Journal of Depression and Anxiety
Open Access

Abstract

Late Life Depression and Anxiety in Four Types of Medicare Advantage Plans: Comorbidity with other Medical Diseases and Resource Utilization

Gail McAvay and Erik Goetz

Background: The prevalence of anxiety and depression and associated medical co-morbidities and costs has not been studied across different types of Medicare Advantage plans that vary in their level of utilization management and patient costs. Methods: A cross-sectional study of 74,290 older adults belonging to four different Universal American Medicare Advantage Plans was conducted, to estimate the period prevalence of depression and anxiety, the comorbidity between these disorders and major medical illnesses and associated costs. Results: The prevalence of anxiety or depression ranged from 14.5% to 18.8% across four types of Medicare Advantage plans, with HMO members less likely to be identified than members from fee-for-service or preferred provider organizations. Regardless of the type of plan, there was a high degree of comorbidity between depression and anxiety and other medical conditions, and higher utilization of services and costs in members with these disorders. Conclusions: A substantial prevalence of depression and anxiety disorders is present among older adult members of Medicare Advantage Plans and the presence of both disorders is associated with substantial medical comorbidity and costs. Clinicians in all care settings will encounter a substantial number of medically complex older adults with depression and anxiety, requiring close follow-up and coordination of care.