# Evaluating Policies to Improve Heart Failure Outcomes in Medicare

> **NIH NIH K23** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2024 · $169,416

## Abstract

PROJECT SUMMARY/ABSTRACT
In the United States, 6.5 million people have heart failure (HF), the vast majority of whom are enrolled in
Medicare. Unfortunately, HF mortality is rising among Medicare beneficiaries despite significant advances in
HF therapies, and evidence suggests this may be partially due to gaps in health care access and affordability.
However, recent Medicare policy changes could meaningfully address these gaps, and ultimately improve HF
outcomes nationwide. One major change in the Medicare program has been the rapid growth of Medicare
Advantage (MA) plans, which now cover over 50% of all beneficiaries, and may be an important strategy to
improve HF care. In contrast to fee-for-service (FFS) Medicare, these private insurance plans receive capitated
payments from the government, and their design could impact HF patients in both beneficial and harmful ways.
In Aim 1, we will determine whether health care access, affordability, and clinical outcomes differ among
Medicare beneficiaries with HF enrolled in MA vs FFS Medicare, which is especially important given the
substantial burden of HF in Medicare. In addition to the rapid growth in MA, the recent passage of the Inflation
Reduction Act (IRA) has the potential to improve HF outcomes in Medicare. The IRA will cap annual OOP drug
costs at $2000/year and expand low-income subsidies for Medicare beneficiaries, which could have major
implications for those with HF. In Aim 2, we will use quasi-experimental approaches to determine whether the
IRA leads to real-world changes in OOP costs and associated improvements in medication adherence and
outcomes for Medicare beneficiaries with HF. Data on the real-world impact of the IRA will be critical as
policymakers consider strategies to improve HF outcomes in Medicare. Finally, as enrollment in MA continues
and the IRA is fully implemented, identifying ongoing and/or new barriers to HF care in Medicare will be critical.
In Aim 3, we will use semi-structured interviews of Medicare beneficiaries with HF and clinicians to identify
barriers in care access, affordability, and GDMT adherence, and novel strategies to address them. Qualitative
results from these interviews will serve as preliminary data for future studies that test and implement new
interventions to improve HF outcomes in Medicare. The overarching goal of this proposal is to use Medicare
claims, national survey, and qualitative data combined with advanced statistical methods to evaluate the
impact of new Medicare policies on the millions of beneficiaries with HF, and to identify emerging barriers to
care in this population. I will perform this work in the setting of a comprehensive career development plan
designed to provide me with the experience and skills necessary to become an independent research scientist.
My long-term career goal is to use mixed methods to evaluate how policies and interventions impact care
delivery and outcomes for HF patients, and I will use the research and sk...

## Key facts

- **NIH application ID:** 10865455
- **Project number:** 1K23HL173636-01
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Andrew Seymour Oseran
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $169,416
- **Award type:** 1
- **Project period:** 2024-07-01 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10865455

## Citation

> US National Institutes of Health, RePORTER application 10865455, Evaluating Policies to Improve Heart Failure Outcomes in Medicare (1K23HL173636-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10865455. Licensed CC0.

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