The impact of the affordable care Act (ACA) on favorable risk selection and Beneficiaries’ health status in Medicare advantage: a preliminary assessment

Table 3 Second Objective - Changes in health status

Dependent Variable	Focal Variable^a	Model 1^b	Model 2^c	Model 3^d
Dependent Variable	Focal Variable^a	Effect (SE)	Effect (SE)	Effect (SE)
Self-Rated Health (SRH)	Secular Trend	−0.022 (0.002)^***	−0.019 (0.002)^***	−0.015 (0.002)^***
Self-Rated Health (SRH)	Policy Measure	0.034 (0.002)^***	0.028 (0.002)^***	0.028 (0.002)^***
Falls	Secular Trend	1.034 (0.009)^***	1.029 (0.009)^**	1.020 (0.009)^*
Falls	Policy Measure	0.958 (0.008)^***	0.965 (0.008)^***	0.965 (0.008)^***
Balance Problems	Secular Trend	1.064 (0.009)^***	1.055 (0.009)^***	1.049 (0.009)^***
Balance Problems	Policy Measure	0.944 (0.008)^***	0.958 (0.008)^***	0.958 (0.008)^***
Falls Management	Secular Trend	1.093 (0.008)^***	1.083 (0.008)^***	1.073 (0.009)^***
Falls Management	Policy Measure	0.951 (0.008)^***	0.971 (0.008)^***	0.981 (0.008)^*
Frailty/disability	Secular Trend	1.056 (0.006)^***	1.049 (0.006)^***	1.043 (0.006)^***
Frailty/disability	Policy Measure	0.930 (0.005)^***	0.943 (0.005)^***	0.944 (0.005)^***
Morbidity Score	Secular Trend	1.005 (0.004)	1.004 (0.004)	1.005 (0.004)
Morbidity Score	Policy Measure	0.984 (0.004)^***	0.986 (0.004)^***	0.986 (0.004)^***

Significance level: * p-value <0.05 **; p-value <0.01; *** p-value <0.001. Due to space limitations, only focal variables of interest were displayed. Complete tables including coefficients of all included variables are available upon request
^aSecular Trend is a time-dependent indicator that captures any temporal changes in the outcomes of interest over time between 2007 and 2013; Policy Measure is the policy implementation measure (PIM) which reflects the changes in MA reimbursement
^bModel 1 includes (i) secular trend variable, (ii) policy effect, (iii) outcome indicator at baseline
^cModel 2 includes (i), (ii), (iii), and (iv) demographics (age, sex, race-ethnicity, education, and marital status)
^dModel 3 includes (i), (ii), (iii), and (iv) health status (SRH, falls, balance problems, falls management, frailty [when Balance is the DV, ADL score is calculated excluding walking disability component], and morbidity). A health status adjustor variable is not included when it is the DV

ISSN: 1472-6963