Modeling the Impact of Medicare Advantage Payment Cuts on Ambulatory Care Sensitive and Elective Hospitalizations PDF Download
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Author: Lauren Hersch Nicholas
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Objective. To assess relationships between changes in Medicare Advantage (MA) payment rates and Medicare beneficiary hospitalizations and to simulate the effects of scheduled payment cuts on ambulatory care sensitive and elective hospitalization rates. Data. State Inpatient Database discharge abstracts from Arizona, Florida, and New York merged with administrative Medicare enrollment and MA payment data. Study Design. Retrospective, fixed effect regression analysis of the relationship between Medicare Advantage payment rates and rates of ambulatory care sensitive and elective hospitalizations amongst Medicare beneficiaries in counties with at least 10,000 Medicare beneficiaries and 3 percent MA penetration from 1999 - 2005. Principal Findings. MA payment rates were negatively related to rates of ACS admissions. Simulations suggest that payment cuts could be associated with higher rates of ACS admissions. No relationship between MA payments and rates of elective hospitalizations was found. Conclusions. Reductions in Medicare Advantage payment rates may result in a small increase in ambulatory care sensitive admissions. Trends in ambulatory care sensitive admissions amongst chronically ill Medicare beneficiaries should be tracked following MA payment cuts.
Author: Lauren Hersch Nicholas
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Objective. To assess relationships between changes in Medicare Advantage (MA) payment rates and Medicare beneficiary hospitalizations and to simulate the effects of scheduled payment cuts on ambulatory care sensitive and elective hospitalization rates. Data. State Inpatient Database discharge abstracts from Arizona, Florida, and New York merged with administrative Medicare enrollment and MA payment data. Study Design. Retrospective, fixed effect regression analysis of the relationship between Medicare Advantage payment rates and rates of ambulatory care sensitive and elective hospitalizations amongst Medicare beneficiaries in counties with at least 10,000 Medicare beneficiaries and 3 percent MA penetration from 1999 - 2005. Principal Findings. MA payment rates were negatively related to rates of ACS admissions. Simulations suggest that payment cuts could be associated with higher rates of ACS admissions. No relationship between MA payments and rates of elective hospitalizations was found. Conclusions. Reductions in Medicare Advantage payment rates may result in a small increase in ambulatory care sensitive admissions. Trends in ambulatory care sensitive admissions amongst chronically ill Medicare beneficiaries should be tracked following MA payment cuts.
Author: Gregory Berger
Publisher:
ISBN:
Category : Economics
Languages : en
Pages : 134
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Book Description
One controversial option to control growth in the rate of federal spending on health care is to transform Medicare into a "voucher" program for beneficiaries to purchase health insurance from managed care plans in the private market. Approximately one-quarter of Medicare beneficiaries are currently enrolled in a private health plan through Medicare Advantage, which has higher average costs than the traditional fee-for-service program but potentially reduces costly and unnecessary medical services by increasing the use of preventive care. Using a nationally representative sample of Medicare beneficiaries from the Medical Expenditure Panel Survey (MEPS) from 2006 to 2010, I compared the prevalence of potentially avoidable hospital admissions and use of preventive services for beneficiaries in Medicare Advantage to beneficiaries in the traditional fee-for-service program. Using propensity score estimation to control for observable bias, I found no relationship between enrollment in Medicare Advantage and potentially avoidable hospital admissions, and a significant but small positive relationship with use of select preventive services. Considered together, these findings suggest that Medicare Advantage may not achieve better health outcomes for beneficiaries than the traditional fee-for-service program. These findings have implications for policy discussions surrounding the future expansion of private managed care plans in the Medicare program.
Author: Joseph P. Newhouse
Publisher:
ISBN: 9780674319141
Category : Business & Economics
Languages : en
Pages : 489
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Book Description
From 1971 to 1982, researchers at the RAND Corporation devised an experiment to address two key questions in health care financing: how much more medical care will people use if it is provided free of charge? and what are the consequences for their health? This book presents a comprehensive account of the experiment and its findings. It will be an invaluable teaching tool and reference for anyone concerned with health-care policy.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030907343X
Category : Medical
Languages : en
Pages : 257
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Book Description
How good is the quality of health care in the United States? Is quality improving? Or is it suffering? While the average person on the street can follow the state of the economy with economic indicators, we do not have a tool that allows us to track trends in health care quality. Beginning in 2003, the Agency for Healthcare Research and Quality (AHRQ) will produce an annual report on the national trends in the quality of health care delivery in the United States. AHRQ commissioned the Institute of Medicine (IOM) to help develop a vision for this report that will allow national and state policy makers, providers, consumers, and the public at large to track trends in health care quality. Envisioning the National Health Care Quality Report offers a framework for health care quality, specific examples of the types of measures that should be included in the report, suggestions on the criteria for selecting measures, as well as advice on reaching the intended audiences. Its recommendations could help the national health care quality report to become a mainstay of our nation's effort to improve health care.
Author: Medicare Payment Advisory Commission (U.S.)
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 184
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Book Description
Author: National Research Council
Publisher: National Academies Press
ISBN: 0309264146
Category : Social Science
Languages : en
Pages : 421
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Book Description
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
Author: Jerry Cromwell
Publisher: RTI Press
ISBN: 1934831042
Category : Medical
Languages : en
Pages : 388
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Book Description
This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.
Author: William A. Haseltine
Publisher: Brookings Institution Press
ISBN: 0815724160
Category : Business & Economics
Languages : en
Pages : 198
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Book Description
"Today Singapore ranks sixth in the world in healthcare outcomes well ahead of many developed countries, including the United States. The results are all the more significant as Singapore spends less on healthcare than any other high-income country, both as measured by fraction of the Gross Domestic Product spent on health and by costs per person. Singapore achieves these results at less than one-fourth the cost of healthcare in the United States and about half that of Western European countries. Government leaders, presidents and prime ministers, finance ministers and ministers of health, policymakers in congress and parliament, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think-tanks should know how this system works to achieve affordable excellence."--Publisher's website.
Author: OECD
Publisher: OECD Publishing
ISBN: 9264805907
Category :
Languages : en
Pages : 447
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Book Description
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Author: Jennifer Baldwin
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 110
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Book Description
