UVA Health neurologist Jonathan R. Crowe is launching a new research initiative to investigate the effects of Medicare policies on stroke patient care and outcomes, according to a June 16 announcement. Crowe aims to identify the specific policies that influence treatment and recovery for Medicare patients, focusing on differences between traditional fee-for-service Medicare and Medicare Advantage plans offered by private insurers.
Crowe said that Medicare covers three-quarters of all stroke care in the United States, accounting for more than $2 billion annually. He will use data from both Medicare claims and the American Heart Association to pinpoint areas where access to care differs between plan types. Stroke remains the fourth-leading cause of death in the country, with nearly 800,000 Americans experiencing strokes each year.
In previous research, Crowe and his colleagues found that patients with Medicare Advantage insurance were more likely to have access to certain types of preventive care for strokes and tended to recover more quickly compared to those on traditional Medicare. These patients also had lower rates of hospital readmission and were more likely to live independently after a stroke. Conversely, patients with traditional Medicare Parts A, B, and D received more intensive post-stroke rehabilitation but faced different incentives due to how their coverage is structured.
Despite these variations in treatment pathways, overall outcomes were similar across both groups. Crowe's new project has been awarded a $231,000 Career Development Award from the American Heart Association over three years. His study will analyze over 12.5 million claims records as well as American Heart Association data regarding interventions such as clot-dissolving thrombolysis or mechanical thrombectomy among Advantage plan enrollees versus those with traditional coverage. The research will also examine factors like in-hospital mortality rates and post-discharge destinations for stroke survivors.
Crowe plans interviews with survivors and caregivers as part of his efforts "to identify barriers to best-practice stroke care." He said, "We know that insurance is an important non-medical factor that impacts patients and their families... it is critical for us to better understand how differences in the structure of patients' Medicare insurance impact the type of medical care patients receive." He added, "Our hope is that we can use this information to improve stroke outcomes and stroke care across the United States... We believe that this is an important opportunity for research to make a meaningful difference in the lives of patients and their families."
