National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (7)
- Adverse Drug Events (ADE) (1)
- Adverse Events (4)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Arthritis (1)
- Autism (2)
- Behavioral Health (1)
- Blood Thinners (1)
- Cancer (6)
- Cancer: Lung Cancer (2)
- Cancer: Prostate Cancer (1)
- Cancer: Skin Cancer (1)
- Cardiovascular Conditions (3)
- Children/Adolescents (2)
- Community-Based Practice (1)
- COVID-19 (3)
- Data (1)
- Diagnostic Safety and Quality (1)
- Elderly (2)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (2)
- Falls (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (4)
- (-) Healthcare Costs (72)
- Healthcare Delivery (1)
- Healthcare Utilization (3)
- Health Information Technology (HIT) (3)
- Health Insurance (20)
- Health Systems (2)
- Hospitalization (5)
- Hospital Readmissions (1)
- Hospitals (8)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (1)
- Infectious Diseases (4)
- Injuries and Wounds (2)
- Labor and Delivery (1)
- Long-Term Care (1)
- Low-Income (2)
- Maternal Care (1)
- Medicaid (7)
- Medical Expenditure Panel Survey (MEPS) (4)
- Medicare (17)
- Medication (6)
- Medication: Safety (1)
- Men's Health (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Neurological Disorders (2)
- Newborns/Infants (3)
- Nursing Homes (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Opioids (2)
- Orthopedics (2)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Payment (3)
- Policy (6)
- Pregnancy (3)
- Prevention (3)
- Primary Care (2)
- Primary Care: Models of Care (1)
- Provider: Pharmacist (1)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (3)
- Rural Health (1)
- Screening (1)
- Sexual Health (3)
- Skin Conditions (2)
- Stroke (1)
- Substance Abuse (2)
- Surgery (13)
- Telehealth (3)
- Transitions of Care (1)
- Transplantation (1)
- Vaccination (3)
- Women (4)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 50 of 72 Research Studies DisplayedReid RO, Mafi JN, Baseman LH
Waste in the Medicare program: a national cross-sectional analysis of 2017 low-value service use and spending.
Low-value health care services offer patients little to no clinical benefit, increase spending, and may cause patient harm. In this analysis, the investigators provided updated national estimates of low-value service use and spending in Medicare in 2017. The investigators concluded that their findings suggest that targeted interventions to reduce low-value services—particularly the narrow subset responsible for the majority of spending—could substantially reduce wasteful Medicare spending.
AHRQ-funded; HS024067.
Citation: Reid RO, Mafi JN, Baseman LH .
Waste in the Medicare program: a national cross-sectional analysis of 2017 low-value service use and spending.
J Gen Intern Med 2021 Aug;36(8):2478-82. doi: 10.1007/s11606-020-06061-0..
Keywords: Medicare, Healthcare Costs
Eisenberg MD, Meiselbach MK, Bai G
Large self-insured employers lack power to effectively negotiate hospital prices.
This study examined the ability of self-insured employers to negotiate hospital prices and investigated the relationship between hospital prices and employer market power in the United States. Findings showed that employer market power was low in most metropolitan statistical areas. Recommendations included encouraging self-insured employers to consider building purchase alliances with state and local government employee groups in order to enhance their market power and to lower negotiated prices for hospital services.
AHRQ-funded; HS000029.
Citation: Eisenberg MD, Meiselbach MK, Bai G .
Large self-insured employers lack power to effectively negotiate hospital prices.
Am J Manag Care 2021 Jul;27(7):290-96. doi: 10.37765/ajmc.2021.88702..
Keywords: Health Insurance, Medicare, Medicaid, Healthcare Costs, Hospitals
Chua KP, Fendrick AM, Conti RM
Out-of-pocket spending for deliveries and newborn hospitalizations among the privately insured.
The authors estimated national data on out-of-pocket spending across the childbirth episode, including both deliveries and newborn hospitalizations, using national commercial claims data. They found that, during 2016–2019, privately insured families paid $3000 out-of-pocket for maternal and newborn hospitalizations, with out-of-pocket spending exceeding $5000 for 1 in 6 families. They recommended that clinicians counsel privately insured families concerning their childbirth benefits.
Citation: Chua KP, Fendrick AM, Conti RM .
Out-of-pocket spending for deliveries and newborn hospitalizations among the privately insured.
Pediatrics 2021 Jul;148(1):e2021050552. doi: 10.1542/peds.2021-050552..
Keywords: Newborns/Infants, Labor and Delivery, Pregnancy, Healthcare Costs
Chua KP, Fendrick AM, Conti RM
Prevalence and magnitude of potential surprise bills for childbirth.
This research letter describes a cross-sectional study that examined surprise bills that are received for childbirths and newborn hospitalizations, and whether new legislation to protect families from surprise bills would have a benefit. The authors analyzed 2019 data from Optum’s deidentified Clinformatics Data Mart and identified families with an in-network delivery in 2019 that could be linked to 1 or more in-network newborn hospitalization that was covered by the same family plan. The analysis included 95,384 families, and of those 17,949 (18.8%) had 1 or more potential surprise bill for the delivery, newborn hospitalization(s), or both. The median total liability for potential surprise bills was $744 for 6417 families, with total liability exceeding $2000. Among 32,203, and 63,181 deliveries with and without 1 or more cesarean delivery, 6594 (20.5%) and 5597 (8.9%) had 1 or more potential surprise bill, with a median liability of $1825 respectively. For 5970 and 90,991 newborn hospitalizations with or without 1 or more neonatal intensive care claim, 15.5% and 8.9% had 1 or more potential surprise bill, with a median liability of $1282 and $262 respectively. While this study was limited by lack of information whether these families actually received surprise bills, the findings suggest that federal protections against surprise bills could benefit many families.
AHRQ-funded; HS025465.
Citation: Chua KP, Fendrick AM, Conti RM .
Prevalence and magnitude of potential surprise bills for childbirth.
JAMA Health Forum 2021 Jul; 2(7):e211460. doi: 10.1001/jamahealthforum.2021.1460..
Keywords: Healthcare Costs, Maternal Care, Newborns/Infants, Hospitalization
Khanijow AN, Wood LN, Xie R
The impact of an enhanced recovery program (ERP) on the costs of colorectal surgery.
This study’s objective was to investigate the costs associated with a colorectal Enhanced Recovery Program (ERP) in a large academic health system. Subjects were patients who underwent colorectal surgery 2012-14 (pre-ERP) and 2015-17 (ERP). Findings showed that implementation of an ERP for colorectal surgery was associated with lower variable costs compared to pre-ERP.
AHRQ-funded; HS023009.
Citation: Khanijow AN, Wood LN, Xie R .
The impact of an enhanced recovery program (ERP) on the costs of colorectal surgery.
Am J Surg 2021 Jul;222(1):186-92. doi: 10.1016/j.amjsurg.2020.11.034..
Keywords: Surgery, Adverse Events, Healthcare Costs
Herb JN, Ollila DW, Stitzenberg KB
Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: analysis of a population-based registry.
This study looked at the utility of sentinel lymph node biopsy (SLNB) for non-ulcerated T1b melanoma. The aim of the study was to estimate SLNB use, positivity, prevalence, and procedural costs in patients with non-ulcerated T1b melanoma using a population-based registry. Patients with clinically node-negative, non-ulcerated T1b melanoma were identified in the SEER database from 2010 to 2016. Among 7245 included patients, 53% underwent SLNB of which 156 (4.1%) had a positive SLNB. Higher odds of positivity were associated with younger age, >1 mitosis per mm2, female sex, and truncal tumor location. Estimated SLNB costs to identify one patient with Stage II disease was $71,700. Out-of-pocket expenses for a Medicare patient was estimated to be $652 for a wide local excision (WLE) and SLNB and $79 for WLE alone.
AHRQ-funded; HS000032.
Citation: Herb JN, Ollila DW, Stitzenberg KB .
Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: analysis of a population-based registry.
Ann Surg Oncol 2021 Jul;28(7):3470-78. doi: 10.1245/s10434-021-09998-6..
Keywords: Cancer: Skin Cancer, Cancer, Surgery, Healthcare Costs, Skin Conditions
Childers CP, Ettner SL, Hays RD
Variation in intraoperative and postoperative utilization for 3 common general surgery procedures.
The goal of this study was to understand variation in intraoperative and postoperative utilization for common general surgery procedures. Electronic health record data for 7762 operations from two health systems were analyzed. Findings showed that surgeons were significant drivers of variation in surgical supply costs and procedure time, but much less so for postoperative length of stay. Intraoperative and postoperative utilization profiles can be generated for individual surgeons and may be an important tool for reducing surgical costs.
AHRQ-funded; HS025079.
Citation: Childers CP, Ettner SL, Hays RD .
Variation in intraoperative and postoperative utilization for 3 common general surgery procedures.
Ann Surg 2021 Jul 1;274(1):107-13. doi: 10.1097/sla.0000000000003571..
Keywords: Surgery, Healthcare Costs
Medbery RL, Fernandez FG, Kosinski AS
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Researchers sought to identify underlying case mix factors that contribute to variability of 90-day costs of lobectomy for early-stage lung cancer. Using the Society of Thoracic Surgeons General Thoracic Surgery Database, they found that lobectomy is associated with substantial variability of episode-of-care costs. Variability is driven by patient demographic and clinical factors, hospital characteristics, and the occurrence and severity of complications.
AHRQ-funded; R01 HS022279.
Citation: Medbery RL, Fernandez FG, Kosinski AS .
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Ann Thorac Surg 2021 Jun;111(6):1781-90. doi: 10.1016/j.athoracsur.2020.08.073..
Keywords: Cancer: Lung Cancer, Cancer, Healthcare Costs, Surgery, Elderly, Medicare
Roberts ET, Desai SM
Does Medicaid coverage of Medicare cost sharing affect physician care for dual-eligible Medicare beneficiaries?
The objective of this paper was to assess changes in physicians' provision of care to duals (low-income individuals with Medicare and Medicaid) in response to a policy that required Medicaid to fully pay Medicare's cost sharing for office visits with these patients. This policy-a provision of the Affordable Care Act-effectively increased payments for office visits with duals by 0%-20%, depending on the state, in 2013 and 2014.
AHRQ-funded; HS026727; HS026980.
Citation: Roberts ET, Desai SM .
Does Medicaid coverage of Medicare cost sharing affect physician care for dual-eligible Medicare beneficiaries?
Health Serv Res 2021 Jun;56(3):528-39. doi: 10.1111/1475-6773.13650..
Keywords: Medicare, Medicaid, Health Insurance, Access to Care, Healthcare Costs, Low-Income
Cowper PA, Feng L, Kosinski AS
Initial and longitudinal cost of surgical resection for lung cancer.
This study looked at the 4-year longitudinal cost of surgical resection of non-small cell lung cancer (NSCLC). The study describes initial and 4-year resource use and cost for NSCLC patients aged 65 years of age or older who were treated surgically from 2008 to 2013. Clinical data for NSCLC resections from The Society of Thoracic Surgery Database linked to Medicare claims, resource use and cost of preoperative staging, surgery, and subsequent care through 4 years were examined. Outcomes were stratified by pathologic stage and surgical approach for stage I lobectomy patients. In the first 90 days costs ranged from $12,430 for stage I to $26,350 for stage IV. Cumulative costs ranged from $131,032 for stage I to $205,368 for stage IV. For the stage I lobectomy cohort, patients who had minimally invasive procedures had lower 4-year costs than thoracotomy patients ($120,346 versus $136,250).
AHRQ-funded; R01 HS022279.
Citation: Cowper PA, Feng L, Kosinski AS .
Initial and longitudinal cost of surgical resection for lung cancer.
Ann Thorac Surg 2021 Jun;111(6):1827-33. doi: 10.1016/j.athoracsur.2020.07.048..
Keywords: Cancer: Lung Cancer, Cancer, Surgery, Healthcare Costs
Lyu PF, Chernew ME, McWilliams JM
Soft consolidation In Medicare ACOs: potential for higher prices without mergers or acquisitions.
Using commercial claims and data on health system membership and Medicare accountable care organizations (ACOs) participation, investigators found some abrupt, large price increases for independent primary care practices that joined health system-led ACOs but were not acquired by systems. These price jumps were rare, however, increasing prices by just 4 percent, on average, among all independent practices in system-led ACOs. The price jumps were more consistent with an extension of existing pricing power from systems to some independent practices than with a major expansion of system market power.
AHRQ-funded; HS024072; HS027531.
Citation: Lyu PF, Chernew ME, McWilliams JM .
Soft consolidation In Medicare ACOs: potential for higher prices without mergers or acquisitions.
Health Aff 2021 Jun;40(6):979-88. doi: 10.1377/hlthaff.2020.02449..
Keywords: Medicare, Health Insurance, Healthcare Costs
Chhabra KR, Fan Z, Chao GF
The role of commercial health insurance characteristics in bariatric surgery utilization.
The goal of this study was to understand relationships among insurance plan type, out-of-pocket cost sharing, and the utilization of bariatric surgery among commercially insured patients. Over 73,000 commercially insured members of the IBM MarketScan commercial claims database who underwent bariatric surgery from 2014-17 were retroactively reviewed. Findings showed that insurance plan types with higher cost sharing have lower utilization of bariatric surgery.
AHRQ-funded; HS025778; HS000053.
Citation: Chhabra KR, Fan Z, Chao GF .
The role of commercial health insurance characteristics in bariatric surgery utilization.
Ann Surg 2021 Jun;273(6):1150-56. doi: 10.1097/sla.0000000000003569..
Keywords: Health Insurance, Obesity, Obesity: Weight Management, Surgery, Healthcare Costs, Healthcare Utilization
Chen HF, Rose AM, Waisbren S
Newborn screening and treatment of phenylketonuria: projected health outcomes and cost-effectiveness.
This study’s objective was to evaluate the cost-effectiveness of newborn screening and treatment for phenylketonuria (PKU) in the context of new data on adherence to a recommended diet treatment and a newly available drug (sapropterin dihydrochloride). A computer simulation model was developed to project outcomes for a hypothetical cohort of newborns which compared four strategies. The strategies compared were: 1) clinical identification (CI) with diet treatment; 2) newborn screening (NBS) with diet treatment; 3) CI with diet and medication; and 4) NBS with diet and medication. The range of incremental cost-effectiveness ratio went from $6400/QALY for newborn screening with diet treatment compared to clinical identification with diet treatment up to $16,000,000/QALY for adding medication to NBS with diet treatment. Future research is needed to consider conditions under which sapropterin dihydrochloride would be more economically attractive.
AHRQ-funded; HS020644.
Citation: Chen HF, Rose AM, Waisbren S .
Newborn screening and treatment of phenylketonuria: projected health outcomes and cost-effectiveness.
Children 2021 May 12;8(5). doi: 10.3390/children8050381..
Keywords: Newborns/Infants, Neurological Disorders, Screening, Healthcare Costs
Powell D, Goldman D
Disentangling moral hazard and adverse selection in private health insurance.
This study used claims data from a large firm which changed health insurance plan options to isolate moral hazard from plan selection to estimate a discrete choice model to predict household plan preferences and attrition. The authors found the estimates imply that 53% of the additional medical spending observed in the most generous plan in their data relative to the least generous is due to adverse selection. They found that quantifying adverse selection by using prior medical expenditures overstates the true magnitude of selection due to mean reversion.
AHRQ-funded; HS023628.
Citation: Powell D, Goldman D .
Disentangling moral hazard and adverse selection in private health insurance.
J Econom 2021 May;222(1):141-60. doi: 10.1016/j.jeconom.2020.07.030..
Keywords: Health Insurance, Healthcare Costs
Whaley CM, Zhao X, Richards M
Higher Medicare spending on imaging and lab services after primary care physician group vertical integration.
This study looked at the impact of direct ownership of physician practices by hospitals and health systems (vertical integration) on Medicare spending for imaging and lab services. A 100% sample of 2013-16 Medicare fee-for-service claims data was examined to determine if vertical integration was associated with changes in site of care and Medicare reimbursement rates for ten common diagnostic imaging and laboratory services. After vertical integration, the monthly number of diagnostic imaging tests per 1,000 attributed beneficiaries increased in a hospital setting by 26.3 per 1000, and the number performed in a nonhospital setting decreased by 24.8 per 1,000. Hospital-based laboratory tests increased by 44.5 per 1,000 and non-hospital-based laboratory tests decreased by 36.0 per 1,000. Average Medicare reimbursement rose by $6.38 for imaging tests and $0.57 for laboratory tests. This translates to $40.2 million increase for imaging and $32.9 million increase for laboratory tests in Medicare spending for the study period.
AHRQ-funded; HS024067.
Citation: Whaley CM, Zhao X, Richards M .
Higher Medicare spending on imaging and lab services after primary care physician group vertical integration.
Health Aff 2021 May;40(5):702-09. doi: 10.1377/hlthaff.2020.01006..
Keywords: Medicare, Healthcare Costs, Imaging, Primary Care
Bartsch SM, O'Shea KJ, Wedlock PT
The benefits of vaccinating with the first available COVID-19 coronavirus vaccine.
This study’s objective was to determine quantitatively the benefits of early vaccination for COVID-19 even if later on in the pandemic a latter vaccine has substantially higher efficacy. The team developed this model in 2020 before vaccinations became available. For example if a vaccine with 50% efficacy becomes available when 10% of the population has already been infected, waiting until 40% of the population are infected for a vaccine with 80% efficacy results in 15.6 million additional cases and 1.5 million additional hospitalizations, costing $20.6 billion more in direct medical costs and $12.4 billion more in productivity losses.
AHRQ-funded; HS028165.
Citation: Bartsch SM, O'Shea KJ, Wedlock PT .
The benefits of vaccinating with the first available COVID-19 coronavirus vaccine.
Am J Prev Med 2021 May;60(5):605-13. doi: 10.1016/j.amepre.2021.01.001..
Keywords: COVID-19, Vaccination, Healthcare Costs, Prevention, Infectious Diseases
Krah NM, Jones TW, Lake J
The impact of antibiotic allergy labels on antibiotic exposure, clinical outcomes, and healthcare costs: a systematic review.
In this systematic review, the authors aimed to determine how antibiotic allergy labels influenced three domains. They found that antibiotic allergy labels have negative effects on antibiotic use and exposure, clinical outcomes, and economic outcomes in a variety of clinical settings and populations.
AHRQ-funded; HS023320.
Citation: Krah NM, Jones TW, Lake J .
The impact of antibiotic allergy labels on antibiotic exposure, clinical outcomes, and healthcare costs: a systematic review.
Infect Control Hosp Epidemiol 2021 May;42(5):530-48. doi: 10.1017/ice.2020.1229..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Healthcare Costs
Narla S, Silverberg JI
The inpatient burden and comorbidities of pyoderma gangrenosum in adults in the United States.
The objective of this study was to determine the prevalence, predictors, outcomes, and costs of hospitalization for pyoderma gangrenosum (PG) in United States adults. Data from the 2002-2012 National Inpatient Sample were analyzed. Findings showed that PG admissions were more likely at teaching and medium or large hospitals. The majority of inpatients with PG were classified with minor or moderate likelihood of dying, but moderate and major loss of function. PG was associated with numerous other health disorders. This study demonstrated a substantial and increasing inpatient burden of PG in the United States, with considerable disability and mortality risk, multiple comorbid health disorders, and costs.
AHRQ-funded; HS023011.
Citation: Narla S, Silverberg JI .
The inpatient burden and comorbidities of pyoderma gangrenosum in adults in the United States.
Arch Dermatol Res 2021 May;313(4):245-53. doi: 10.1007/s00403-020-02098-7..
Keywords: Healthcare Cost and Utilization Project (HCUP), Skin Conditions, Injuries and Wounds, Hospitalization, Healthcare Costs
Kaltenborn Z, Paul K, Kirsch JD
Super fragmented: a nationally representative cross-sectional study exploring the fragmentation of inpatient care among super-utilizers.
Researchers sought to determine the prevalence of super-utilizers who receive fragmented care across different hospitals and to describe associated risks, costs, and health outcomes. Using HCUP data, they found that inpatient care fragmentation was common among super-utilizers and disproportionately affected vulnerable populations. It was associated with high yearly costs and a decreased probability of correctly identifying super-utilizers.
AHRQ-funded; HS026732.
Citation: Kaltenborn Z, Paul K, Kirsch JD .
Super fragmented: a nationally representative cross-sectional study exploring the fragmentation of inpatient care among super-utilizers.
BMC Health Serv Res 2021 Apr 14;21(1):338. doi: 10.1186/s12913-021-06323-5..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Hospitalization
O'Hara NN, Mullins CD, Slobogean GP
Association of postoperative infections after fractures with long-term income among adults.
This retrospective cohort study evaluated the association between postoperative infection in patients with surgically treated fractures and long-term income loss. Out of 11,673 adults who underwent surgery to treat fractures of the extremities or pelvis from 2003-2016, a total of 3.5% had a postoperative infection. These infections were associated with a $6080 annual decrease in household income in the 6 years after injury. There was a 6.6% increase in the risk of catastrophic wage loss within 2 years of the fracture and a 45% increase in the odds of receiving Social Security benefits. However, postoperative infections were not associated with an increase in the value of the Social Security benefits received.
AHRQ-funded; HS027218.
Citation: O'Hara NN, Mullins CD, Slobogean GP .
Association of postoperative infections after fractures with long-term income among adults.
JAMA Netw Open 2021 Apr;4(4):e216673. doi: 10.1001/jamanetworkopen.2021.6673..
Keywords: Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Adverse Events, Healthcare Costs
Roberts ET, Glynn A, Cornelio N
Medicaid coverage 'cliff' increases expenses and decreases care for near-poor Medicare beneficiaries.
Cost sharing in traditional Medicare can consume a substantial portion of the income of beneficiaries who do not have supplemental insurance, resulting in a supplemental coverage cliff. The authors estimated that Medicaid beneficiaries affected by this cliff incurred an additional $2,288 in out-of-pocket spending over the course of two years, used 55 percent fewer outpatient evaluation and management services per year, and filled fewer prescriptions. They recommended expanding eligibility for Medicaid supplemental coverage and increasing take-up of Part D subsidies to lessen cost-related barriers to health care among near-poor Medicare beneficiaries.
AHRQ-funded; HS026727.
Citation: Roberts ET, Glynn A, Cornelio N .
Medicaid coverage 'cliff' increases expenses and decreases care for near-poor Medicare beneficiaries.
Health Aff 2021 Apr;40(4):552-61. doi: 10.1377/hlthaff.2020.02272..
Keywords: Medicaid, Medicare, Healthcare Costs, Low-Income, Health Insurance
Haddad DN, Shipe ME, Absi TS
Preparing for bundled payments: impact of complications post-coronary artery bypass grafting on costs.
This study examined the impact of complications on bundled payments for coronary artery bypass grafting (CABG) for care provided from admission through 90 days post-discharge. The authors linked clinical and internal cost data for patients undergoing CABG from 2014 to 2017 at a single institution. They performed multivariable linear regression to evaluate drivers of high costs, adjusting for preoperative and intraoperative characteristics and postoperative complications. They reviewed records of 1789 patients undergoing CABG with an average of 2.7 vessels. A large proportion of patients were diabetic and obese. Factors associated with increased adjusted costs were preoperative renal failure, diabetes and body mass index, postoperative stroke, prolonged ventilation, rebleeding requiring reoperation, and renal failure with varying magnitude.
AHRQ-funded; HS026122.
Citation: Haddad DN, Shipe ME, Absi TS .
Preparing for bundled payments: impact of complications post-coronary artery bypass grafting on costs.
Ann Thorac Surg 2021 Apr;111(4):1258-63. doi: 10.1016/j.athoracsur.2020.06.105..
Keywords: Cardiovascular Conditions, Surgery, Adverse Events, Healthcare Costs, Payment
Jacobs PD, Kronick R
AHRQ Author: Jacobs PD
The effects of coding intensity in Medicare Advantage on plan benefits and finances.
The authors assessed how beneficiary premiums, expected out-of-pocket costs, and plan finances in the Medicare Advantage (MA) market are related to coding intensity. The study sample included beneficiaries enrolled in both MA and Part D from 2008-2015; Medicare claims and drug utilization data for Traditional Medicare beneficiaries were used to calibrate an independent measure of health risk. The authors found that, while coding intensity increased taxpayers' costs of the MA program, enrollees and plans both benefitted but with larger gains for plans. They concluded that the adoption of policies to adjust more completely for coding intensity would likely affect both beneficiaries and plan profits.
AHRQ-authored.
Citation: Jacobs PD, Kronick R .
The effects of coding intensity in Medicare Advantage on plan benefits and finances.
Health Serv Res 2021 Apr;56(2):178-87. doi: 10.1111/1475-6773.13591..
Keywords: Medicare, Health Insurance, Healthcare Costs, Policy
Moniz MH, Peahl AF, Fendrick AM
Cost sharing, postpartum contraceptive use, and short interpregnancy interval rates among commercially insured women.
This study compared postpartum contraceptive use among women who had high, low, or no cost sharing for different types of contraception. The authors conducted a retrospective cohort analysis of commercially insured women undergoing childbirth from 2014 to 2018 using Optum's (Eden Prairie, MN) de-identified Clinformatics Data Mart database. The women were included if they had continuous enrollment for 12 months postpartum. Among 25,298 plans with cost sharing data, 172,941 women were identified, including 47.7% with no cost sharing, 13.1% in low cost sharing, and 39.2% in high cost sharing plans. Women in no cost sharing plans had a higher predicted probability of using long-acting reversible contraceptives and a lower predicted probability of no prescription method use than those in low or high cost sharing plans. There was no difference in short interpregnancy intervals between the plan cost sharing types.
AHRQ-funded; HS025465.
Citation: Moniz MH, Peahl AF, Fendrick AM .
Cost sharing, postpartum contraceptive use, and short interpregnancy interval rates among commercially insured women.
Am J Obstet Gynecol 2021 Mar;224(3):282.e1-82.e17. doi: 10.1016/j.ajog.2020.08.109..
Keywords: Healthcare Costs, Women, Health Insurance, Access to Care, Sexual Health
Rabideau B, Eisenberg MD, Reid R
Effects of employer-offered high-deductible plans on low-value spending in the privately insured population.
Enrollment in plans with high deductibles has increased more than seven-fold in the last decade. This study uses individual-level insurance claims data (2008-2013) and plausibly exogenous changes in plan offerings within firms over time to estimate the intent-to-treat and local-average treatment effects of high-deductible plan offerings on spending on 24 low-value services received in the outpatient setting.
AHRQ-funded; HS000029.
Citation: Rabideau B, Eisenberg MD, Reid R .
Effects of employer-offered high-deductible plans on low-value spending in the privately insured population.
J Health Econ 2021 Mar;76:102424. doi: 10.1016/j.jhealeco.2021.102424..
Keywords: Health Insurance, Healthcare Costs