TY - JOUR
T1 - Understanding Medicare
T2 - Hearing Loss and Health Literacy
AU - Willink, Amber
AU - Reed, Nicholas S.
N1 - Funding Information:
This study was funded in part by the Commonwealth Fund (Grant No. 20192345) and the Cochlear Center for Hearing and Public Health at Johns Hopkins University School of Public Health. Amber Willink received an honorarium from the American Speech and Hearing Association to speak at the ASHA convention. Nicholas S. Reed is on the Scientific Advisory Board for Clearwater Clinical. Amber Willink crafted the study concept and design, and she acquired the data and conducted the analysis. Both Amber Willink and Nicholas S. Reed contributed to the interpretation of the data and preparation of the manuscript. The Commonwealth Fund and the Cochlear Center for Hearing and Public Health had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
This study was funded in part by the Commonwealth Fund (Grant No. 20192345) and the Cochlear Center for Hearing and Public Health at Johns Hopkins University School of Public Health. Amber Willink received an honorarium from the American Speech and Hearing Association to speak at the ASHA convention. Nicholas S. Reed is on the Scientific Advisory Board for Clearwater Clinical.
Publisher Copyright:
© 2020 The American Geriatrics Society
PY - 2020/10/1
Y1 - 2020/10/1
N2 - BACKGROUND/OBJECTIVES: Medicare has become an increasingly complex program to navigate with numerous choices available to beneficiaries with important implications for their financial exposure and access to care. Although research has identified poor health literacy as a barrier to understanding Medicare, little information is available on the experience of individuals with hearing loss. This study examined how hearing loss impacts Medicare beneficiaries in understanding the program, their ability to compare and review plan options, and their satisfaction with available information. DESIGN: Cross-sectional analysis using multivariate ordinal logistic regression. SETTING: Nationally representative survey of Medicare beneficiaries in the United States (Medicare Current Beneficiary Survey [MCBS]) 2017. PARTICIPANTS: A total of 10,510 Medicare beneficiaries were analyzed, representing 50,084,169 beneficiaries with survey weights applied. MEASUREMENTS: The primary outcome was difficulty understanding Medicare, determined by this MCBS question: “Overall, how easy or difficult do you think the Medicare program is to understand?” The predictor of interest was self-reported hearing loss measured categorically as no trouble, a little trouble, and a lot of trouble hearing. Covariates included age, sex, race, educational attainment, household income relative to the federal poverty level, enrollment in either traditional Medicare or Medicare Advantage, dementia diagnosis, trouble with vision, and number of chronic conditions. RESULTS: Medicare beneficiaries with a little or a lot of trouble hearing had 18% (95% confidence interval [CI] odds ratio [OR] = 1.10–1.27) and 25% (95% CI OR = 1.07–1.47) increased odds of reporting greater difficulty with understanding Medicare, respectively, compared with those with no hearing trouble. About one in five Medicare beneficiaries with hearing loss identified that their hearing made it difficult to find Medicare information. CONCLUSION: The existing tools to support Medicare beneficiaries’ understanding and navigation of the program must evolve to meet the needs of those with hearing loss, a highly prevalent condition among Medicare beneficiaries. J Am Geriatr Soc 68:2336–2342, 2020.
AB - BACKGROUND/OBJECTIVES: Medicare has become an increasingly complex program to navigate with numerous choices available to beneficiaries with important implications for their financial exposure and access to care. Although research has identified poor health literacy as a barrier to understanding Medicare, little information is available on the experience of individuals with hearing loss. This study examined how hearing loss impacts Medicare beneficiaries in understanding the program, their ability to compare and review plan options, and their satisfaction with available information. DESIGN: Cross-sectional analysis using multivariate ordinal logistic regression. SETTING: Nationally representative survey of Medicare beneficiaries in the United States (Medicare Current Beneficiary Survey [MCBS]) 2017. PARTICIPANTS: A total of 10,510 Medicare beneficiaries were analyzed, representing 50,084,169 beneficiaries with survey weights applied. MEASUREMENTS: The primary outcome was difficulty understanding Medicare, determined by this MCBS question: “Overall, how easy or difficult do you think the Medicare program is to understand?” The predictor of interest was self-reported hearing loss measured categorically as no trouble, a little trouble, and a lot of trouble hearing. Covariates included age, sex, race, educational attainment, household income relative to the federal poverty level, enrollment in either traditional Medicare or Medicare Advantage, dementia diagnosis, trouble with vision, and number of chronic conditions. RESULTS: Medicare beneficiaries with a little or a lot of trouble hearing had 18% (95% confidence interval [CI] odds ratio [OR] = 1.10–1.27) and 25% (95% CI OR = 1.07–1.47) increased odds of reporting greater difficulty with understanding Medicare, respectively, compared with those with no hearing trouble. About one in five Medicare beneficiaries with hearing loss identified that their hearing made it difficult to find Medicare information. CONCLUSION: The existing tools to support Medicare beneficiaries’ understanding and navigation of the program must evolve to meet the needs of those with hearing loss, a highly prevalent condition among Medicare beneficiaries. J Am Geriatr Soc 68:2336–2342, 2020.
KW - Medicare
KW - health literacy
KW - hearing loss
UR - http://www.scopus.com/inward/record.url?scp=85088835148&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088835148&partnerID=8YFLogxK
U2 - 10.1111/jgs.16705
DO - 10.1111/jgs.16705
M3 - Article
C2 - 32744734
AN - SCOPUS:85088835148
SN - 0002-8614
VL - 68
SP - 2336
EP - 2342
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 10
ER -