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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 503 Research Studies Displayed
Zrelak PA, Utter GH, McDonald KM
Incorporating harms into the weighting of the revised Agency for Healthcare Research and Quality Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90).
The purpose of this study was to reweight AHRQ’s Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90) from weights based solely on the frequency of component Patient Safety Indicators (PSIs) to those that incorporate excess harm reflecting patients' preferences for outcome-related health states. Findings showed that including harms in the weighting scheme changed individual component weights from the original frequency-based weighting. In the reweighted composite, PSIs 11, 13, and 12 contributed the greatest harm. The investigators concluded that reformulation of PSI 90 with harm-based weights is feasible and results in satisfactory reliability and discrimination.
AHRQ-authored; AHRQ-funded; 290201200003I.
Citation: Zrelak PA, Utter GH, McDonald KM . Incorporating harms into the weighting of the revised Agency for Healthcare Research and Quality Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90). Health Serv Res 2022 Jun;57(3):654-67. doi: 10.1111/1475-6773.13918..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Quality Indicators (QIs), Quality Measures, Quality of Care, Adverse Events, Medicare
Anderson KE, Polsky D, Dy S
Prescribing of low- versus high-cost Part B drugs in Medicare Advantage and traditional Medicare.
The purpose of this study was to compare Medicare Advantage (MA) coverage with traditional Medicare (TM) coverage as it relates to whether MA is associated with greater efficiency of prescribing Part B drugs. The authors sampled 20% of all 2016 outpatient and carrier TM claims and MA encounter records and Master Beneficiary Summary File data and analyzed whether MA enrollees more often received the low-cost Part B drug compared to TM enrollees. Four clinical scenarios were evaluated where multiple, similarly effective drugs exist: (1) anti-VEGF agents to treat macular degeneration, (2) bone resorption inhibitors for osteoporosis, (3) bone resorption inhibitors for malignant neoplasms, and (4) intravenous iron for iron deficiency anemia. The researchers estimated spending differences if TM prescribing aligned with MA prescribing and evaluated whether differences between MA and TM prescribing patterns were due to differences in the hospitals and provider practices who treat MA and TM enrollees or differences in how those hospitals and provider practices engage with their MA vs TM patients. The researchers found that more MA enrollees received the low-cost drug vs. TM enrollees in all 4 clinical scenarios, and that if TM prescribing matched that of ME prescribing, there would be a spending savings of 6% to 20% for each of the 4 scenarios. The study concluded that in 4 clinical scenarios in which similarly or equally effective treatment options exist, MA enrollees were more likely than TM enrollees to receive low-cost Part B drugs.
Citation: Anderson KE, Polsky D, Dy S . Prescribing of low- versus high-cost Part B drugs in Medicare Advantage and traditional Medicare. Health Serv Res 2022 Jun;57(3):537-47. doi: 10.1111/1475-6773.13912..
Keywords: Medication, Medicare, Healthcare Costs
Wang J, Mao Y, McGarry B
Post-acute care transitions and outcomes among Medicare beneficiaries in assisted living communities.
This study examined the post-acute care transitions among assisted living (AL) residents and their association with outcomes in the first 30 and 60 days after hospital discharge. Findings showed that the most common post-acute care referral was to skilled nursing facilities (SNF), followed by home without home health care (HHC), home with HHC, and others. Compared to discharge home without HHC, discharge to SNF was associated with a lower likelihood of ED visits and hospital readmissions, and higher likelihood of long-stay nursing home placement and mortality. Discharge home with HHC was associated with a higher likelihood of hospital readmissions and a lower likelihood of long-stay nursing home placement than discharge home without HHC. The results were similar within the first 30 days and 60 days after hospital discharge.
Citation: Wang J, Mao Y, McGarry B . Post-acute care transitions and outcomes among Medicare beneficiaries in assisted living communities. J Am Geriatr Soc 2022 May;70(5):1429-41. doi: 10.1111/jgs.17669..
Keywords: Elderly, Medicare, Nursing Homes, Long-Term Care
Taylor K, Diaz A, Nuliyalu U
Association of dual Medicare and Medicaid eligibility with outcomes and spending for cancer surgery in high-quality hospitals.
The purpose of this study was to assess whether treatment at high-quality hospitals mitigates dual-eligibility-associated disparities in outcomes and spending for cancer surgery. Medicare beneficiaries 65 years or older who underwent colectomy, rectal resection, lung resection, or pancreatectomy were evaluated. The findings indicate that, even among the highest-quality hospitals, dual-eligibility patients had poorer outcomes and higher spending. Dually eligible patients were more likely to be discharged to a facility and thus incurred higher post-acute care costs. Although treatment at high-quality hospitals is associated with reduced differences in outcomes, dual-eligibility patients remain at high risk for adverse post-operative outcomes as well as increased readmissions and post-acute care use.
Citation: Taylor K, Diaz A, Nuliyalu U . Association of dual Medicare and Medicaid eligibility with outcomes and spending for cancer surgery in high-quality hospitals. JAMA Surg 2022 Apr;157(4):e217586. doi: 10.1001/jamasurg.2021.7586..
Keywords: Cancer, Surgery, Medicare, Medicaid, Outcomes, Hospitals
Jacobs PD, Abdus S
AHRQ Author: Jacobs PD, Abdus S
Changes in preventive service use by race and ethnicity after Medicare eligibility in the United States.
Researchers examined whether widespread eligibility for Medicare at age 65 narrows disparate preventive service use by race and ethnicity. Using MEPS data and examining six preventive services, they found that, for non-Hispanic Black adults, preventive service use increased after age 65. Further, for all four preventive health measures that were lower for Hispanic adults compared with non-Hispanic White adults prior to age 65, service use was indistinguishable between these groups after reaching the Medicare eligibility age. They concluded that Medicare eligibility appeared to reduce most racial and ethnic disparities in preventive service use.
Citation: Jacobs PD, Abdus S . Changes in preventive service use by race and ethnicity after Medicare eligibility in the United States. Prev Med 2022 Apr;157:106996. doi: 10.1016/j.ypmed.2022.106996..
Keywords: Medical Expenditure Panel Survey (MEPS), Racial / Ethnic Minorities, Medicare, Prevention, Access to Care, Disparities, Health Insurance
Herrin J, Yu H, Venkatesh AK
Identifying high-value care for Medicare beneficiaries: a cross-sectional study of acute care hospitals in the USA.
Investigators sought to define hospital value and identify the characteristics of hospitals which provide high-value care. Participants were Medicare beneficiaries with claims included in CMS Overall Star Ratings or in publicly available Medicare spending per beneficiary data. The researchers found that there are high quality hospitals that are not high value, and a number of factors are strongly associated with being low or high value. They suggested that their findings can inform efforts of policymakers and hospitals to increase the value of care.
AHRQ-funded; HS022882; HS026980.
Citation: Herrin J, Yu H, Venkatesh AK . Identifying high-value care for Medicare beneficiaries: a cross-sectional study of acute care hospitals in the USA. BMJ Open 2022 Mar 31;12(3):e053629. doi: 10.1136/bmjopen-2021-053629..
Keywords: Medicare, Quality of Care, Hospitals
Behr CL, Joynt Maddox KE, Meara E
Anti-SARS-CoV-2 monoclonal antibody distribution to high-risk Medicare beneficiaries, 2020-2021.
The authors assessed how the limited supply of monoclonal antibodies (mAbs) therapy was allocated to patients at highest risk of severe disease. They found that, among non-hospitalized Medicare beneficiaries with a COVID-19 diagnosis between November 2020 and August 2021, only 7.2% received mAb therapy. In many cases, patients at the highest risk of severe disease were the least likely to receive mAb therapy, with extreme variation geographically. Their analysis did not account for patient vaccination status or observed disease severity, which could influence clinicians’ decisions.
Citation: Behr CL, Joynt Maddox KE, Meara E . Anti-SARS-CoV-2 monoclonal antibody distribution to high-risk Medicare beneficiaries, 2020-2021. JAMA 2022 Mar 8;327(10):980-83. doi: 10.1001/jama.2022.1243..
Keywords: COVID-19, Medicare, Medication
Hua CL, Thomas KS, Bunker JN
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
This retrospective cohort study examined the association between a dementia diagnosis listed on a hospital claim and patient outcomes among individuals with a Minimum Data Set (MDS) assessment. The cohort was comprised of hospitalized patients aged 66 years and older with advanced dementia noted on an MDS assessment completed within 120 days prior to their first hospitalization in 2017. Among 120,989 patients with advanced dementia and a nursing home stay, 90.6% had a dementia diagnosis on their hospital claims. Documentation of a dementia diagnosis was associated with lower use of intensive care unit or coronary care unit, use of invasive mechanical ventilation, and 30-day mortality. These patients also had a shorter hospital length of stay.
Citation: Hua CL, Thomas KS, Bunker JN . Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set. J Am Geriatr Soc 2022 Mar;70(3):846-53. doi: 10.1111/jgs.17564..
Keywords: Dementia, Diagnostic Safety and Quality, Medicare, Hospitals, Neurological Disorders
Presskreischer R, Steinglass JE, Anderson KE
Eating disorders in the U.S. Medicare population.
This cross-sectional study explored the prevalence, sociodemographic and clinical characteristics, and health care spending for Medicare enrollees with eating disorders. A representative 20% sample of 2016 Medicare inpatient, outpatient, carrier, and home health fee-for-service claims and Medicare Advantage encounter records was used. The sample included almost 12 million Medicare enrollees of whom 0.15% had an eating disorder diagnosis. A greater proportion of individuals diagnosed with an eating disorder diagnosis were female, under age 65, and dually eligible for Medicaid due to disability or low-income qualification than those without a diagnosis. Individuals with eating disorders had higher rates of comorbid conditions, with the greatest differences in cardiac arrythmias, arthritis, and thyroid conditions. Spending was $29,456 for enrollees with eating disorders compared to $7,418 without.
Citation: Presskreischer R, Steinglass JE, Anderson KE . Eating disorders in the U.S. Medicare population. Int J Eat Disord 2022 Mar;55(3):362-71. doi: 10.1002/eat.23676..
Keywords: Behavioral Health, Medicare, Healthcare Costs
Rodriguez HP, Ciemins EL, Rubio K
Physician practices with robust capabilities spend less on Medicare beneficiaries than more limited practices.
Researchers used data from the 2017 National Survey of Healthcare Organizations and Systems to examine the association of practice-level capabilities with process measures of quality, utilization, and spending. They found that quality and utilization did not differ by practice-level capabilities. Physician practice locations with robust capabilities spent less on Medicare fee-for-service beneficiaries but delivered quality of care comparable to the quality delivered in locations with low or mixed capabilities.
Citation: Rodriguez HP, Ciemins EL, Rubio K . Physician practices with robust capabilities spend less on Medicare beneficiaries than more limited practices. Health Aff 2022 Mar;41(3):414-23. doi: 10.1377/hlthaff.2021.00302..
Keywords: Healthcare Costs, Medicare, Provider: Physician
Adler-Milstein J, Linden A, Bernstein S
Longitudinal participation in delivery and payment reform programs among US primary care organizations.
The purpose of this retrospective, observational study was to assess longitudinal primary care organization participation patterns in large-scale reform programs and to identify organizational characteristics associated with multiprogram participation. Medicare claims were used to identify organizations that delivered primary care services. Findings showed that no program achieved more than 50% participation; 36% of organizations did not participate in any program; 50% participated in one; 13% in two; and 1% in all three. Larger organizations, those with younger providers, those with more primary care providers, and those with larger Medicare patient panels were more likely to participate in more programs.
Citation: Adler-Milstein J, Linden A, Bernstein S . Longitudinal participation in delivery and payment reform programs among US primary care organizations. Health Serv Res 2022 Feb;57(1):47-55. doi: 10.1111/1475-6773.13646..
Keywords: Primary Care, Medicare, Healthcare Delivery
Markovitz AA, Ryan AM, Peterson TA
ACO awareness and perceptions among specialists versus primary care physicians: a survey of a large Medicare Shared Savings program.
This research letter describes a survey that was conducted to compare accountable care organization (ACO) awareness and perceptions among specialists versus primary care physicians (PCPs). The survey was administered in 2018 to clinicians in the Physician Organization of Michigan ACO, which was the largest Medicare Shared Savings Program (MSSP) in Michigan and among the ten largest nationally at the time. The analysis focused on 1022 non-pediatrician physician respondents practicing within 10 provider organizations. Physician respondents included PCPs (23%) and specialists (77%). The most common specialty was internal medicine (20%), followed by surgeons (14%). Specialists were less likely to be aware of ACO participation and incentives. They were also 25% less likely to know they were in an ACO compared to PCPs. In addition, specialists were 18% less likely to know their ACO was accountable for both spending and quality or that their ACO had lowered spending in the previous year. This difference in perception may help to explain ACOs’ modest impact on spending and quality.
Citation: Markovitz AA, Ryan AM, Peterson TA . ACO awareness and perceptions among specialists versus primary care physicians: a survey of a large Medicare Shared Savings program. J Gen Intern Med 2022 Feb;37(2):492-94. doi: 10.1007/s11606-020-06556-w..
Keywords: Primary Care, Healthcare Costs, Medicare, Provider: Physician
Wickwire EM, Bailey MD, Somers VK
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
The purpose of this study was to examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization among a nationally representative and sample of older adults with multiple morbidities and pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea in the United States. The investigators concluded that in this nationally representative sample of older Medicare beneficiaries with multiple morbidities and relative to low adherers, high adherers demonstrated reduced inpatient utilization.
Citation: Wickwire EM, Bailey MD, Somers VK . CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease. J Clin Sleep Med 2022 Jan;18(1):39-45. doi: 10.5664/jcsm.9478..
Keywords: Elderly, Medicare, Sleep Problems, Cardiovascular Conditions, Patient Adherence/Compliance, Hospitalization
Wilcock AD, Joshi S, Escarce J
Luck of the draw: role of chance in the assignment of Medicare readmissions penalties.
Pay-for-performance programs are one strategy used by health plans to improve the efficiency and quality of care delivered to beneficiaries. Under such programs, providers are often compared against their peers in order to win bonuses or face penalties in payment. The purpose of this study was to investigate the impact luck can have on the assessment of performance, the researchers investigated its role in assigning penalties under Medicare's Hospital Readmissions Reduction Policy (HRRP), a program that penalizes hospitals with excess readmissions.
Citation: Wilcock AD, Joshi S, Escarce J . Luck of the draw: role of chance in the assignment of Medicare readmissions penalties. PLoS One 2021 Dec 21;16(12):e0261363. doi: 10.1371/journal.pone.0261363..
Keywords: Medicare, Payment, Hospital Readmissions, Provider Performance, Quality of Care
Cornelio N, McInerney MP, Mellor JM
Increasing Medicaid's stagnant asset test for people eligible for Medicare and Medicaid will help vulnerable seniors.
Researchers examined states' income and asset tests for full-benefit Medicaid during the period 2006-18 and examined how alternative asset tests would affect eligibility for community-dwelling Medicare beneficiaries ages sixty-five and older. They found that increasing asset limits would lessen restrictions on Medicaid eligibility that arise from stagnant asset tests, broadening eligibility for certain low-income Medicare beneficiaries and allowing them to retain higher, yet still modest, savings.
AHRQ-funded; HS025422; HS026727; HS027698.
Citation: Cornelio N, McInerney MP, Mellor JM . Increasing Medicaid's stagnant asset test for people eligible for Medicare and Medicaid will help vulnerable seniors. Health Affairs 2021 Dec;40(12):1943-52. doi: 10.1377/hlthaff.2021.00841..
Keywords: Elderly, Medicaid, Medicare, Low-Income, Vulnerable Populations
Liao JM, Chatterjee P, Wang E
The effect of hospital safety net status on the association between bundled payment participation and changes in medical episode outcomes.
This study evaluated whether hospital safety net status affected the association between bundled payment participation and medical outcomes. The hospitals included were participants in Medicare’s Bundled Payments for Care Improvement (BCPI) program from 2011-2016. Data from Medicare fee-for-service beneficiaries hospitalized for acute myocardial infarction, pneumonia, congestive heart failure, and chronic obstructive pulmonary disease were used. Among BCPI hospitals, safety net status was not associated with differential postdischarge spending or quality. However, BPCI safety net hospitals had differentially greater discharge due to institutional post-acute care and lower discharge home with home health than BPCI non-safety net hospitals.
Citation: Liao JM, Chatterjee P, Wang E . The effect of hospital safety net status on the association between bundled payment participation and changes in medical episode outcomes. J Hosp Med 2021 Dec;16(12):716-23. doi: 10.12788/jhm.3722..
Keywords: Medicare, Payment, Safety Net, Hospitals
Neprash HT, Zink A, Sheridan B
The effect of Medicaid expansion on Medicaid participation, payer mix, and labor supply in primary care.
Citation: Neprash HT, Zink A, Sheridan B . The effect of Medicaid expansion on Medicaid participation, payer mix, and labor supply in primary care. J Health Econ 2021 Dec;80:102541. doi: 10.1016/j.jhealeco.2021.102541..
Keywords: Medicare, Healthcare Utilization, Primary Care, Workforce, Health Insurance
Meyers DJ, Rahman M, Wilson IB
The relationship between Medicare Advantage Star Ratings and enrollee experience.
Medicare Advantage plans, private managed care plans that enrolled 34% of Medicare beneficiaries in 2019, received $6 billion in annual bonus payments on the basis of their performance on a 5-star rating system. Little is known, however, as to the extent these ratings adequately capture enrollee experience. The objective of this study was to measure the effect of exposure to higher rated Medicare Advantage contracts on enrollee experience.
Citation: Meyers DJ, Rahman M, Wilson IB . The relationship between Medicare Advantage Star Ratings and enrollee experience. J Gen Intern Med 2021 Dec;36(12):3704-10. doi: 10.1007/s11606-021-06764-y..
Keywords: Medicare, Patient Experience
Duvalyan A, Pandey A, Vaduganathan M
Trends in anticoagulation prescription spending among Medicare Part D and Medicaid beneficiaries between 2014 and 2019.
Researchers examined contemporary direct oral anticoagulant (DOAC) spending patterns within Medicare Part D and Medicaid between 2014 and 2019. They found that, although overall DOAC spending is increasing, DOAC use may be associated with lower downstream medical expenditures compared with warfarin stemming from decreased risk of major bleeding and stroke and reduced drug monitoring.
Citation: Duvalyan A, Pandey A, Vaduganathan M . Trends in anticoagulation prescription spending among Medicare Part D and Medicaid beneficiaries between 2014 and 2019. J Am Heart Assoc 2021 Dec 21;10(24):e022644. doi: 10.1161/jaha.121.022644..
Keywords: Blood Thinners, Medication, Medicare, Medicaid, Healthcare Costs
McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
The authors examined whether Medicaid participation by low-income adults age 65 and up increased as a result of Medicaid expansions to working-age adults under the Affordable Care Act (ACA). Using American Community Survey data and state variation in ACA Medicaid expansions, they found that Medicaid expansions to working-age adults increased Medicaid participation among low-income older adults by 4.4 percent. They also found evidence of an “on-ramp” effect, which is an important mechanism behind welcome mat effects among some older adults.
Citation: McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM . Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid. J Policy Anal Manage 2021 Win;40(1):12-41. doi: 10.1002/pam.22259..
Keywords: Elderly, Medicaid, Medicare, Low-Income, Health Insurance, Policy
Chhabra KR, Sheetz KH, Regenbogen SE
Wide variation in surgical spending within hospital systems: a missed opportunity for bundled payment success.
Researchers sought to measure the extent of variation in episode spending around total hip replacement for fee-for-service Medicare patients within and across hospital systems identified in the American Hospital Association Annual Survey. They found that average episode payments varied nearly as much within hospital systems as they did between the lowest- and highest-cost quintiles of systems, with variation driven by post-acute care utilization.
Citation: Chhabra KR, Sheetz KH, Regenbogen SE . Wide variation in surgical spending within hospital systems: a missed opportunity for bundled payment success. Ann Surg 2021 Dec 1;274(6):e1078-e84. doi: 10.1097/sla.0000000000003741..
Keywords: Surgery, Healthcare Systems, Medicare, Healthcare Costs, Hospitals
Herb J, Staley BS, Roberson M
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
The investigators’ objective was to determine national usage and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism among insured older adults. Data was obtained using Medicare claims. They found that parathyroidectomy was underused and recommended that quality improvement efforts, rooted in equitable care, be undertaken to increase access to parathyroidectomy for this disease.
Citation: Herb J, Staley BS, Roberson M . Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population. Surgery 2021 Nov;170(5):1376-82. doi: 10.1016/j.surg.2021.05.026..
Keywords: Elderly, Disparities, Medicare, Surgery, Racial / Ethnic Minorities
Grafova IB, Jarrín OF
Beyond Black and White: mapping misclassification of Medicare beneficiaries race and ethnicity.
This study examined state-level variation in racial/ethnic misclassification of race and ethnicity in the Centers for Medicare and Medicaid Services administrative database using the enrollment database (EDB) beneficiary race code and the Research Triangle Institute (RTI) race code. The cohort included 4,231,370 Medicare beneficiaries who utilized home health care services in 2015. The authors found substantial variation between states in misclassification of self-identified Hispanic, Asian American/Pacific Islander, and American Indian/Alaska Native beneficiaries.
Citation: Grafova IB, Jarrín OF . Beyond Black and White: mapping misclassification of Medicare beneficiaries race and ethnicity. Med Care Res Rev 2021 Oct;78(5):616-26. doi: 10.1177/1077558720935733..
Keywords: Medicare, Racial / Ethnic Minorities, Disparities
Arntson E, Dimick JB, Nuliyalu U
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
This study evaluated changes in Hospital-Acquired Conditions (HACs) and 30-day mortality after the announcement of the Centers for Medicare and Medicare Services’ Hospital-Acquired Condition Reduction Program (HACRP) in August 2013. The authors evaluated models to test for changes in HACs and 30-day mortality before and after the Affordable Care Act (ACA), and after the HACRP. Fee-for-service Medicare claims from 2009 to 2015 were used. The HAC rate declined after the ACA was passed and declined further after the HACRP announcement. However, 30-day mortality rates were unchanged.
Citation: Arntson E, Dimick JB, Nuliyalu U . Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program. Ann Surg 2021 Oct 1;274(4):e301-e07. doi: 10.1097/sla.0000000000003641..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Mortality, Medicare, Payment, Prevention, Patient Safety
Roberts ET, Song Z, Ding L
Changes in patient experiences and assessment of gaming among large clinician practices in precursors of the merit-based incentive payment system.
Medicare's Merit-Based Incentive Payment System (MIPS), a public reporting and pay-for-performance program, adjusts clinician payments based on publicly reported measures that are chosen primarily by clinicians or their practices. Within precursor programs of the MIPS, this study examined 1) practices' selection of Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience measures for quality scoring under pay-for-performance and 2) the association between mandated public reporting on CAHPS measures and performance on those measures.
Citation: Roberts ET, Song Z, Ding L . Changes in patient experiences and assessment of gaming among large clinician practices in precursors of the merit-based incentive payment system. JAMA Health Forum 2021 Oct;2(10). doi: 10.1001/jamahealthforum.2021.3105..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Medicare, Provider Performance, Payment, Quality Improvement, Quality of Care