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Medicaid's role in the many markets for health care. 医疗补助在许多医疗保健市场中的作用。
Health Care Financing Review Pub Date : 2007-01-01
Kevin Quinn, Martin Kitchener
{"title":"Medicaid's role in the many markets for health care.","authors":"Kevin Quinn,&nbsp;Martin Kitchener","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To illuminate Medicaid's growing role as a health care purchaser, we estimated Medicaid spending and market shares for 30 markets defined by provider category of service. For approximately 15 markets, our estimates are more detailed than the data available from standard sources. Two-thirds of Medicaid spending occurs in markets where the program has a modest market share. The other one-third occurs in markets that Medicaid dominates, especially in the areas of long-term care (LTC), mental retardation, and mental health. We explore the implications of the different roles for payment policy, industry organization, data availability, and quality of care.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"28 4","pages":"69-82"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26909052","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's quality improvement organization program value in nursing homes. 医疗保险质量改进组织计划在养老院的价值。
Health Care Financing Review Pub Date : 2007-01-01
Anthony Shih, Diane M Dewar, Thomas Hartman
{"title":"Medicare's quality improvement organization program value in nursing homes.","authors":"Anthony Shih,&nbsp;Diane M Dewar,&nbsp;Thomas Hartman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>CMS operates the quality improvement organization (QIO) program to improve the quality of care delivered to Medicare beneficiaries. Although there have been several studies regarding the effectiveness of this program, there have not been studies regarding this program's value. This article seeks to answer the value question using costutility analysis. Although additional research is warranted, the results suggest that CMS' investment in the QIO program, estimated at $2,063 to $7,667 per quality-adjusted life year (QALY) gained for nursing home quality improvement (QI) work, represents a good value for health care dollars.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"28 3","pages":"109-16"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26841981","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
Understanding the reporting practices of CAHPS sponsors. 了解 CAHPS 赞助商的报告做法。
Health Care Financing Review Pub Date : 2007-01-01
Stephanie S Teleki, David E Kanouse, Marc N Elliott, Liisa Hiatt, Han de Vries, Denise D Quigley
{"title":"Understanding the reporting practices of CAHPS sponsors.","authors":"Stephanie S Teleki, David E Kanouse, Marc N Elliott, Liisa Hiatt, Han de Vries, Denise D Quigley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article examines the reporting of Consumer Assessment of Healthcare Providers and Systems (CAHPSO) consumer experience data by sponsors, those that fund data collection and decide how information is summarized and disseminated. We found that sponsors typically publicly reported comparative data to consumers, employers, and/or purchasers. They presented health plan-level data in print and online at least annually, usually in combination with non-CAHPS information. Many provided trend data, comparisons to individual plans, and summary scores. Most shared information consistent with known successful reporting practices. Areas meriting attention include: tailoring reports to specific audiences, assessing literacy, planning dissemination, educating vendors, and evaluating products and programs.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"28 3","pages":"17-30"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26841975","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's drug discount card program: beneficiaries' experience with choice. 医疗保险药品折扣卡项目:受益人的选择经验。
Health Care Financing Review Pub Date : 2007-01-01
Andrea Hassol, Marian V Wrobel, Teresa Doksum
{"title":"Medicare's drug discount card program: beneficiaries' experience with choice.","authors":"Andrea Hassol,&nbsp;Marian V Wrobel,&nbsp;Teresa Doksum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article describes Medicare beneficiaries' experience with the choice among Medicare drug discount cards and is based primarily on surveys and focus groups with beneficiaries as well as interviews with other stakeholders. Although competition and choice have the potential to reduce cost and enhance quality in the Medicare Program, our findings highlight some of the challenges involved in making choice work in practice. Despite the unique and temporary nature of the drug discount card program, these findings have considerable relevance to the Part D drug benefit and to other Medicare initiatives that rely on choice.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"28 4","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26909047","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 drug coverage on medical expenditures among the elderly. 药品覆盖对老年人医疗支出的影响。
Health Care Financing Review Pub Date : 2007-01-01
Boyd H Gilman, Barbara Gage, Susan Haber, Sonja Hoover, Jyoti Aggarwal
{"title":"Impact of drug coverage on medical expenditures among the elderly.","authors":"Boyd H Gilman,&nbsp;Barbara Gage,&nbsp;Susan Haber,&nbsp;Sonja Hoover,&nbsp;Jyoti Aggarwal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Our study compares expenditures for Medicare covered medical services among enrollees in three State pharmacy assistance programs with spending among low-income residents eligible or near-eligible for, but not enrolled in such State-sponsored programs after controlling for between-group differences in demographic, socioeconomic, health status, and insurance status characteristics. We estimate a two-part model in total and by type of service (inpatient, outpatient, and professional) and chronic condition (hypertension, heart disease, and arthritis). We find that drug coverage has no discernible effect on the use and cost of inpatient services, but is associated with a statistically significant increase in Medicare spending for physician services.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"29 1","pages":"103-18"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27531608","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
Evolution of state outreach efforts under SCHIP. 在SCHIP下国家外联工作的演变。
Health Care Financing Review Pub Date : 2007-01-01
Susan R Williams, Margo L Rosenbach
{"title":"Evolution of state outreach efforts under SCHIP.","authors":"Susan R Williams,&nbsp;Margo L Rosenbach","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>States have shown creativity and adaptability in developing outreach strategies to promote State Children's Health Insurance Program (SCHIP) enrollment. As the program has matured and the fiscal environment has tightened, States have learned what efforts are successful and have tailored their approaches accordingly. This article reviews the evolution of State outreach strategies under SCHIP, using qualitative information from all 50 States and the District of Columbia. Early campaigns were aimed at building broad awareness of SCHIP. Over time, States have adapted their outreach campaigns to close the gaps in enrolling hard-to-reach populations, by modifying their target populations, messages, methods, organizational strategies, and emphasis.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"28 4","pages":"95-107"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26909868","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
Hospital size, uncertainty, and pay-for-performance. 医院规模、不确定性和绩效薪酬。
Health Care Financing Review Pub Date : 2007-01-01
Gestur Davidson, Ira Moscovice, Denise Remus
{"title":"Hospital size, uncertainty, and pay-for-performance.","authors":"Gestur Davidson,&nbsp;Ira Moscovice,&nbsp;Denise Remus","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We construct statistical models to assess whether hospital size will impact the ability to identify \"true\" hospital ranks in pay-for-performance (P4P) programs. We use Bayesian hierarchical models to estimate the uncertainty associated with the ranking of hospitals by their raw composite score values for three medical conditions: acute myocardial infarction (AMI), heart failure (HF), and community acquired pneumonia (PN). The results indicate a dramatic inverse relationship between the size of the hospital and its expected range of ranking positions for its true or stabilized mean rank. The smallest hospitals among the augmented dataset would likely experience five to seven times more uncertainty concerning their true ranks.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"29 1","pages":"45-57"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27531604","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
Medicaid and SCHIP coverage: findings from California and North Carolina. 医疗补助计划和医疗保险计划的覆盖范围：加利福尼亚州和北卡罗来纳州的调查结果。
Health Care Financing Review Pub Date : 2007-01-01
Genevieve Kenney, Jamie Rubenstein, Anna Sommers, Stephen Zuckerman, Fredric Blavin
{"title":"Medicaid and SCHIP coverage: findings from California and North Carolina.","authors":"Genevieve Kenney, Jamie Rubenstein, Anna Sommers, Stephen Zuckerman, Fredric Blavin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article examines experiences under Medicaid and the State Children's Health Insurance Program (SCHIP), drawing on surveys of over 3,000 enrollees in California and North Carolina in 2002. In both States, Medicaid enrollees were less likely than SCHIP enrollees to have parents who were covered by employer-sponsored insurance (ESI). With the exception of dental care and provider perceptions, access experiences were fairly comparable across the two programs, despite differences in the characteristics of the children served by the two programs. Relative to being uninsured, Medicaid enrollment was found to improve access to care along a number of different dimensions, controlling for other factors. Furthermore, this study emphasizes the need for continued evaluation of access to care for both programs.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"29 1","pages":"71-85"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27531606","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 physician group practice demonstration design: quality and efficiency pay-for-performance. 医疗保险医师团体执业示范设计:质量与效率按绩效付费。
Health Care Financing Review Pub Date : 2007-01-01
John Kautter, Gregory C Pope, Michael Trisolini, Sherry Grund
{"title":"Medicare physician group practice demonstration design: quality and efficiency pay-for-performance.","authors":"John Kautter,&nbsp;Gregory C Pope,&nbsp;Michael Trisolini,&nbsp;Sherry Grund","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Medicare Physician Group Practice (PGP) demonstration is Medicare's first physician pay-for-performance (P4P) initiative. The demonstration, which is legislatively mandated, establishes incentives for quality improvement (QI) and cost efficiency at the level of the PGP Ten large physician groups are participating in the demonstration, which started on April 1, 2005, and will run for 3 years. In this article the authors provide an overview of the PGP demonstration's key design elements, including the selection process for PGP participants; beneficiary assignment; comparison population; measurement of demonstration savings; performance payments; and quality measurement and reporting. A summary of early case study findings is also provided.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"29 1","pages":"15-29"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27532267","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
SCHIP structure and children's use of care. SCHIP结构与儿童护理的使用。
Health Care Financing Review Pub Date : 2006-01-01
Janet M Bronstein, E Kathleen Adams, Curtis S Florence
{"title":"SCHIP structure and children's use of care.","authors":"Janet M Bronstein,&nbsp;E Kathleen Adams,&nbsp;Curtis S Florence","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study explores the impact of program structure on children's use of care by comparing care use in State Children's Health Insurance Program (SCHIP) and Medicaid covered populations in a State where children share the same provider network and are both in a primary care case management system with the same Medicaid fee structure. We then compare care use in this system to care use in an SCHIP structured as a fee-for-service (FFS) system using a private insurance provider network and fee schedule. Where SCHIP and Medicaid Programs share a primary care case management (PCCM) system, we find more use of well-child care among Medicaid covered children, but more use of office-based physician care among SCHIP covered children. Across the Medicaid PCCM-based and the private insurance FFS-based system, we find more use of primary and specialty care in the FFS system, and more use of well-child care and less use of emergency departments for non-urgent care in the PCCM-based system.</p>","PeriodicalId":55071,"journal":{"name":"Health Care Financing Review","volume":"27 4","pages":"41-51"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26544109","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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