Medicare & medicaid research review最新文献_第7页

Statistical uncertainty in the Medicare shared savings program. 医疗保险共享储蓄计划的统计不确定性。

Medicare & medicaid research review Pub Date : 2012-12-28 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.04.a04

Derek DeLia, Donald Hoover, Joel C Cantor

{"title":"Statistical uncertainty in the Medicare shared savings program.","authors":"Derek DeLia, Donald Hoover, Joel C Cantor","doi":"10.5600/mmrr.002.04.a04","DOIUrl":"https://doi.org/10.5600/mmrr.002.04.a04","url":null,"abstract":"Objective: Analyze statistical risks facing CMS and Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP).Methods: We calculate the probability that shared savings formulas lead to inappropriate payment, payment denial, and/or financial penalties, assuming that ACOs generate real savings in Medicare spending ranging from 0-10%. We also calculate expected payments from CMS to ACOs under these scenarios.Results: The probability of an incorrect outcome is heavily dependent on ACO enrollment size. For example, in the MSSP two-sided model, an ACO with 5,000 enrollees that keeps spending constant faces a 0.24 probability of being inappropriately rewarded for savings and a 0.26 probability of paying an undeserved penalty for increased spending. For an ACO with 50,000 enrollees, both of these probabilities of incorrect outcomes are equal to 0.02. The probability of inappropriate payment denial declines as real ACO savings increase. Still, for ACOs with 5,000 patients, the probability of denial is at least 0.15 even when true savings are 5-7%. Depending on ACO size and the real ACO savings rate, expected ACO payments vary from $115,000 to $35.3 million.Discussion: Our analysis indicates there may be greater statistical uncertainty in the MSSP than previously recognized. CMS and ACOs will have to consider this uncertainty in their financial, administrative, and care management planning. We also suggest analytic strategies that can be used to refine ACO payment formulas in the longer term to ensure that the MSSP (and other ACO initiatives that will be influenced by it) work as efficiently as possible.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006477/pdf/mmrr2012-002-04-a04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319043","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: 12

Reconciling medical expenditure estimates from the MEPS and NHEA, 2007. 协调2007年MEPS和NHEA的医疗支出估算。

Medicare & medicaid research review Pub Date : 2012-12-28 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.04.a09

Didem Bernard, Cathy Cowan, Thomas Selden, Liming Cai, Aaron Catlin, Stephen Heffler

{"title":"Reconciling medical expenditure estimates from the MEPS and NHEA, 2007.","authors":"Didem Bernard, Cathy Cowan, Thomas Selden, Liming Cai, Aaron Catlin, Stephen Heffler","doi":"10.5600/mmrr.002.04.a09","DOIUrl":"https://doi.org/10.5600/mmrr.002.04.a09","url":null,"abstract":"Objective: Provide a comparison of health care expenditure estimates for 2007 from the Medical Expenditure Panel Survey (MEPS) and the National Health Expenditure Accounts (NHEA). Reconciling these estimates serves two important purposes. First, it is an important quality assurance exercise for improving and ensuring the integrity of each source's estimates. Second, the reconciliation provides a consistent baseline of health expenditure data for policy simulations. Our results assist researchers to adjust MEPS to be consistent with the NHEA so that the projected costs as well as budgetary and tax implications of any policy change are consistent with national health spending estimates.Data sources: The Medical Expenditure Panel Survey produced by the Agency for Healthcare Research and Quality, and the National Health Center for Health Statistics and the National Health Expenditures produced by the Centers for Medicare & Medicaid Service's Office of the Actuary.Results: In this study, we focus on the personal health care (PHC) sector, which includes the goods and services rendered to treat or prevent a specific disease or condition in an individual. The official 2007 NHEA estimate for PHC spending is $1,915 billion and the MEPS estimate is $1,126 billion. Adjusting the NHEA estimates for differences in underlying populations, covered services, and other measurement concepts reduces the NHEA estimate for 2007 to $1,366 billion. As a result, MEPS is $240 billion, or 17.6 percent, less than the adjusted NHEA total.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006479/pdf/mmrr2012-002-04-a09.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319485","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: 113

Medicare beneficiary knowledge of the Part D program and its relationship with voluntary enrollment. 医疗保险受益人对D部分计划的了解及其与自愿登记的关系。

Medicare & medicaid research review Pub Date : 2012-12-12 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.04.a03

Benjamin Lee Howell, Jennifer Wolff, Bradley Herring

{"title":"Medicare beneficiary knowledge of the Part D program and its relationship with voluntary enrollment.","authors":"Benjamin Lee Howell, Jennifer Wolff, Bradley Herring","doi":"10.5600/mmrr.002.04.a03","DOIUrl":"https://doi.org/10.5600/mmrr.002.04.a03","url":null,"abstract":"Background: The 2003 Medicare Modernization Act established the Part D drug benefit in 2006. Because the benefit involves a voluntary enrollment process with numerous plan options, there has been concern about whether beneficiaries have adequate knowledge of the program, but research on this issue has been limited.Objectives: To examine Medicare beneficiary knowledge of the Part D program and estimate how knowledge affected voluntary enrollment decisions at the program's outset.Methods: We linked data from the 2005 Medicare Current Beneficiary Survey with CMS administrative data regarding beneficiary 2006 drug coverage and market characteristics. We estimated a multivariate logistic regression model to explore the relationship between Part D knowledge and beneficiaries' voluntary enrollment in a Part D plan.Results: At the inception of the Medicare Part D benefit, no single knowledge test question was correctly answered by more than three-fourths of beneficiaries. Correct responses to five knowledge test questions were positively associated with enrollment: \"everyone has plan choices\" (adjusted odds ratio = 1.4); \"plans can change costs once per year\" (aOR = 1.2); \"beneficiaries must use plan pharmacies\" (aOR = 1.5); \"beneficiaries must pay a penalty if they enroll late\" (aOR = 1.3); \"assistance is available for low income beneficiaries\" (aOR = 1.2).Conclusion: Beneficiary understanding of the Part D program in early 2006 was limited. Beneficiary knowledge of Part D program details was associated with enrollment in Medicare Part D. Efforts to educate Medicare beneficiaries about Part D may improve rates of prescription drug coverage.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006476/pdf/mmrr2012-002-04-a03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319596","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: 6

Linking Medicare, Medicaid, and cancer registry data to study the burden of cancers in West Virginia. 将医疗保险、医疗补助和癌症登记数据联系起来，研究西弗吉尼亚州的癌症负担。

Medicare & medicaid research review Pub Date : 2012-11-05 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.04.a01

Pramit A Nadpara, Suresh S Madhavan

{"title":"Linking Medicare, Medicaid, and cancer registry data to study the burden of cancers in West Virginia.","authors":"Pramit A Nadpara, Suresh S Madhavan","doi":"10.5600/mmrr.002.04.a01","DOIUrl":"https://doi.org/10.5600/mmrr.002.04.a01","url":null,"abstract":"Objective: Develop the WVCR-Linked dataset by combining the West Virginia Cancer Registry (WVCR) with Medicare, Medicaid, and other data sources. Determine health care utilization, costs, and overall burden of four major cancers among the elderly in a rural and medically underserved state population, and to compare them with national estimates.Method: We extracted personal identifiers from the West Virginia Cancer Registry (WVCR) data file for individuals ≥ 65 years of age with an incident diagnosis of any cancer between January 1, 2002 and December 31, 2007. We linked the extracted data with Medicare and Medicaid administrative data using deterministic record linkage procedures. We updated missing vital status information by linking the National Death Index (NDI) data file. The updated WVCR-Linked dataset was enriched by links to the U.S. decennial census (2000) file and the Area Resource File.Results: We identified 42,333 individuals, of which 41,574 (98.2%) and 6,031 (14.3%) individuals were matched with Medicare and Medicaid administrative data files, respectively. The NDI data added or updated vital status information for 3,295 (7.8%) individuals in the WVCR-Linked dataset.Conclusion: The WVCR-Linked dataset is a comprehensive dataset offering many opportunities to understand factors related to cancer treatment patterns, costs, and outcomes in a rural and medically underserved elderly Appalachian population. Following our example, non-participant states in the Surveillance, Epidemiology and End Results (SEER) program can build a powerful dataset to identify and target cancer disparities, and to improve cancer-related outcomes for their elderly and dual-eligible citizens.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006474/pdf/mmrr2012-002-04-a01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319594","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: 16

The role of data in health care disparities in Medicaid managed care. 数据在医疗补助管理性护理的医疗差距中的作用。

Medicare & medicaid research review Pub Date : 2012-11-05 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.04.a02

David Moskowitz, Bruce Guthrie, Andrew B Bindman

{"title":"The role of data in health care disparities in Medicaid managed care.","authors":"David Moskowitz, Bruce Guthrie, Andrew B Bindman","doi":"10.5600/mmrr.002.04.a02","DOIUrl":"10.5600/mmrr.002.04.a02","url":null,"abstract":"Background: The Affordable Care Act includes provisions to standardize the collection of data on health care quality that can be used to measure disparities. We conducted a qualitative study among leaders of Medicaid managed care plans, that currently have access to standardized quality data stratified by race and ethnicity, to learn how they use it to address disparities.Methods: We conducted semi-structured interviews with 21 health plan leaders across 9 Medicaid managed care plans in California. We used purposive sampling to maximize heterogeneity in geography and plan type (e.g., non-profit, commercial). We performed a thematic analysis based on iterative coding by two investigators.Results: We found 4 major themes. Improving overall quality was tightly linked to a focus on standardized metrics that are integral to meeting regulatory or financial incentives. However, reducing disparities was not driven by standardized data, but by a mix of factors. Data were frequently only examined by race and ethnicity when overall performance was low. Disparities were attributed to either individual choices or cultural and linguistic factors, with plans focusing interventions on recently immigrated groups.Conclusions: While plans' efforts to address overall quality were often informed by standardized data, actions to reduce disparities were not, at least partly because there were few regulatory or financial incentives driving meaningful use of data on disparities. Standardized data, as envisaged by the Affordable Care Act, could become more useful for addressing disparities if they are combined with policies and regulations that promote health care equity.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006475/pdf/mmrr2012-002-04-a02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319595","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

Service utilization of veterans dually eligible for VA and Medicare fee-for-service: 1999-2004. 同时符合退伍军人事务部和医疗保险付费服务资格的退伍军人的服务使用情况：1999-2004 年。

Medicare & medicaid research review Pub Date : 2012-10-19 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.03.a06

Jennifer Humensky, Henry Carretta, Kristin de Groot, Melissa M Brown, Elizabeth Tarlov, Denise M Hynes

{"title":"Service utilization of veterans dually eligible for VA and Medicare fee-for-service: 1999-2004.","authors":"Jennifer Humensky, Henry Carretta, Kristin de Groot, Melissa M Brown, Elizabeth Tarlov, Denise M Hynes","doi":"10.5600/mmrr.002.03.a06","DOIUrl":"10.5600/mmrr.002.03.a06","url":null,"abstract":"Objective: To examine care system choices for Veterans dually-eligible for VA and Medicare FFS following changes in VA eligibility policy, which expanded availability of VA health care services.Data sources: VA and Medicare FFS enrollment and outpatient utilization databases in 1999 and 2004.Study design: Multinomial logistic regression was used to examine odds of VA-only and Medicare-only utilization, relative to dual utilization, in 1999 and 2004. Observational cohort comprising a 5% random sample of dually-eligible Veterans: 73,721 in 1999 and 125,042 in 2004.Principal findings: From 1999 to 2004, persons with the highest HCC risk scores had decreasing odds of exclusive VA reliance (OR=0.26 in 1999 and 0.17 in 2004, p<0.05), but had increasing odds of exclusive Medicare reliance (OR=0.43 in 1999 and 0.56 in 2004, p<0.05).Persons in high VA priority groups had decreasing odds of exclusive VA reliance, as well as decreasing odds of exclusive Medicare reliance, indicating increasing odds of dual use. Newly eligible Veterans with the highest HCC risk scores had higher odds of dual system use, while newly eligible Black Veterans had lower odds of dual system use.Conclusions: Veterans newly eligible for VA healthcare services, particularly those with the highest risk scores, had higher odds of dual system use compared to earlier eligibles. Providers should ensure coordination of care for Veterans who may be receiving care from multiple sources. Provisions of the Patient Protection and Affordable Care Act may help to ensure care coordination for persons receiving care from multiple systems.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006386/pdf/mmrr2012-002-03-a06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319590","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

Evaluating comorbidity scores based on health service expenditures. 基于卫生服务支出评估共病评分。

Medicare & medicaid research review Pub Date : 2012-10-03 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.03.a05

Meredith L Kilgore, Wilson Smith, Jeffrey R Curtis, Michael A Morrisey, David J Becker, Kenneth G Saag, Elizabeth Delzell

{"title":"Evaluating comorbidity scores based on health service expenditures.","authors":"Meredith L Kilgore, Wilson Smith, Jeffrey R Curtis, Michael A Morrisey, David J Becker, Kenneth G Saag, Elizabeth Delzell","doi":"10.5600/mmrr.002.03.a05","DOIUrl":"https://doi.org/10.5600/mmrr.002.03.a05","url":null,"abstract":"Objective: To describe the performance of Charlson Comorbidity Index (CCI) specifications among Medicare beneficiaries and subgroups.Data sources: Medicare data for beneficiaries covered by Parts A and B and not Medicare Advantage throughout 2007.Study design: We evaluated several CCI specifications, particularly a model using expenditures related to Charlson categories, to predict 1 year mortality.Data collection/extraction methods: Data were obtained from the Chronic Condition Data Warehouse.Principal findings: The use of Charlson related expenditures did not result in improved mortality prediction. CCI models perform less well in population subgroups with higher underlying mortality risks based on age and chronic conditions.Conclusions: Relatively simple models provide quite adequate discrimination compared to more sophisticated models. Our proposed and more sophisticated model, which added in expenditure information, did not perform as well as much more easily executed methods.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006378/pdf/mmrr2012-002-03-a05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318085","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: 4

Medication days' supply, adherence, wastage, and cost among chronic patients in Medicaid. 医疗补助中慢性病患者用药天数的供应、依从性、浪费和成本。

Medicare & medicaid research review Pub Date : 2012-09-19 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.03.a04

Michael Taitel, Leonard Fensterheim, Heather Kirkham, Ryan Sekula, Ian Duncan

{"title":"Medication days' supply, adherence, wastage, and cost among chronic patients in Medicaid.","authors":"Michael Taitel, Leonard Fensterheim, Heather Kirkham, Ryan Sekula, Ian Duncan","doi":"10.5600/mmrr.002.03.a04","DOIUrl":"https://doi.org/10.5600/mmrr.002.03.a04","url":null,"abstract":"Background: In an attempt to contain Medicaid pharmacy costs, nearly all states impose dispensing limits on medication days' supply. Although longer days' supply appears to increase the potential for medication wastage, previous studies suggest that it may also decrease pharmacy expenditures by reducing dispensing fees and drug ingredient costs. This study was conducted to determine whether 90-day refills at community pharmacies could improve adherence, minimize wastage, and control costs.Methods: This retrospective observational study used California Medicaid claims, from the Walgreens pharmacy chain dated January 2010, to identify 52,898 patients prescribed statin, antihypertensive, selective serotonin reuptake inhibitor (SSRI), or oral hypoglycemic medications. Adherence was measured by medication possession ratio (MPR) and persistency with a 30-day gap. Medication wastage was defined as a switch of drug or drug strength within the same therapeutic class that occurred before the expected refill date.Results: Adherence was 20% higher and persistency was 23% higher for the 90-day group than the 30-day group. This amounted to an average increase of 0.14 MPR and 44 days of continuous therapy. The two groups had comparable proportions of patients with wastage. After subtracting an average wastage cost of $7.34 per person per year (PPPY), all therapeutic classes had PPPY savings: statins ($7.70), antihypertensives ($10.80), SSRIs ($18.52), and oral hypoglycemics ($26.86).Conclusion: Across four drug categories and compared to 30-day refills, patients with 90-day refills had greater medication adherence, greater persistency, nominal wastage, and greater savings.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006393/pdf/mmrr2012-002-03-a04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319592","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: 57

Volume of home- and community-based services and time to nursing-home placement. 以家庭和社区为基础的服务量和入住养老院的时间。

Medicare & medicaid research review Pub Date : 2012-08-06 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.03.a03

Laura P Sands, Huiping Xu, Joseph Thomas, Sudeshna Paul, Bruce A Craig, Marc Rosenman, Caroline C Doebbeling, Michael Weiner

{"title":"Volume of home- and community-based services and time to nursing-home placement.","authors":"Laura P Sands, Huiping Xu, Joseph Thomas, Sudeshna Paul, Bruce A Craig, Marc Rosenman, Caroline C Doebbeling, Michael Weiner","doi":"10.5600/mmrr.002.03.a03","DOIUrl":"10.5600/mmrr.002.03.a03","url":null,"abstract":"Objective: The purpose of this study was to determine whether the volume of Home- and Community-Based Services (HCBS) that target Activities of Daily Living disabilities, such as attendant care, homemaking services, and home-delivered meals, increases recipients' risk of transitioning from long-term care provided through HCBS to long-term care provided in a nursing home.Data sources: Data are from the Indiana Medicaid enrollment, claims, and Insite databases. Insite is the software system that was developed for collecting and reporting data for In-Home Service Programs.Study design: Enrollees in Indiana Medicaid's Aged and Disabled Waiver program were followed forward from time of enrollment to assess the association between the volume of attendant care, homemaking services, home-delivered meals, and related covariates, and the risk for nursing-home placement. An extension of the Cox proportional hazard model was computed to determine the cumulative hazard of nursing-home placement in the presence of death as a competing risk.Principal findings: Of the 1354 Medicaid HCBS recipients followed in this study, 17% did not receive any attendant care, homemaking services, or home-delivered meals. Among recipients who survived through 24 months after enrollment, one in five transitioned from HCBS to a nursing-home. Risk for nursing-home placement was significantly lower for each five-hour increment in personal care (HR=0.95, 95% CI=0.92-0.98) and homemaking services (HR=0.87, 95% CI=0.77-0.99).Conclusions: Future policies and practices that are focused on optimizing long-term care outcomes should consider that a greater volume of HCBS for an individual is associated with reduced risk of nursing-home placement.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006382/pdf/mmrr2012-002-03-a03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318086","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

CHIP reporting in the CPS. CPS中的CHIP报告。

Medicare & medicaid research review Pub Date : 2012-07-31 eCollection Date: 2012-01-01 DOI: 10.5600/mmrr.002.03.b01

Jacob Klerman, Michael R Plotzke, Mike Davern

{"title":"CHIP reporting in the CPS.","authors":"Jacob Klerman, Michael R Plotzke, Mike Davern","doi":"10.5600/mmrr.002.03.b01","DOIUrl":"https://doi.org/10.5600/mmrr.002.03.b01","url":null,"abstract":"Objective: To assess the quality of the Current Population Survey's (CPS) Child Health Insurance Program (CHIP) data.Data sources: Linked 2000-2004 Medicaid Statistical Information System (MSIS) and the 2001-2004 CPS.Data collection methods: Centers for Medicare & Medicaid Services provided the Census Bureau with its MSIS file. The Census Bureau linked the MSIS to the CPS data within its secure data analysis facilities.Study design: We compared responses to the CPS health insurance items with Medicaid and CHIP status according to the MSIS.Principal findings: CHIP reporting in the CPS is unreliable. Only 10-30 percent of those with CHIP (but not Medicaid) report this type of coverage in the CPS. Many with CHIP report Medicaid coverage, so the reporting error for a Medicaid-CHIP composite is smaller, but still substantial.Conclusions: The quality of the CPS CHIP information renders it effectively unusable for health policy analysis. Analysts should consider using a Medicaid-CHIP composite for CPS-based analyses.","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006394/pdf/mmrr2012-002-03-b01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319593","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: 6