Beneficiary activation in the Medicare population

Patient activation questions from a major national Medicare survey are used to highlight characteristics of Medicare beneficiaries with low activation. We demonstrate that Medicare Current Beneficiary Survey (MCBS) data is an untapped resource for further research on patient activation within Medicare beneficiaries and programs. Data are from the 2012 MCBS Access to Care file and include 10,650 beneficiaries. Patient Activation levels were derived by taking the weighted average responses to the Patient Activation Supplement. Cut points for high, moderate, and low activation were assigned at +/- ½ standard deviation of the mean. Data were analyzed using SAS survey procedures. Within group comparisons were tested using chi-square tests with post hoc pairwise comparisons. Logistic regression identified predictors of low patient engagement. In a multiple logistic regression, beneficiary characteristics associated with low activation included Hispanic origin, being widowed or never married, select age groups, male gender, fair or poor health, difficulty with an IADL or ADLs, and having no usual source of care, with failure to complete high school as the strongest predictor (OR=2.22, p