Medicare & medicaid research review最新文献

{"title":"Medicare payments: how much do chronic conditions matter?","authors":"Erkan Erdem, Sergio I Prada, Samuel C Haffer","doi":"10.5600/mmrr.003.02.b02","DOIUrl":"10.5600/mmrr.003.02.b02","url":null,"abstract":"<p><strong>Objective: </strong>Analyze differences in Medicare Fee-for-Service utilization (i.e., program payments) by beneficiary characteristics, such as gender, age, and prevalence of chronic conditions.</p><p><strong>Methods: </strong>Using the 2008 and 2010 Chronic Conditions Public Use Files, we conduct a descriptive analysis of enrollment and program payments by gender, age categories, and eleven chronic conditions.</p><p><strong>Results: </strong>We find that the effect of chronic conditions on Medicare payments is dramatic. Average Medicare payments increase significantly with the number of chronic conditions. Finally, we quantify the effect of individual conditions and find that \"Stroke / Transient Ischemic Attack\" and \"Chronic Kidney Disease\" are the costliest chronic conditions for Part A, and \"Cancer\" and \"Chronic Kidney Disease\" are the costliest for Part B.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983726/pdf/mmrr2013-003-02-b02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32281977","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}

{"title":"The impact of electronic health records on ambulatory costs among Medicaid beneficiaries.","authors":"Julia Adler-Milstein,&nbsp;Claudia Salzberg,&nbsp;Calvin Franz,&nbsp;E John Orav,&nbsp;David Westfall Bates","doi":"10.5600/mmrr.003.02.a03","DOIUrl":"https://doi.org/10.5600/mmrr.003.02.a03","url":null,"abstract":"<p><strong>Background: </strong>Broad adoption of electronic health records (EHRs) is a potential strategy for curbing healthcare cost growth, which is particularly vital for Medicaid. Despite limited evidence for EHR-related cost savings, the 2009 HITECH Act included incentives for providers to become meaningful users of EHRs. We evaluated a large Massachusetts EHR pilot to obtain early insight into the potential for the national strategy to reduce short-run healthcare costs in the Medicaid population.</p><p><strong>Methods: </strong>We calculated monthly ambulatory cost and visit measures from Medicaid claims data for beneficiaries receiving the majority of their care in the three Massachusetts eHealth Collaborative (MAeHC) pilot communities or in six matched control communities. Using a difference-in-differences of slope analysis, we assessed whether cost and visit trajectories differed in the pre-implementation period compared to the post-implementation period for intervention and control community members.</p><p><strong>Results: </strong>We found evidence that EHR adoption impacted ambulatory medical cost in two of the three communities, but the effects were in opposite directions. Ambulatory medical costs increased more slowly in one intervention compared to its control communities in the pre-to-post period (difference-in-differences=-1.98%, p<0.001; PMPM savings of $41.60). In contrast, for a second pilot community, ambulatory medical cost increased more slowly in the control communities (difference-in-differences=2.56%, p=0.005; PMPM increase of $43.34).</p><p><strong>Conclusions: </strong>As a stand-alone approach, adoption of commercially-available EHRs in community practices did not consistently impact Medicaid costs in the short-run. This suggests that future meaningful use criteria may need to specifically target cost savings and coordinate with payment reform efforts.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5600/mmrr.003.02.a03","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32282056","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}

{"title":"Expansion of Medicaid covered smoking cessation services: maternal smoking and birth outcomes.","authors":"E Kathleen Adams,&nbsp;Sara Markowitz,&nbsp;Patricia M Dietz,&nbsp;Van T Tong","doi":"10.5600/mmrr.003.03.a02","DOIUrl":"https://doi.org/10.5600/mmrr.003.03.a02","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether Medicaid coverage of smoking cessation services reduces maternal smoking and improves birth outcomes.</p><p><strong>Methods: </strong>Pooled, cross-sectional data for 178,937 women with live births from 1996 to 2008, who were insured by Medicaid in 34 states plus New York City, were used to analyze self-reported smoking before pregnancy (3 months), smoking during the last 3 months of pregnancy, smoking after delivery (3-4 months), infant birth weight, and gestational age at delivery. Maternal socio-demographic and behavior variables from survey data and birth outcomes from vital records were merged with annual state data on Medicaid coverage for nicotine replacement therapies (NRT), medications and cessation counseling. Probit and OLS regression models were used to test for effects of states' Medicaid cessation coverage on mother's smoking and infant outcomes relative to mothers in states without coverage.</p><p><strong>Results: </strong>Medicaid coverage of NRT and medications is associated with 1.6 percentage point reduction (p<.05) in smoking before pregnancy among Medicaid insured women relative to no coverage. Adding counseling coverage to NRT and medication coverage is associated with a 2.5 percentage point reduction in smoking before pregnancy (p<.10). Medicaid cessation coverage during pregnancy was associated with a small increase (<1 day) in infant gestation (p<.05).</p><p><strong>Conclusions: </strong>In this sample, Medicaid coverage of smoking cessation only affected women enrolled prior to pregnancy. Expansions of Medicaid eligibility to include more women prior to pregnancy in participating states, and mandated coverage of some cessation services without co-pays under the Affordable Care Act (ACA) should reduce the number of women smoking before pregnancy.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983727/pdf/mmrr2013-003-03-a02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32281978","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}

{"title":"Medicare readmission rates showed meaningful decline in 2012.","authors":"Geoffrey Gerhardt,&nbsp;Alshadye Yemane,&nbsp;Peter Hickman,&nbsp;Allison Oelschlaeger,&nbsp;Eric Rollins,&nbsp;Niall Brennan","doi":"10.5600/mmrr.003.02.b01","DOIUrl":"https://doi.org/10.5600/mmrr.003.02.b01","url":null,"abstract":"<p><strong>Objective: </strong>Descriptive analysis of 30-day, all-cause hospital readmission rate patterns from 2007-2012.</p><p><strong>Population: </strong>Medicare FFS beneficiaries experiencing at least one acute inpatient hospital stay.</p><p><strong>Methods: </strong>Using Chronic Condition Data Warehouse claims, we estimate unadjusted, monthly, readmission rates for the nation, within the Dartmouth Hospital Referral Regions (HRR), and compare participating and non-participating hospitals in the Partnership for Patients (P4P) program (overall and by number of inpatient beds at each facility).</p><p><strong>Results: </strong>From 2007 through 2011, the national 30-day, all-cause, hospital readmission rate averaged 19 percent. During calendar year 2012, the readmission rate averaged 18.4 percent. Of the 306 HRRs, rates in 166 HRRs fell by between 1 and 5 percent, while rates dropped by more than 5 percent in 73 HRRs, with the largest reduction in Longview, Texas. Rates increased by more than 1 percent in only 30 HRRs, with the largest increase in Bloomington, Illinois. Readmission rates at hospitals participating in the P4P program have been, on average, consistently lower than the rates at non-participating hospitals within all size categories except for the very smallest and largest hospitals, but rates at both participant and non-participant hospitals fell in 2012.</p><p><strong>Discussion: </strong>Although claims data are not yet final for 2012, our analysis indicates that hospital readmission rates for all Medicare FFS beneficiaries dropped noticeably during the year. The reasons behind the apparent reduction are not yet clear and merit further investigation.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983725/pdf/mmrr2013-003-02-b01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32281976","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}

{"title":"Forecasting the use of electronic health records: an expert opinion approach.","authors":"Fredric Evan Blavin,&nbsp;Melinda Beeuwkes Buntin","doi":"10.5600/mmrr.003.02.a02","DOIUrl":"https://doi.org/10.5600/mmrr.003.02.a02","url":null,"abstract":"BACKGROUND To promote the widespread adoption and use of electronic health records (EHRs), in 2011, CMS started making Medicare and Medicaid incentive payments to providers who demonstrate that they are \"meaningful users\" of certified EHR systems. DATA AND METHODS This paper combines an expert opinion method, a modified Delphi technique, with a technological diffusion framework to create a forecast of the percent of office-based physicians who will become adopters and \"meaningful users\" of health information technology from 2012 to 2019. The panel consisted of 18 experts from industry, academia, and government who are knowledgeable about the adoption and use of EHRs in office-based settings and are recognized as opinion leaders in their respective professions. RESULTS Overall, the expert panel projected that primary care physicians in large group practices are more likely to achieve the meaningful use of EHRS relative to primary care physicians in small group practices and all other specialists: the group projected that 65 percent of primary care physicians in large group practices, 45 percent of primary care physicians in small group practices, and 44 percent of all other specialists could achieve meaningful use by 2015. In 2019, these projections increase to 80 percent, 65 percent, and 66 percent for these three groups, respectively. CONCLUSIONS AND POLICY IMPLICATIONS The information from this study is especially valuable when there is a lack of data and a high degree of uncertainty in a new policy environment and could help inform and evaluate government programs, such as the Regional Extension Centers (REC), by providing data from leading experts.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983723/pdf/mmrr2013-003-02-a02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32282055","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}

{"title":"Medicare Part D roulette: potential implications of random assignment and plan restrictions.","authors":"Rajul A Patel,&nbsp;Mark P Walberg,&nbsp;Joseph A Woelfel,&nbsp;Michelle M Amaral,&nbsp;Paresh Varu","doi":"10.5600/mmrr.003.02.a01","DOIUrl":"https://doi.org/10.5600/mmrr.003.02.a01","url":null,"abstract":"<p><strong>Background: </strong>Dual-eligible (Medicare/Medicaid) beneficiaries are randomly assigned to a benchmark plan, which provides prescription drug coverage under the Part D benefit without consideration of their prescription drug profile. To date, the potential for beneficiary assignment to a plan with poor formulary coverage has been minimally studied and the resultant financial impact to beneficiaries unknown.</p><p><strong>Objective: </strong>We sought to determine cost variability and drug use restrictions under each available 2010 California benchmark plan.</p><p><strong>Methods: </strong>Dual-eligible beneficiaries were provided Part D plan assistance during the 2010 annual election period. The Medicare Web site was used to determine benchmark plan costs and prescription utilization restrictions for each of the six California benchmark plans available for random assignment in 2010. A standardized survey was used to record all de-identified beneficiary demographic and plan specific data. For each low-income subsidy-recipient (n = 113), cost, rank, number of non-formulary medications, and prescription utilization restrictions were recorded for each available 2010 California benchmark plan. Formulary matching rates (percent of beneficiary's medications on plan formulary) were calculated for each benchmark plan.</p><p><strong>Results: </strong>Auto-assigned beneficiaries had only a 34% chance of being assigned to the lowest cost plan; the remainder faced potentially significant avoidable out-of-pocket costs. Wide variations between benchmark plans were observed for plan cost, formulary coverage, formulary matching rates, and prescription utilization restrictions.</p><p><strong>Conclusions: </strong>Beneficiaries had a 66% chance of being assigned to a sub-optimal plan; thereby, they faced significant avoidable out-of-pocket costs. Alternative methods of beneficiary assignment could decrease beneficiary and Medicare costs while also reducing medication non-compliance.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983722/pdf/mmrr2013-003-02-a01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32282054","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}

{"title":"The effect of the children's health insurance program on pediatricians' work hours.","authors":"Fang He,&nbsp;Chapin White","doi":"10.5600/mmrr.003.01.a01","DOIUrl":"https://doi.org/10.5600/mmrr.003.01.a01","url":null,"abstract":"<p><strong>Objective: </strong>Our study examines changes in physicians' work hours in response to a coverage expansion.</p><p><strong>Methods: </strong>We use as a natural experiment the Children's Health Insurance Program (CHIP), which was established in 1997 and significantly expanded children's eligibility for public health insurance coverage. The magnitude of the CHIP expansion varied across states and over time, allowing its effects to be identified using a state-year fixed effects model. We focus on pediatricians, and we measure their self-reported work hours using multiple waves (pre- and post-CHIP) of the physician survey component of the Community Tracking Study. To address endogeneity concerns, we instrument for CHIP enrollment using key program features (income eligibility cutoffs and waiting times).</p><p><strong>Results: </strong>We find a large negative relationship between the magnitude of a state's CHIP expansion and trends in pediatricians' work hours. This relationship could be due to key supply-side features of CHIP, including relatively low provider reimbursements and heavy use of managed care tools.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983738/pdf/mmrr2013_003_01_a01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32282053","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}

{"title":"Assessing the usability of MAX 2008 encounter data for comprehensive managed care.","authors":"Vivian L H Byrd,&nbsp;Allison Hedley Dodd","doi":"10.5600/mmrr.003.01.b01","DOIUrl":"https://doi.org/10.5600/mmrr.003.01.b01","url":null,"abstract":"<p><strong>Background: </strong>As growing numbers of Medicaid enrollees receive health benefits through comprehensive managed care, researchers and policymakers seeking to understand the service use of these enrollees must rely on encounter data.</p><p><strong>Objective: </strong>To assess the availability, completeness, and quality of physician, clinic, and outpatient service (OT), inpatient (IP), and prescription drug (RX) encounter claims to judge the usability of the 2008 Medicaid Analytical eXtract (MAX) encounter data.</p><p><strong>Data: </strong>2008 MAX encounter data, which are derived from the state-submitted Medicaid Statistical Information System (MSIS) files.</p><p><strong>Methods: </strong>For each basis of eligibility (BOE) group in each state that had at least ten percent participation in comprehensive managed care and submitted at least 200 encounter claims, the completeness and quality of the OT, IP, and RX encounter data were evaluated using comparison metrics created from the full-benefit, non-dual fee-for-service (FFS) population across all states with substantial FFS participation. Data that met both the completeness and quality criteria were considered usable.</p><p><strong>Results: </strong>The completeness and the quality of the encounter data were high. The encounter data were considered usable for a least one BOE category for 22 of the 25 states that submitted OT encounter data, 20 of the 24 states that submitted IP data, and 13 of the 15 states that submitted RX data.</p><p><strong>Conclusions: </strong>Most states that have comprehensive managed care plans are reporting OT, IP, and RX encounter data. Of those data, the majority are complete and of comparable quality to FFS data for adults, children, the disabled, and aged populations.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983721/pdf/mmrr2013-003-01-b01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32282052","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}

{"title":"The effects of Medicaid policy changes on adults' service use patterns in Kentucky and Idaho.","authors":"James Marton,&nbsp;Genevieve M Kenney,&nbsp;Jennifer E Pelletier,&nbsp;Jeffery Talbert,&nbsp;Ariel Klein","doi":"10.5600/mmrr.002.04.a05","DOIUrl":"https://doi.org/10.5600/mmrr.002.04.a05","url":null,"abstract":"<p><strong>Background: </strong>In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007.</p><p><strong>Methods: </strong>Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group.</p><p><strong>Results: </strong>While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact.</p><p><strong>Conclusions: </strong>We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006377/pdf/mmrr2012-002-04-a05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319487","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}

{"title":"Impact of chronic conditions on the cost of cancer care for Medicaid beneficiaries.","authors":"Sujha Subramanian,&nbsp;Florence K L Tangka,&nbsp;Susan A Sabatino,&nbsp;David Howard,&nbsp;Lisa C Richardson,&nbsp;Susan Haber,&nbsp;Michael T Halpern,&nbsp;Sonja Hoover","doi":"10.5600/mmrr.002.04.a07","DOIUrl":"https://doi.org/10.5600/mmrr.002.04.a07","url":null,"abstract":"<p><strong>Background: </strong>No study has assessed the cost of treating adult Medicaid cancer patients with preexisting chronic conditions. This information is essential for understanding the cost of cancer care to the Medicaid program above that expended for other chronic conditions, given the increasing prevalence of chronic conditions among cancer patients.</p><p><strong>Research design: </strong>We used administrative data from 3 state Medicaid programs' linked cancer registry data to estimate cost of care during the first 6 months following cancer diagnosis for beneficiaries with 4 preexisting chronic conditions: cardiac disease, respiratory diseases, diabetes, and mental health disorders. Our base cohort consisted of 6,212 Medicaid cancer patients aged 21 to 64 years (cancer diagnosed during 2001-2003) who were continuously enrolled in fee-for-service Medicaid for 6 months after diagnosis. A subset of these patients who did not die during the 6-month follow-up (n=4,628), were matched with 2 non-cancer patients each (n=8,536) to assess incremental cost of care.</p><p><strong>Results: </strong>The average cost of care for cancer patients with the chronic conditions studied was higher than for cancer patients without any of these conditions. The increase in cancer treatment cost associated with the chronic conditions ranged from $4,385 for cardiac disease to $11,009 for mental health disorders.</p><p><strong>Conclusions: </strong>Chronic conditions, especially the presence of multiple conditions, are associated with a higher cost of care among Medicaid cancer patients, and these increased costs should be reflected in projections of future Medicaid cancer care costs. The implementation of better care-management processes for cancer patients with preexisting chronic conditions may be one way to reduce these costs.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006381/pdf/mmrr2012-002-04-a07.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319488","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}