316-OR: Diabetes Care among Older Adults Enrolled in Medicare Advantage vs. Traditional Medicare Fee-for-Service Plans: The Diabetes Collaborative Registry

Background: While Medicare Advantage (MA) is projected to be the most common Medicare plan by 2030, little is known regarding differential diabetes care quality delivered under MA vs. traditional Fee-for-Service (FFS). Methods: Among 345,911 adults >65y with T2D enrolled in the Diabetes Collaborative Registry (2014-2017), 229,598 (66%) were enrolled in FFS and 116,313 (34%) in MA plans (for ≥1 month). Quality measures, intermediate outcomes, and prescription patterns were compared, adjusted for sociodemographic and clinical factors. Results: Mean age was 75±7y, 48% were women, and 51% had CAD in both plans. MA beneficiaries were more likely to receive ACEi/ARBs for CAD, have tobacco cessation counseling, and screening for retinopathy, foot care, and nephropathy (adj P≤0.001). However, MA beneficiaries had higher SBP (+0.2mmHg), LDL-c (+1.0mg/dL), and HbA1c (+0.1%) (adj P Conclusion: While MA plans enable greater access to preventative care, this may not translate to improved intermediate health outcomes nor access to newer antihyperglycemic therapies with proven outcome benefits. Long-term outcomes under various Medicare plans require surveillance. Disclosure U. Essien: None. Y. Tang: None. T. Litam: None. R. Patel: None. R. K. Wadhera: None. N. Desai: Research Support; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Cytokinetics Inc., MyoKardia, Novartis Pharmaceuticals Corporation. S. N. Mehta: None. M. N. Kosiborod: Consultant; Self; Amgen Inc., Applied Therapeutics, AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Scientific Affairs, LLC., Merck & Co., Inc., Novo Nordisk, Sanofi, Vifor Pharma Management Ltd., Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH. M. Vaduganathan: Advisory Panel; Self; American Regent, Inc., Amgen Inc., AstraZeneca, Bayer AG, Boehringer Ingelheim Pharmaceuticals, Inc., Cytokinetics Inc., Relypsa Inc., Speaker’s Bureau; Self; Novartis AG. Funding American College of Cardiology