Health Care Service Use among Elderly Seasonal Migrators

Molly Moore Jeffery, Julian Wolfson, Sarah K. Meier, Bryan E Dowd, Jean M Abraham, Robert L. Kane

Research output: Contribution to journalArticle

Abstract

Elderly seasonal migrators share time between homes in different states, presenting challenges for care coordination and patient attribution methods. Medicare has prioritized alternative payment models, putting health care providers at risk for quality and value of services delivered to their attributed patients, regardless of the location of care. Little research is available to guide providers and payers on the service use of seasonal migrators. The authors use claims data on fee-for-service (FFS) Medicare beneficiaries' locations throughout the year to (1) identify seasonal migrators and (2) describe the care they receive in each seasonal home, focusing on primary care and emergency department (ED) visits and the relationships between the two. In all, 5.5% of the Medicare aged FFS population were identified as seasonal migrators, with 4.1% following the traditional snowbird pattern of migration, spending warm months in the north and cold months in the south. Migrators had higher rates of ED visits and primary care treatable (PCT) ED visits than the nonmigratory groups, controlling for location, age, race, sex, Medicaid status, season, and comorbidities. They also had more visits with specialist physicians, more days with outpatient services, and more days seeing a physician in any setting. Having local primary care strongly reduced rates of both PCT ED visits and total ED visits for all migration categories, with the greatest reduction seen in PCT ED visits by migrators (local primary care was associated with a 58% reduction in PCT ED visits by snowbirds and a 65% reduction in PCT ED visits by other migrators).

Original languageEnglish (US)
Pages (from-to)415-421
Number of pages7
JournalPopulation Health Management
Volume21
Issue number5
DOIs
StatePublished - Oct 1 2018

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Health Services
Hospital Emergency Service
Primary Health Care
Delivery of Health Care
Medicare
Fee-for-Service Plans
Physicians
Medicaid
Ambulatory Care
Health Personnel
Comorbidity
Patient Care
Research
Population

Keywords

  • Medicare
  • health care service use
  • seasonal migration

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, P.H.S.

Cite this

Health Care Service Use among Elderly Seasonal Migrators. / Jeffery, Molly Moore; Wolfson, Julian; Meier, Sarah K.; Dowd, Bryan E; Abraham, Jean M; Kane, Robert L.

In: Population Health Management, Vol. 21, No. 5, 01.10.2018, p. 415-421.

Research output: Contribution to journalArticle

Jeffery, Molly Moore ; Wolfson, Julian ; Meier, Sarah K. ; Dowd, Bryan E ; Abraham, Jean M ; Kane, Robert L. / Health Care Service Use among Elderly Seasonal Migrators. In: Population Health Management. 2018 ; Vol. 21, No. 5. pp. 415-421.
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