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Diabetes in the Medicare aged population, 2004. 老年医疗保险人口中的糖尿病，2004。
Health Care Financing Review Pub Date : 2008-01-01
Gerald S Adler
{"title":"Diabetes in the Medicare aged population, 2004.","authors":"Gerald S Adler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Medicare Current Beneficiary Survey (MCBS) contains a wealth of information on the health status of Medicare beneficiaries. In particular, the 2004 MCBS included a series of questions about diabetes care for those who reported they had the condition, and diabetes screening for those who said they did not. This highlight reviews some of the characteristics of the diabetic population compared to the non-diabetic population.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"29 3","pages":"69-79"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27510883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare and Medicaid: the past as prologue. 医疗保险和医疗补助:作为序幕的过去。
Health Care Financing Review Pub Date : 2008-01-01
Edward Berkowitz
{"title":"Medicare and Medicaid: the past as prologue.","authors":"Edward Berkowitz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>On July 30, 1965, President Lyndon B. Johnson signed the Social Security Amendments of 1965 into law. With his signature he created Medicare and Medicaid, which became two of America's most enduring social programs. The signing ceremony took place in Independence, Missouri, in the presence of former President Harry S. Truman, as if to indicate that what President Truman and other Presidents before him had tried to get done had now been accomplished. Yet, for all of the appearance of continuity, the law that President Johnson approved differed in significant ways from the law that President Franklin D. Roosevelt would have passed in the thirties or President Truman would have signed in the forties. The very idea of national health insurance underwent a major transformation between the beginning of the century and 1965. Even as the passage of Medicare became assured late in 1964 and in 1965, the legislation remained fluid, with important matters related to consumer choice and the basic design of the program in constant flux.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"29 3","pages":"81-93"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27510884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost of lifetime immunosuppression coverage for kidney transplant recipients. 肾移植受者终生免疫抑制覆盖率的成本。
Health Care Financing Review Pub Date : 2008-01-01
Timothy F Page, Robert S Woodward
{"title":"Cost of lifetime immunosuppression coverage for kidney transplant recipients.","authors":"Timothy F Page,&nbsp;Robert S Woodward","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>On January 1, 2000, Medicare extended the coverage of immunosuppression medications from 3 years to life for elderly and disabled kidney transplant recipients. This research estimates the impact of extending this lifetime coverage to all kidney transplant recipients on Medicare's cash flows. The study finds that extending coverage to all kidney transplant recipients would have increased Medicare's net cash outflows if the coverage were extended for patients of all income levels. There is evidence that extending coverage to only patients in the lowest income quartile could have resulted in a net cost savings to Medicare.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"30 2","pages":"95-104"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28104237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
15-site randomized trial of coordinated care in Medicare FFS. 医疗保险FFS协调护理的15点随机试验。
Health Care Financing Review Pub Date : 2008-01-01
Randall Brown, Deborah Peikes, Arnold Chen, Jennifer Schore
{"title":"15-site randomized trial of coordinated care in Medicare FFS.","authors":"Randall Brown, Deborah Peikes, Arnold Chen, Jennifer Schore","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Medicare beneficiaries in fee-for-service (FFS) who had chronic illnesses and volunteered to participate in 15 care coordination programs were randomized to treatment or control status. Nurses provided patient education (mostly by telephone) to improve adherence and ability to communicate with physicians. Patients were contacted an average of two times per month. The findings after 2 years are not encouraging. Few programs improved patient behaviors, health, or quality of care. The treatment group had significantly fewer hospitalizations in only one program; no program reduced gross or net expenditures. However, effects may be observed when 4 years of followup are available and sample sizes increase.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"30 1","pages":"5-25"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27864877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Facility service environments, staffing, and psychosocial care in nursing homes. 养老院的设施服务环境、人员配备和社会心理护理。
Health Care Financing Review Pub Date : 2008-01-01
Ning Jackie Zhang, Denise Gammonley, Seung Chun Paek, Kathryn Frahm
{"title":"Facility service environments, staffing, and psychosocial care in nursing homes.","authors":"Ning Jackie Zhang,&nbsp;Denise Gammonley,&nbsp;Seung Chun Paek,&nbsp;Kathryn Frahm","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Using 2003 Online Survey Certification and Reporting (OSCAR) data for Medicare and Medicaid certified facilities (N = 14, 184) and multinomial logistic regression this study investigated if (1) psychosocial care quality was better in facilities where State requirements for qualified social services staffing exceeded Federal minimum regulations and (2) facility service environments are associated with psychosocial care quality. For-profit status and higher percentage of Medicaid residents are associated with lower quality. Staffing, market demand, and market competition are associated with better quality. Psychosocial care quality is more associated with payer status and market forces and less with regulatory requirements.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"30 2","pages":"5-17"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28179780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare disease management in policy context. 政策背景下的医疗保险疾病管理。
Health Care Financing Review Pub Date : 2008-01-01
Ariel Linden, Julia Adler-Milstein
{"title":"Medicare disease management in policy context.","authors":"Ariel Linden,&nbsp;Julia Adler-Milstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Interim results of the Medicare health support (MHS) demonstration projects suggest that commercial disease management (DM) is unable to deliver short-term medical cost savings. This is not surprising given the current DM program focus on compliance with process measures that may only lead to cost savings in the long-term. A program focused on reducing near-term hospitalizations is more likely to deliver savings during the initial 3-year phase of MHS. If the early trends in MHS are indicative of the final results, CMS will face the decision of whether to abandon commercial DM in favor of other chronic care management strategies. This article supports the upcoming assessment by describing the characteristics of the current commercial DM model that limit its ability to deliver short-term medical cost savings and the changes required to overcome these limitations.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"29 3","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27510878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare risk adjustment for the frail elderly. 老年人体弱多病的医疗保险风险调整。
Health Care Financing Review Pub Date : 2008-01-01
John Kautter, Melvin Ingber, Gregory C Pope
{"title":"Medicare risk adjustment for the frail elderly.","authors":"John Kautter,&nbsp;Melvin Ingber,&nbsp;Gregory C Pope","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>CMS has had a continuing interest in exploring ways to incorporate frailty adjustment into the CMS Hierarchical Condition Categories (CMS-HCC) risk adjustment methodology for Medicare Advantage and other Medicare private organizations. In this article we present research results for Medicare risk adjustment of the frail elderly since the adoption of frailty adjustment for Program of All-Inclusive Care for the Elderly (PACE) organizations in 2004. In particular, we present results on the revised frailty adjuster that is being phased in for PACE organizations between 2008 and 2012.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"30 2","pages":"83-93"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28104236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impacts of a disease management program for dually eligible beneficiaries. 疾病管理计划对双重合格受益人的影响。
Health Care Financing Review Pub Date : 2008-01-01
Dominick Esposito, Randall Brown, Arnold Chen, Jennifer Schore, Rachel Shapiro
{"title":"Impacts of a disease management program for dually eligible beneficiaries.","authors":"Dominick Esposito,&nbsp;Randall Brown,&nbsp;Arnold Chen,&nbsp;Jennifer Schore,&nbsp;Rachel Shapiro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The LifeMasters Supported SelfCare demonstration program provides disease management (DM) services to Florida Medicare beneficiaries who are also enrolled in Medicaid and have congestive heart failure (CHF), diabetes, or coronary artery disease (CAD). The population-based program provides primarily telephonic patient education and monitoring services. Findings from the randomized, intent-to-treat design over the first 18 months of operations show virtually no overall impacts on hospital or emergency room (ER) use, Medicare expenditures, quality of care, or prescription drug use for the 33,000 enrollees. However, for beneficiaries with CHF who resided in high-cost South Florida counties, the program reduced Medicare expenditures by 9.6 percent.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"30 1","pages":"27-45"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27864878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identifying potentially preventable readmissions. 识别可能可预防的再入院。
Health Care Financing Review Pub Date : 2008-01-01
Norbert I Goldfield, Elizabeth C McCullough, John S Hughes, Ana M Tang, Beth Eastman, Lisa K Rawlins, Richard F Averill
{"title":"Identifying potentially preventable readmissions.","authors":"Norbert I Goldfield,&nbsp;Elizabeth C McCullough,&nbsp;John S Hughes,&nbsp;Ana M Tang,&nbsp;Beth Eastman,&nbsp;Lisa K Rawlins,&nbsp;Richard F Averill","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The potentially preventable readmission (PPR) method uses administrative data to identify hospital readmissions that may indicate problems with quality of care. The PPR logic determines whether the reason for readmission is clinically related to a prior admission, and therefore potentially preventable. The likelihood of a PPR was found to be dependent on severity of illness, extremes of age, and the presence of mental health diagnoses. Analyses using PPRs show that readmission rates increase with increasing severity of illness and increasing time between admission and readmission, vary by the type of prior admission, and are stable within hospitals over time.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"30 1","pages":"75-91"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27864881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of resource-based practice expenses on the Medicare physician volume. 基于资源的实践费用对医疗保险医师数量的影响。
Health Care Financing Review Pub Date : 2007-12-01
Stephanie Maxwell, Stephen Zuckerman
{"title":"Impact of resource-based practice expenses on the Medicare physician volume.","authors":"Stephanie Maxwell,&nbsp;Stephen Zuckerman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 1999, Medicare implemented a resource-based relative value unit (RVU) system for physician practice expense payments, and increased the number of services for which practice expense payments differ by site. Using 1998-2004 data, we examined RVU growth and decomposed that growth into resource-based RVUs, site of service, and service quantity and mix. We found that the number services with site of service differentials doubled, and that shifts in site of service and introduction of resource-based practice expenses (RBPE)were important sources of change in practice expense RVU volume. Service quantity and mix remained the largest source of growth in total RVU volume.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"29 2","pages":"65-79"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27402881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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