed using vendor records; measures of socioeconomic status included the neighborhood deprivation index (NDI) and prior receipt of medical financial assistance (MFA) from the health system. Patients were invited to complete an email or phone survey about their satisfaction with the meals and food insecurity. Multivariable log‐binomial regression models were used to examine the association between socioeconomic disadvantage and food insecurity with meals uptake and satisfaction. Results Sixty‐two percent of patients referred for the benefit accepted the meals (mean age: 79 ± 9, 59% people of color). While there was no significant relationship between NDI and meals uptake (RR: 0.99, 95% CI: 0.92–1.07, p = 0.77), patients who received prior MFA were more likely to accept the meals (RR: 1.09, 95% CI: 1.02–1.16, p &lt; 0.01). Sixty‐nine percent of patients who completed the survey (23% response rate) reported that meals were very or extremely helpful. Patients with food insecurity (29% of survey respondents) were more likely to report that the meals were helpful for their recovery compared to food secure patients (RR: 1.21, 95% CI: 1.09–1.35, p &lt; 0.01). Conclusions The home‐delivered meals appeared to be particularly utilized by and helpful to patients with greater financial strain and/or food insecurity, suggesting that supplemental benefits could be more targeted toward addressing unmet needs of vulnerable adults. See related Editorial by Amit Kumar.</description><identifier>ISSN: 0002-8614</identifier><identifier>ISSN: 1532-5415</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.18907</identifier><identifier>PMID: 38551247</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Aged ; Aged, 80 and over ; California ; Congestive heart failure ; Cross-Sectional Studies ; Electronic medical records ; Female ; Food Assistance - statistics &amp; numerical data ; Food Insecurity ; Food security ; Heart Failure - therapy ; home‐delivered meals ; Hospitalization ; Hospitalization - statistics &amp; numerical data ; Humans ; Male ; Meals ; Medicare ; Medicare Advantage ; Medicare Part C - statistics &amp; numerical data ; Older people ; Patient Discharge - statistics &amp; numerical data ; Patient Satisfaction - statistics &amp; numerical data ; Regression analysis ; Socioeconomic Factors ; supplemental benefit ; Surveys ; Surveys and Questionnaires ; United States</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2024-08, Vol.72 (8), p.2460-2470</ispartof><rights>2024 The American Geriatrics Society.</rights><rights>2024 American Geriatrics Society and Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-a696e42fb49bdbfb2522beacddef9096af100de058522f3a1f387cac66eef7083</citedby><cites>FETCH-LOGICAL-c3537-a696e42fb49bdbfb2522beacddef9096af100de058522f3a1f387cac66eef7083</cites><orcidid>0000-0002-3650-3705 ; 0000-0001-6842-9418</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.18907$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.18907$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38551247$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Richards, Anna L.</creatorcontrib><creatorcontrib>Vallejo, Jessica</creatorcontrib><creatorcontrib>Duan, Lewei</creatorcontrib><creatorcontrib>Dinsdale, Mary P.</creatorcontrib><creatorcontrib>Akiyama‐Ciganek, Jaime</creatorcontrib><creatorcontrib>Arakelian, Annet</creatorcontrib><creatorcontrib>Lee, Janet S.</creatorcontrib><creatorcontrib>Shen, Ernest</creatorcontrib><creatorcontrib>Nguyen, Huong Q.</creatorcontrib><title>Socioeconomic factors associated with uptake and satisfaction with a post‐hospitalization meals benefit in Medicare Advantage</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>Background Kaiser Permanente Southern California began offering a 4‐week supplemental benefit of home‐delivered meals to Medicare Advantage members after discharge from a hospitalization for heart failure and other medical conditions in 2021. The purpose of this study is to explore the associations between socioeconomic disadvantage and food insecurity with patient uptake of and satisfaction with the meals. Methods Data for this cross‐sectional study were drawn from survey and electronic medical record data for members referred for the meals benefit (n = 6169) and linked to a hospitalization encounter (n = 2254) between January and December 2021. Uptake was assessed using vendor records; measures of socioeconomic status included the neighborhood deprivation index (NDI) and prior receipt of medical financial assistance (MFA) from the health system. Patients were invited to complete an email or phone survey about their satisfaction with the meals and food insecurity. Multivariable log‐binomial regression models were used to examine the association between socioeconomic disadvantage and food insecurity with meals uptake and satisfaction. Results Sixty‐two percent of patients referred for the benefit accepted the meals (mean age: 79 ± 9, 59% people of color). While there was no significant relationship between NDI and meals uptake (RR: 0.99, 95% CI: 0.92–1.07, p = 0.77), patients who received prior MFA were more likely to accept the meals (RR: 1.09, 95% CI: 1.02–1.16, p &lt; 0.01). Sixty‐nine percent of patients who completed the survey (23% response rate) reported that meals were very or extremely helpful. Patients with food insecurity (29% of survey respondents) were more likely to report that the meals were helpful for their recovery compared to food secure patients (RR: 1.21, 95% CI: 1.09–1.35, p &lt; 0.01). Conclusions The home‐delivered meals appeared to be particularly utilized by and helpful to patients with greater financial strain and/or food insecurity, suggesting that supplemental benefits could be more targeted toward addressing unmet needs of vulnerable adults. See related Editorial by Amit Kumar.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>California</subject><subject>Congestive heart failure</subject><subject>Cross-Sectional Studies</subject><subject>Electronic medical records</subject><subject>Female</subject><subject>Food Assistance - statistics &amp; numerical data</subject><subject>Food Insecurity</subject><subject>Food security</subject><subject>Heart Failure - therapy</subject><subject>home‐delivered meals</subject><subject>Hospitalization</subject><subject>Hospitalization - statistics &amp; numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Meals</subject><subject>Medicare</subject><subject>Medicare Advantage</subject><subject>Medicare Part C - statistics &amp; numerical data</subject><subject>Older people</subject><subject>Patient Discharge - statistics &amp; numerical data</subject><subject>Patient Satisfaction - statistics &amp; numerical data</subject><subject>Regression analysis</subject><subject>Socioeconomic Factors</subject><subject>supplemental benefit</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>United States</subject><issn>0002-8614</issn><issn>1532-5415</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10b9O3TAYBXCrKiq3tENfoLLUpR0CthPHyYhQyx-BGGjn6Iv9GXxJ4hA7RXRpH6HPyJPgS2gHJLxY8vnpyNIh5ANnuzydvfVl2OVVzdQrsuIyF5ksuHxNVowxkVUlL7bJ2xDWjHHBquoN2c4rKbko1Ir8vvDaedR-8L3T1IKOfgoUQkjvENHQWxev6DxGuEYKg6EBogsb5_ywhEBHH-L9n79XPowuQud-wWPaI3SBtjigdZG6gZ6hcRompPvmJwwRLvEd2bIJ4fune4f8-Pb1-8FRdnp-eHywf5rpXOYqg7IusRC2LerWtLYVUogWQRuDtmZ1CZYzZpDJKgU2B27zSmnQZYloFavyHfJ56R0nfzNjiE3vgsaugwH9HJqcCSEVk6pI9NMzuvbzNKTfJVXzWilWbNSXRenJhzChbcbJ9TDdNZw1m1WatErzuEqyH58a57ZH81_-myGBvQXcug7vXm5qTg4vlsoHTlCaPA</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Richards, Anna L.</creator><creator>Vallejo, Jessica</creator><creator>Duan, Lewei</creator><creator>Dinsdale, Mary P.</creator><creator>Akiyama‐Ciganek, Jaime</creator><creator>Arakelian, Annet</creator><creator>Lee, Janet S.</creator><creator>Shen, Ernest</creator><creator>Nguyen, Huong Q.</creator><general>John Wiley &amp; Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3650-3705</orcidid><orcidid>https://orcid.org/0000-0001-6842-9418</orcidid></search><sort><creationdate>202408</creationdate><title>Socioeconomic factors associated with uptake and satisfaction with a post‐hospitalization meals benefit in Medicare Advantage</title><author>Richards, Anna L. ; Vallejo, Jessica ; Duan, Lewei ; Dinsdale, Mary P. ; Akiyama‐Ciganek, Jaime ; Arakelian, Annet ; Lee, Janet S. ; Shen, Ernest ; Nguyen, Huong Q.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-a696e42fb49bdbfb2522beacddef9096af100de058522f3a1f387cac66eef7083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>California</topic><topic>Congestive heart failure</topic><topic>Cross-Sectional Studies</topic><topic>Electronic medical records</topic><topic>Female</topic><topic>Food Assistance - statistics &amp; numerical data</topic><topic>Food Insecurity</topic><topic>Food security</topic><topic>Heart Failure - therapy</topic><topic>home‐delivered meals</topic><topic>Hospitalization</topic><topic>Hospitalization - statistics &amp; numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Meals</topic><topic>Medicare</topic><topic>Medicare Advantage</topic><topic>Medicare Part C - statistics &amp; numerical data</topic><topic>Older people</topic><topic>Patient Discharge - statistics &amp; numerical data</topic><topic>Patient Satisfaction - statistics &amp; numerical data</topic><topic>Regression analysis</topic><topic>Socioeconomic Factors</topic><topic>supplemental benefit</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Richards, Anna L.</creatorcontrib><creatorcontrib>Vallejo, Jessica</creatorcontrib><creatorcontrib>Duan, Lewei</creatorcontrib><creatorcontrib>Dinsdale, Mary P.</creatorcontrib><creatorcontrib>Akiyama‐Ciganek, Jaime</creatorcontrib><creatorcontrib>Arakelian, Annet</creatorcontrib><creatorcontrib>Lee, Janet S.</creatorcontrib><creatorcontrib>Shen, Ernest</creatorcontrib><creatorcontrib>Nguyen, Huong Q.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Richards, Anna L.</au><au>Vallejo, Jessica</au><au>Duan, Lewei</au><au>Dinsdale, Mary P.</au><au>Akiyama‐Ciganek, Jaime</au><au>Arakelian, Annet</au><au>Lee, Janet S.</au><au>Shen, Ernest</au><au>Nguyen, Huong Q.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Socioeconomic factors associated with uptake and satisfaction with a post‐hospitalization meals benefit in Medicare Advantage</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2024-08</date><risdate>2024</risdate><volume>72</volume><issue>8</issue><spage>2460</spage><epage>2470</epage><pages>2460-2470</pages><issn>0002-8614</issn><issn>1532-5415</issn><eissn>1532-5415</eissn><abstract>Background Kaiser Permanente Southern California began offering a 4‐week supplemental benefit of home‐delivered meals to Medicare Advantage members after discharge from a hospitalization for heart failure and other medical conditions in 2021. The purpose of this study is to explore the associations between socioeconomic disadvantage and food insecurity with patient uptake of and satisfaction with the meals. Methods Data for this cross‐sectional study were drawn from survey and electronic medical record data for members referred for the meals benefit (n = 6169) and linked to a hospitalization encounter (n = 2254) between January and December 2021. Uptake was assessed using vendor records; measures of socioeconomic status included the neighborhood deprivation index (NDI) and prior receipt of medical financial assistance (MFA) from the health system. Patients were invited to complete an email or phone survey about their satisfaction with the meals and food insecurity. Multivariable log‐binomial regression models were used to examine the association between socioeconomic disadvantage and food insecurity with meals uptake and satisfaction. Results Sixty‐two percent of patients referred for the benefit accepted the meals (mean age: 79 ± 9, 59% people of color). While there was no significant relationship between NDI and meals uptake (RR: 0.99, 95% CI: 0.92–1.07, p = 0.77), patients who received prior MFA were more likely to accept the meals (RR: 1.09, 95% CI: 1.02–1.16, p &lt; 0.01). Sixty‐nine percent of patients who completed the survey (23% response rate) reported that meals were very or extremely helpful. Patients with food insecurity (29% of survey respondents) were more likely to report that the meals were helpful for their recovery compared to food secure patients (RR: 1.21, 95% CI: 1.09–1.35, p &lt; 0.01). Conclusions The home‐delivered meals appeared to be particularly utilized by and helpful to patients with greater financial strain and/or food insecurity, suggesting that supplemental benefits could be more targeted toward addressing unmet needs of vulnerable adults. See related Editorial by Amit Kumar.</abstract><cop>Hoboken, USA</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>38551247</pmid><doi>10.1111/jgs.18907</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-3650-3705</orcidid><orcidid>https://orcid.org/0000-0001-6842-9418</orcidid></addata></record>
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subjects Aged
Aged, 80 and over
California
Congestive heart failure
Cross-Sectional Studies
Electronic medical records
Female
Food Assistance - statistics & numerical data
Food Insecurity
Food security
Heart Failure - therapy
home‐delivered meals
Hospitalization
Hospitalization - statistics & numerical data
Humans
Male
Meals
Medicare
Medicare Advantage
Medicare Part C - statistics & numerical data
Older people
Patient Discharge - statistics & numerical data
Patient Satisfaction - statistics & numerical data
Regression analysis
Socioeconomic Factors
supplemental benefit
Surveys
Surveys and Questionnaires
United States
title Socioeconomic factors associated with uptake and satisfaction with a post‐hospitalization meals benefit in Medicare Advantage
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