Abstract Body (Do not enter title and authors here): Background: The federal government spends billions of dollars per year on payments to Medicare Advantage (MA) plans based largely on beneficiaries’ risk scores. Despite this, little is known about the true burden of cardiovascular risk factors among MA beneficiaries, or whether they receive better management of these conditions, compared to those in traditional Medicare (TM).

Goal: To determine whether the prevalence of cardiovascular risk factors, as well as treatment and control rates, differ between MA and TM beneficiaries.

Methods: We performed a cross-sectional analysis of adults >65 years enrolled in MA or TM participating in the National Health and Nutrition Examination Survey (2015-2018). We compared the prevalence of hypertension, obesity, hyperlipidemia, diabetes, and chronic kidney disease between MA and TM beneficiaries, and examined treatment and control rates for hypertension, hyperlipidemia, and diabetes. All outcomes were age- and sex-adjusted.

Results: The age- and sex-adjusted prevalence of hypertension (67.8% vs 67.4%, OR 0.96 [95% CI 0.72, 1.26]), obesity (40.8% vs 40.7%, OR 1.02 [95% CI 0.81, 1.29]), hyperlipidemia (75.8% vs 76.2%, OR 0.96 [95% CI 0.75, 1.22]), and chronic kidney disease (19.9% vs 22.2%, OR 0.80 [95% CI 0.55, -1.16], p=0.25) were similar between MA and TM beneficiaries, while the prevalence of diabetes was higher in MA (31.5% vs 24.2%, OR 1.48 [95% CI 1.21, 1.80]). Adjusted rates of hypertension treatment (82.3% vs 79.1%, OR 1.25 [95% CI 0.94, 1.65], p=0.14) and control (53.3% vs 58.7%, OR 0.86 [95% CI 0.62, 1.20], p=0.38), hyperlipidemia treatment (56.4% vs 56.0%, OR 1.02 [95% CI 0.79, 1.32], p=0.87) and control (82.0% vs 74.9%, OR 1.63 [95% CI 1.02, 2.61], p=0.051), as well as diabetes treatment (76.3% vs 82.5%, OR 0.73 [95% CI 0.45, 1.20], p=0.23) and control (53.3% vs 55.1%, OR 0.88 [95% CI 0.57, 1.36], p=0.56) were all similar between these groups.

Conclusions: In this nationally representative study using physical examination, biometric, and laboratory data from NHANES, the prevalence of common cardiovascular risk factors was similar between MA and TM beneficiaries. There were no differences in treatment or control rates for hypertension, hyperlipidemia, and diabetes.