Health affairs (Project Hope)最新文献_第5页

Medicare Part D Preferred Pharmacy Networks And The Risk For Pharmacy Closure, 2014-23. 医疗保险D部分首选药房网络和药房关闭的风险，2014-23。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2024.01452

Jenny S Guadamuz, G Caleb Alexander, Genevieve P Kanter, Dima Mazen Qato

引用次数: 0

The Family Front Lines Of The Opioid Epidemic. 阿片类药物流行的家庭前线。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2024.00970

Liba Blumberger

引用次数: 0

Hospital Capital Expenditures Associated With Prices And Hospital Expansion Or Withering, 2010-19. 2010-19年与价格和医院扩张或萎缩相关的医院资本支出。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2024.01172

Nancy D Beaulieu, Andrew L Hicks, Michael E Chernew

{"title":"Hospital Capital Expenditures Associated With Prices And Hospital Expansion Or Withering, 2010-19.","authors":"Nancy D Beaulieu, Andrew L Hicks, Michael E Chernew","doi":"10.1377/hlthaff.2024.01172","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01172","url":null,"abstract":"Prices charged by hospitals in commercial markets are, on average, high and growing rapidly, and they vary within markets. The narrative around these facts has focused on hospitals gaining market power through mergers and acquisitions. Hospitals may also increase their market power by investing in capacity, services, or amenities that, although potentially desirable, increase demand and differentiate them from competitors. Independent of market-power changes, average prices may increase if volume shifts toward high-price hospitals. This study investigated the market dynamics linking hospital capital expenditures during the period 2010-19 to changes in volume, market share, and prices. We found that hospitals investing more in capital gained market share and raised prices, whereas hospitals investing relatively less in capital lost market share and increased prices less. Taken together, these forces perpetuate a cycle of expanding and withering hospitals. Study findings suggest important limits to antitrust as a mechanism to address high and rising prices, and the findings could inform policies to forestall or eliminate the financial decline of withering hospitals, thereby preserving access and promoting competition.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 5","pages":"546-553"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Private Equity-Owned Physician Practices Decreased Access To Retinal Detachment Surgery, 2014-22. 私募股权拥有的医生实践减少了视网膜脱离手术的机会，2014-22。

Health affairs (Project Hope) Pub Date : 2025-05-01 Epub Date: 2025-04-23 DOI: 10.1377/hlthaff.2024.01204

Yashaswini Singh, Geronimo Bejarano Cardenas, Hamid Torabzadeh, Christopher M Whaley, Durga Borkar

{"title":"Private Equity-Owned Physician Practices Decreased Access To Retinal Detachment Surgery, 2014-22.","authors":"Yashaswini Singh, Geronimo Bejarano Cardenas, Hamid Torabzadeh, Christopher M Whaley, Durga Borkar","doi":"10.1377/hlthaff.2024.01204","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01204","url":null,"abstract":"Private equity (PE) firms have increased their ownership stake across health care sectors in the US. PE's focus on short-term profitability may decrease the provision of unprofitable services, reducing access for patients in vulnerable populations. This is a particular concern for certain eye conditions such as retinal detachment, for which access to timely surgery is necessary to prevent irreversible vision loss and for which reimbursement is below cost for the fee-for-service Medicare population. Using a difference-in-differences approach, we examined changes in the provision of retinal detachment repair by 535 physicians in PE-acquired practices and 1,070 matched controls during the period 2014-22. Relative to matched controls, physicians in PE-acquired practices decreased the number of retinal detachment repairs by 19.6 percent after acquisition. These findings shed light on how PE acquisitions can affect the provision of services that do not present financial opportunities for investors. As nearly 30 percent of retina specialists are affiliated with PE firms nationally, further investigation into PE's impact on access for patients is warranted to determine whether PE acquisitions require patients to travel longer distances or have longer wait times, which could have serious effects on patient outcomes.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 5","pages":"589-596"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updated Medicaid-To-Medicare Fee Index: Medicaid Physician Fees Still Lag Behind Medicare Physician Fees. 更新的医疗补助到医疗保险费用指数：医疗补助医师费用仍然落后于医疗保险医师费用。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2024.01530

Laura Skopec, Avani Pugazhendhi, Stephen Zuckerman

{"title":"Updated Medicaid-To-Medicare Fee Index: Medicaid Physician Fees Still Lag Behind Medicare Physician Fees.","authors":"Laura Skopec, Avani Pugazhendhi, Stephen Zuckerman","doi":"10.1377/hlthaff.2024.01530","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01530","url":null,"abstract":"Medicaid plays a critical role in the US health insurance system, but a history of low physician fees has limited physicians' participation in the program. Recent Centers for Medicare and Medicaid Services rules have sought to encourage states to increase their Medicaid physician fees to at least 80 percent of Medicare fees, based on the methods used in the Urban Institute's periodic surveys of Medicaid physician fees. In this article, we show that between 2019 and 2024, Medicaid fees increased slightly, from 72 percent of Medicare fees to 75 percent of Medicare fees for a basket of twenty-seven common physician services. In addition, because the current Medicaid population includes far more nonelderly, nondisabled adults than when the original basket of services was chosen, we present an updated index that better reflects current patterns of spending and service use. We found that, based on this updated index, Medicaid physician fees were approximately 71 percent of Medicare physician fees in 2024, including 69 percent for office visits, 68 percent for hospital and emergency department visits, 87 percent for obstetric care, and 79 percent for other services under our updated approach.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 5","pages":"531-538"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hospitals Acquired By Private Equity Firms: Increased Postoperative Mortality For Common Inpatient Surgeries. 私募股权公司收购的医院：普通住院病人手术的术后死亡率增加。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2024.01102

Adrian Diaz, Mitchell Mead, Stefanie Rohde, Nicholas Kunnath, Justin B Dimick, Andrew M Ibrahim

{"title":"Hospitals Acquired By Private Equity Firms: Increased Postoperative Mortality For Common Inpatient Surgeries.","authors":"Adrian Diaz, Mitchell Mead, Stefanie Rohde, Nicholas Kunnath, Justin B Dimick, Andrew M Ibrahim","doi":"10.1377/hlthaff.2024.01102","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01102","url":null,"abstract":"Private equity (PE) firms have increasingly invested in US hospitals, raising concerns about their effects on the quality of surgical care. We evaluated the impact of PE acquisition of acute care hospitals on outcomes from four common general surgical operations among Medicare beneficiaries, using a difference-in-differences approach. Our study included 67 hospitals acquired by PE and 634 control hospitals not acquired by or previously owned by PE. We found that PE acquisition was associated with a 2.7-percentage-point increase in thirty-day postoperative mortality compared with control hospitals, driven primarily by an increase in failure to rescue (3.9 percentage points), with no observed change in the rate of complications. Subset analysis revealed that the increase in mortality was particularly pronounced for unplanned (emergent) surgeries, whereas no significant changes were observed for planned (elective) surgeries. Our findings suggest that PE acquisition may adversely affect the management of emergent surgical cases, raising critical considerations for policy makers and health care stakeholders regarding the influence of PE ownership on patient safety.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 5","pages":"554-562"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medicaid, Pharmacies, Hospital Markets, And More. 医疗补助，药房，医院市场等。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2025.00510

Donald E Metz, The Editorial Staff

引用次数: 0

Oncology Drugs: The Authors Reply. 肿瘤药物：作者回复。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2025.00103

Henry Grabowski, Joseph A DiMasi, Genia Long

引用次数: 0

Eligibility Assistance Increases Insurance Enrollment Within Community Health Centers But Not At The State Level. 资格援助增加了社区健康中心的保险登记人数，但在州一级却没有。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2024.01311

Leighton Ku, Kristine Namhee Kwon, Feygele Jacobs, Sara Rosenbaum

{"title":"Eligibility Assistance Increases Insurance Enrollment Within Community Health Centers But Not At The State Level.","authors":"Leighton Ku, Kristine Namhee Kwon, Feygele Jacobs, Sara Rosenbaum","doi":"10.1377/hlthaff.2024.01311","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01311","url":null,"abstract":"Although ample evidence exists that community health centers lower federal medical expenditures, it has been hypothesized that the eligibility assistance offered by staff at health centers could also increase insurance enrollment and federal costs. We analyzed the effects of eligibility assistance on insurance enrollment at both the health center and state levels. Using multivariate panel analysis with two-way fixed effects, we examined effects of eligibility assistance during the period 2016-23 to determine how insurance enrollment is affected at the health center and state levels. Data sources were administrative data from health centers and state-level enrollment data from Medicaid, the Children's Health Insurance Program (CHIP), and health insurance Marketplaces. Higher levels of eligibility assistance staffing are associated with modest increases in numbers of Medicaid and CHIP enrollees at health centers and modest reductions in numbers of uninsured patients. However, neither eligibility assistance nor overall health center size significantly affect state-level enrollment for any of the programs. Eligibility assistance modestly increases insurance coverage among health center patients, which improves health centers' financial status and patient care capacity. But this assistance does not significantly increase overall Medicaid, CHIP, or Marketplace enrollment, nor does it raise federal expenditures.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 5","pages":"606-613"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rural Hospital Closures Led To Increased Prices At Nearby 'Surviving' Hospitals, 2012-22. 2012-22年，农村医院关闭导致附近“幸存”医院价格上涨。

Health affairs (Project Hope) Pub Date : 2025-05-01 DOI: 10.1377/hlthaff.2024.00700

Caitlin Carroll, Jessica Y Chang

{"title":"Rural Hospital Closures Led To Increased Prices At Nearby 'Surviving' Hospitals, 2012-22.","authors":"Caitlin Carroll, Jessica Y Chang","doi":"10.1377/hlthaff.2024.00700","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.00700","url":null,"abstract":"Rural hospitals in the US have closed at a rapid pace in recent years, raising concerns about decreased access to care and declining competition in rural markets. Because prices paid by commercial health insurance plans are negotiated between hospitals and insurers, hospital closure may give \"surviving\" hospitals increased leverage to negotiate higher prices. Using commercial claims data, we studied the effect of hospital closure on the prices charged by nearby surviving hospitals. We found that hospital closures during the period 2014-18 led to a 3.6 percent increase in prices at surviving hospitals, driven by larger price increases in the three to four years after closure. Price effects were concentrated among surviving hospitals with market power-hospitals with system affiliations and hospitals operating in less competitive markets. We also found that closed hospitals charged lower prices than nearby hospitals in the preclosure period. Thus, closure eliminated low-price hospital options from rural markets. Overall, our findings suggest that hospital closure can have a meaningful impact on commercial prices. Policies targeting rural hospitals should consider the anticompetitive effects of closure, in addition to devoting continued attention to access to and quality of care.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 5","pages":"563-571"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0