Medication adherence, costs, and visits of nurse practitioner and primary care physician patients: Evidence from three cohorts of Medicare beneficiaries

Objective

To compare medication adherence, cost, and utilization in Medicare beneficiaries attributed to nurse practitioners () and primary care physicians ().

Data

Medicare Part A, B, and D claims and beneficiary summary file data, years 2009‐2013.

Study Design

We used propensity score‐weighted analyses combined with logistic regression and generalized estimating equations to test differences in good medication adherence (proportion of days covered ( >0.8); office‐based and specialty care costs; and visits.

Data Extraction

Beneficiaries with prescription claims for anti‐diabetics, renin‐angiotensin system antagonists (), or statins.

Principal Findings

There were no differences in good medication adherence ( >0.8) between and attributed beneficiaries taking anti‐diabetics or . Beneficiaries taking statins had a slightly higher probability of good adherence when attributed to s (74.6% vs 75.5%;  < 0.05). attributed beneficiaries had lower office‐based and specialty care costs and were less likely to experience an visit across all three medication cohorts ( < 0.01).

Conclusions

Examining the impact of and provided care on outcomes beyond the primary care setting is important to the Medicare program in general but will also help practices seeking to meet benchmarks under alternative payment models that incentivize higher quality and lower costs.