Impact of Medicare Utilization on Mortality and Readmission Rates of Heart Failure Patients 65 Years and Over

Impact of Medicare Utilization on Mortality and Readmission Rates of Heart Failure Patients 65 Years and Over by Joanna Alexander MBA, Keller Graduate School of Management, 2016 BS, University of South Alabama, 2012 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Healthcare Administration Walden University November 2020 Abstract Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address thisRoughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and mortality rates of patients 65 years and over with heart failure, and whether there is a relationship between Medicarecovered services for care and readmission rates of patients 65 years and over with heart failure. The study involved Hospital Compare data from CMS for Medicare patients 65 years and over who were seen in hospitals within the United States and diagnosed with heart failure from 2015 to 2017. Quantitative analyses were conducted through correlational and multiple regression analysis. Findings indicated statistically significant relationships of utilization of Medicare and mortality for 2015, 2016, and 2017 and statistically significant relationships of utilization of Medicare and readmission rates of individuals 65 years and over with heart failure in 2015 and 2016. It can be concluded that covariates and a focus on the impact of socioeconomic variables on Medicare beneficiaries 65 years and over with heart failure should be included for future research. Findings may be used by hospital administrators to create social change by understanding Medicare use and the needs of older adults. Impact of Medicare Utilization on Mortality and Readmission Rates of Heart Failure Patients 65 Years and Over by Joanna Alexander MBA, Keller Graduate School of Management, 2016 BS, University of South Alabama, 2012 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Healthcare Administration Walden University November 2020 Acknowledgments I would like to express my heartfelt appreciation to my family. My husband, parents, and brothers were there to encourage me all the way. They also went above and beyond to take care of our daughter so that I would be able to efficiently conduct research and analysis. The completion of my dissertation would not have been possible without their constant love and unwavering support. I would also like to extend my sincere gratitude to my committee. Dr. Carmen McDonald, my previous chair, guided me and offered valuable advice throughout the dissertation journey. Dr. Cynthia Newell, Dr. Kourtney Nieves, and Dr. Ronald Hudak provided insightful feedback which pushed me to sharpen my thinking and brought my work to a higher level.