Comparative Insights on Care Provision, Access, and Costs in Aging and Chronic Illness

Session Submission Type: Panel

Abstract

This session brings together three studies examining how health system structures, policy incentives, and population differences shape care access, utilization, and costs for aging and chronically ill populations. Cheng and Li use linked Health and Retirement Study (HRS) with Medicare data to evaluate how Medicare reimbursement for Advance Care Planning affects the adoption of advance directives at the end of life. Topal and colleagues analyze administrative records from the Military Health System to compare utilization, expenditures, and quality of HIV care between public and private facilities within a single-payer context, addressing endogeneity in care assignment. Fox, Hart, and Li use nationally representative survey data to document disparities in preventive healthcare use and chronic disease outcomes between sexual minority and heterosexual older adults. Collectively, these studies provide comparative insights across populations and care settings, highlighting how financing mechanisms, institutional design, and patient identity intersect to influence the quality and efficiency of care for individuals with chronic conditions.

Policy Area

• Health Policy

Chair

• Jing Li, University of Washington

Discussants

• Hasan Shahid, University of Maryland, Baltimore County

• Sumedha Gupta, Indiana University

Organizer

• Leslie Ofori, APPAM

Individual Presentations

• Medicare Reimbursement for Advance Care Planning and Presence of Advance Directives: Evidence from Health and Retirement Study- Medicare Linked Data - Presenting Author: Zilin Cheng, University of Washington; Non-Presenting Co-Author: Jing Li, University of Washington

• Disparities in Preventive Healthcare Utilization and Health Outcomes Among Sexual Minority and Heterosexual Older Adults - Presenting Author: Julia Fox, University of Washington; Non-Presenting Co-Author: Jing Li, University of Washington; Non-Presenting Co-Author: Laura Hart

• The Impact of Nurse Practitioner Autonomy on Patient Sorting and Health Outcomes - Presenting Author: Sooa Ahn, The Ohio State University