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The Relationship Between Physician Organization and Health Care Use in Traditional Medicare and Medicare Advantage. 传统医疗保险和医疗保险优势中医师组织与医疗保健使用的关系。
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261477554
Laurence Baker, M Kate Bundorf, Daniel P Kessler, William Shipman
{"title":"The Relationship Between Physician Organization and Health Care Use in Traditional Medicare and Medicare Advantage.","authors":"Laurence Baker, M Kate Bundorf, Daniel P Kessler, William Shipman","doi":"10.1177/10775587261477554","DOIUrl":"https://doi.org/10.1177/10775587261477554","url":null,"abstract":"<p><p>Publicly funded insurance programs increasingly rely on private health plans to manage care, and physicians have organized into larger groups, many of which are owned by hospitals or health care systems. We examine the relationship between physician organization and health care resource use and whether this relationship differs between traditional Medicare and Medicare Advantage. We find that physician group practice is associated with less use of hospital inpatient and outpatient services, but that this relationship is attenuated for patients enrolled in Medicare Advantage. We also find that hospital ownership of physician practices is associated with greater use of hospital outpatient services, and that this relationship is not attenuated by Medicare Advantage. We conclude that, while Medicare Advantage and physician groups can serve as substitutes in care management, Medicare Advantage has had less success in controlling the shift toward hospital outpatient utilization. We also discuss the implications for health care market structure research.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261477554"},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hospital-Physician Integration and the Comprehensive Care for Joint Replacement Program. 医院-医生整合和关节置换术的综合护理。
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261468837
Brady Post, Alexandra Harris, Farbod Alinezhad, Gary Young
{"title":"Hospital-Physician Integration and the Comprehensive Care for Joint Replacement Program.","authors":"Brady Post, Alexandra Harris, Farbod Alinezhad, Gary Young","doi":"10.1177/10775587261468837","DOIUrl":"https://doi.org/10.1177/10775587261468837","url":null,"abstract":"<p><p>We examined how hospital-physician integration influences hip and knee osteoarthritis treatment under different payment models. We leveraged a natural experiment from Medicare's random assignment of metropolitan statistical areas (MSAs) to the Comprehensive Care for Joint Replacement (CJR) program. In the 12 months after diagnosis, CJR was associated with more primary care physician and orthopedist visits (0.14 and 0.23, <i>p</i> < .001 for both), while integration was associated with fewer (-0.16 and -0.59, <i>p</i> < .001 for both). We discovered an extensive margin effect: CJR was associated with lower likelihood of joint replacements (-1.9 percentage points [pp], <i>p</i> < .001); integration was associated with higher likelihood (1.0 pp, <i>p</i> < .001). Among knee replacement patients, those in CJR MSAs were less likely to receive surgery in outpatient settings (-4.6 pp, <i>p</i> < .001). Payment models and organizational structure may create opposing incentives, where bundled payment decreases and vertical integration increases the likelihood of joint replacement surgery.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261468837"},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ideology in Hospital Mergers and Acquisitions: Examining Religious and Secular Health Systems in the United States. 医院并购中的意识形态：审视美国的宗教和世俗卫生系统。
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261479984
Mika K Hamer, Nate C Apathy
{"title":"Ideology in Hospital Mergers and Acquisitions: Examining Religious and Secular Health Systems in the United States.","authors":"Mika K Hamer, Nate C Apathy","doi":"10.1177/10775587261479984","DOIUrl":"https://doi.org/10.1177/10775587261479984","url":null,"abstract":"<p><p>Consolidation has been prominent in US health care markets, yet little is known about the reach of church-owned health systems. Using the 2020-2023 AHRQ Compendium of US Health Systems, we characterized the size, geographic reach, and market share of church-owned health systems and examined the hospitals they newly acquired during this period. In 2023, only 6.3% of health systems were church-owned, but 22.2% of hospitals, 18.4% of hospital beds, 14.6% of primary care physicians, and 18.2% of discharges were in church-owned systems. Church-owned systems acquired fewer hospitals overall, but targeted larger hospitals located in more rural markets, most of which were secular prior to acquisition. Given the outsized presence of church-owned systems in some markets, our findings suggest that antitrust regulation might consider ideological differences and ownership composition in merger transactions as a dimension with potential patient access implications.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261479984"},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hospital Adaptations to New Models of Primary Care. 医院对初级保健新模式的适应
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261480274
Jolynn Suko, Nancy Borkowski, Sue Feldman, Christy Harris Lemak, Larry R Hearld
{"title":"Hospital Adaptations to New Models of Primary Care.","authors":"Jolynn Suko, Nancy Borkowski, Sue Feldman, Christy Harris Lemak, Larry R Hearld","doi":"10.1177/10775587261480274","DOIUrl":"https://doi.org/10.1177/10775587261480274","url":null,"abstract":"<p><p>Since the 1990s, hospitals have acquired primary care networks to ensure sustainability, often growing into health systems with owned primary and specialty care practices. Underperformance of the U.S. primary care system, however, has created opportunities for new primary care market entrants. This study examined how hospitals and health systems may be adapting to a subset of new, primary care market entrants or new primary care models. Primary and secondary data were used to estimate binary logistic regression models that examined the relationship between the number of new primary care models and hospitals' structural and technical service offerings. Six semi-structured interviews explored whether hospitals were collaborating with new primary care models. In general, the number of new models in a market was not associated with hospitals' structural or technical service offerings, with one exception, the provision of virtual visits (a technical offering). Qualitative interviews revealed that hospital leaders were taking a cautious approach before partnering with new primary care models.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261480274"},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cannabis Use and Individual Health Measures. 大麻使用和个人健康措施。
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-08-26 DOI: 10.1177/10775587261475527
Weiwei Chen, Michael T French
{"title":"Cannabis Use and Individual Health Measures.","authors":"Weiwei Chen, Michael T French","doi":"10.1177/10775587261475527","DOIUrl":"https://doi.org/10.1177/10775587261475527","url":null,"abstract":"<p><p>Despite growing acceptance of cannabis, considerable knowledge gaps persist regarding its effects on overall health status and quality of life. This study examines the impact of cannabis use on individuals' overall, physical, and mental health status. To address potential endogeneity in cannabis use, we employ an instrumental variable (IV) approach using individual-level data. Three sets of IVs-state-level cannabis laws, cannabis prices, and average cannabis use within matched gender-age groups-are used to estimate two-stage least-squares models. While the results vary across health measures and IVs, the findings based on the strongest IV-group average cannabis use-suggest that more days of cannabis use are associated with fewer days in good mental health among users aged 21 to 64, particularly males. For adults aged 65 and older, the effects are mixed.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261475527"},"PeriodicalIF":2.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mental Health Therapy Utilization Among Transgender Medicare Beneficiaries, From 2011 to 2019. 2011年至2019年跨性别医疗保险受益人心理健康治疗利用情况
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-08-25 DOI: 10.1177/10775587261475522
Bryce J Stanley, Gray Babbs, Jaclyn M W Hughto, David Meyers
{"title":"Mental Health Therapy Utilization Among Transgender Medicare Beneficiaries, From 2011 to 2019.","authors":"Bryce J Stanley, Gray Babbs, Jaclyn M W Hughto, David Meyers","doi":"10.1177/10775587261475522","DOIUrl":"10.1177/10775587261475522","url":null,"abstract":"<p><p>We examined outpatient mental health counseling use among transgender and gender-diverse (TGD) and cisgender Medicare beneficiaries from 2011 to 2019 using a cross-sectional analysis of Medicare claims data. TGD individuals were identified using a validated claims-based algorithm. The sample included 39,215 TGD beneficiaries and a 20% random sample of cisgender beneficiaries (<i>N</i> = 17,375,985). Similar to prior studies, TGD beneficiaries were more likely to use outpatient mental health counseling than cisgender beneficiaries. TGD beneficiaries were less likely to receive only one visit. TGD beneficiaries were also more likely to have visits with a licensed clinical social worker (LCSW), rather than a clinical psychologist. These findings highlight nuances in mental health counseling use among TGD Medicare beneficiaries and their differences relative to cisgender beneficiaries, including more intense utilization and a different provider specialty mix.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261475522"},"PeriodicalIF":2.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient Perspectives of Health Care Teams: A Narrative Review. 医疗保健团队的病人观点：叙述回顾。
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-08-24 DOI: 10.1177/10775587261477957
Crystal Guo, Roaa M Khinkar, Shehnaz Alidina, Isaac S Chua, Michaela J Kerrissey
{"title":"Patient Perspectives of Health Care Teams: A Narrative Review.","authors":"Crystal Guo, Roaa M Khinkar, Shehnaz Alidina, Isaac S Chua, Michaela J Kerrissey","doi":"10.1177/10775587261477957","DOIUrl":"https://doi.org/10.1177/10775587261477957","url":null,"abstract":"<p><p>Patients engage in teamwork in health care, yet their perspectives on teams remain understudied compared with those of health care professionals. We conducted a narrative review to describe how patients experience and perceive engagement with health care teams. Of 633 articles screened from MEDLINE/PubMed (2010-2024; English), 76 studies met the inclusion criteria. Most were small-sample qualitative studies with little interconnection. They identified 58 team factors that we synthesized into a conceptual model of structures (e.g., expertise mix), processes (e.g., communication), and normative or affective features (e.g., trust). These factors shape outcomes through both patients' perceptions of their team and patients' own engagement. We conclude that patient perspectives on teams elicit important information about health care team functioning and are vital to represent in research and practice. There is a need for a cohesive, conceptually grounded representation of patient-perceived teamwork factors and research that tests teamwork interventions using outcome measures.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261477957"},"PeriodicalIF":2.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of Hospital Infrastructure Investment on Quality of Care. 医院基础设施投资对护理质量的影响。
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-08-16 DOI: 10.1177/10775587261471942
Zachary Levin
{"title":"The Impact of Hospital Infrastructure Investment on Quality of Care.","authors":"Zachary Levin","doi":"10.1177/10775587261471942","DOIUrl":"https://doi.org/10.1177/10775587261471942","url":null,"abstract":"<p><p>Hospitals spend billions of dollars annually on major construction projects and facility upgrades, but limited research to date has examined whether this expenditure benefits patients. Using a novel dataset of California hospital construction projects opening between 2010 and 2019, we estimate the effect of project opening on patient experience and clinical measures using a difference-in-differences framework. We find sizable, statistically significant improvements in patient experience-cleanliness, quietness at night, and likelihood to recommend-with effects persisting for at least 2 years after opening. We find no measurable impact on clinical outcomes, 30-day mortality, and readmission for heart attacks and heart failure. These results suggest infrastructure investments meaningfully affect perceived care environments but may not translate into near-term changes in clinical performance. Policymakers and hospital leaders should weigh these returns when evaluating capital expenditures and potential support for hospital construction.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261471942"},"PeriodicalIF":2.7,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of an Individual Healthcare Provider Database. 个人医疗保健提供者数据库的开发。
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-08-01 Epub Date: 2026-03-05 DOI: 10.1177/10775587261424553
Anton Chorniy, Ali Moghtaderi, Qian Eric Luo, Paula Natalia Barreto Parra, Bernard Black
{"title":"Development of an Individual Healthcare Provider Database.","authors":"Anton Chorniy, Ali Moghtaderi, Qian Eric Luo, Paula Natalia Barreto Parra, Bernard Black","doi":"10.1177/10775587261424553","DOIUrl":"10.1177/10775587261424553","url":null,"abstract":"<p><p>The project described in this article develops a comprehensive, public database of U.S. individual healthcare providers from 1999 to 2025 (\"Provider Database\"). We combine data from multiple sources: NPPES (National Plan and Provider Enumeration System), ResDAC Unique Physician Identification Number Directory (UPIN Directory), Medicare Carrier files; PECOS (Medicare Provider Enrollment, Chain, and Ownership System), MD-PPAS (Medicare Data on Provider Practice and Specialty), DEA (Drug Enforcement Administration), and physician vertical integration data. The database covers 7 million providers, including 1.36 million physicians, covers the 2007 switch from UPIN to National Provider Identifier (NPI), and includes 918,609 NPI-UPIN pairs. Side public databases track providers' zip code and physician integration status over time. Side non-public databases (available to researchers with Carrier file access) include providers' Medicare provider identification number and tax identification number. This article details the database methodology and illustrates its use in studying trends in provider supply, over time and across states, and physician integration.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"282-292"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinician System Affiliation, Practice Size, and Medicare ACO Participation. 临床医生系统隶属关系，实践规模和医疗保险ACO参与。
IF 2.7 3区 医学
Medical Care Research and Review Pub Date : 2026-08-01 Epub Date: 2026-04-01 DOI: 10.1177/10775587261435110
Alexander O Everhart, Peter F Lyu, Jason M Hockenberry, Kenton J Johnston
{"title":"Clinician System Affiliation, Practice Size, and Medicare ACO Participation.","authors":"Alexander O Everhart, Peter F Lyu, Jason M Hockenberry, Kenton J Johnston","doi":"10.1177/10775587261435110","DOIUrl":"10.1177/10775587261435110","url":null,"abstract":"<p><p>The Centers for Medicare and Medicaid Services (CMS) and other policymakers have expressed interest in expanding rates of provider participation in accountable care organizations (ACOs), particularly among smaller physician group practices and independent providers. We described the extent to which clinician-level participation in ACOs varies as a function of both practice size and practice affiliations with health systems. We found that clinicians operating in larger practices and practices affiliated with health systems were more likely to participate in ACOs. Furthermore, engaging the approximately 800 largest practices not enrolled in ACOs as of 2022 in ACOs would increase clinician-level ACO participation rates by nearly 25 percentage points, while achieving the same gains in participation by engaging smaller practices would require engaging over 35,000 smaller practices. Our findings imply that prioritizing independent smaller practices for ACO engagement will yield smaller increases in clinician-level ACO participation rates compared to engaging larger system-affiliated practices.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"293-298"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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