National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Adverse Events (1)
- Cardiovascular Conditions (1)
- Dementia (1)
- (-) Elderly (11)
- Falls (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (5)
- Health Insurance (2)
- Heart Disease and Health (2)
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- Injuries and Wounds (1)
- Long-Term Care (2)
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- Pneumonia (1)
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- Surgery (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedHoffman GJ, U U, Bynum J
Alzheimer's disease and related dementias and episode spending under Medicare's Bundled Payment for Care Improvements Advanced (BPCI-A).
Investigators evaluated the prevalence of Alzheimer’s disease and related dementias (ADRD) across the episodes included in Medicare's Bundled Payments for Care Improvement Advanced (BPCI-A) program and the association between ADRD and 90-day spending among hospitals participating in the BPCI-A program. They found that ADRD is associated with higher episode spending, highlighting the importance of closely monitoring the experience of these patients under BPCI-A to ensure that they are receiving appropriate care. This is particularly important for episodes like sepsis and pneumonia that are common among patients with ADRD and also highly prevalent under BPCI-A.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, U U, Bynum J .
Alzheimer's disease and related dementias and episode spending under Medicare's Bundled Payment for Care Improvements Advanced (BPCI-A).
J Gen Intern Med 2021 Aug;36(8):2499-502. doi: 10.1007/s11606-020-06348-2..
Keywords: Elderly, Dementia, Medicare, Payment
Hambley BC, Anderson KE, Shanbhag SP
Payment incentives and the use of higher-cost drugs: a retrospective cohort analysis of intravenous iron in the Medicare population.
Researchers examined prescribing patterns in the context of intravenous (IV) iron, for which multiple similarly safe and efficacious formulations exist, with wide variations in price. Using Medicare data, they found an increase in the dispensing of a higher-priced IV iron formulation associated with a shortage of a less expensive drug that persisted once the shortage ended. They concluded that their findings in IV iron have broader implications for Part B drug payment policy because the price of the drug determines the physician and health system payment.
AHRQ-funded; HS000029.
Citation: Hambley BC, Anderson KE, Shanbhag SP .
Payment incentives and the use of higher-cost drugs: a retrospective cohort analysis of intravenous iron in the Medicare population.
Am J Manag Care 2020 Dec;26(12):516-22. doi: 10.37765/ajmc.2020.88539..
Keywords: Elderly, Medication, Medicare, Payment, Healthcare Costs, Practice Patterns
He D, McHenry P, Mellor JM
Do financial incentives matter? Effects of Medicare price shocks on skilled nursing facility care.
The authors provided new evidence on how Medicare payment changes affect the amount of skilled nursing facility (SNF) care provided to Medicare patients. They found that increases in Medicare payment rates to SNFs increased the total number of Medicare resident days at SNFs. Further, the effects were asymmetric; although Medicare payment increases affected Medicare days, payment decreases did not. They conclude that their results have important implications for policies that alter the Medicare base payment rates to SNFs and other health care providers.
AHRQ-funded; HS025529.
Citation: He D, McHenry P, Mellor JM .
Do financial incentives matter? Effects of Medicare price shocks on skilled nursing facility care.
Health Econ 2020 Jun;29(6):655-70. doi: 10.1002/hec.4009..
Keywords: Medicare, Nursing Homes, Elderly, Payment, Healthcare Costs
Mroz TM, Patterson DG, Frogner BK
The impact of Medicare's rural add-on payments on supply of home health agencies serving rural counties.
This analysis looked at the impact of Medicare’s rural add-on payments on supply of home health agencies serving rural counties. The authors used data from Home Health Compare. The results suggest that while supply changes are similar in rural counties adjacent to urban areas and urban counties regardless of add-on payments, only higher add-payments of 5 to 10 percent to rural counties keep them on pace with those in urban counties.
AHRQ-funded; HS024777.
Citation: Mroz TM, Patterson DG, Frogner BK .
The impact of Medicare's rural add-on payments on supply of home health agencies serving rural counties.
Health Aff 2020 Jun;39(6):949-57. doi: 10.1377/hlthaff.2019.00952..
Keywords: Elderly, Medicare, Home Healthcare, Rural Health, Payment, Access to Care
Werner RM, Konetzka RT, Qi M
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
The objective of this study was to investigate the impact of Medicare's skilled nursing facility (SNF) copayment policy, with a large increase in the daily copayment rate on the 20th day of a benefit period, on length of stay, patient outcomes, and costs. The investigators concluded that Medicare's SNF copayment policy was associated with shorter lengths of stay and worse patient outcomes, suggesting the copayment policy had unintended and negative effects on patient outcomes.
AHRQ-funded; HS024266.
Citation: Werner RM, Konetzka RT, Qi M .
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
Health Serv Res 2019 Dec;54(6):1184-92. doi: 10.1111/1475-6773.13227..
Keywords: Medicare, Nursing Homes, Payment, Long-Term Care, Healthcare Costs, Elderly, Hospitalization, Hospital Discharge
Shorr RI, Staggs VS, Waters TM
Impact of the hospital-acquired conditions initiative on falls and physical restraints: a longitudinal study.
The Centers for Medicare & Medicaid Services (CMS) implemented the Hospital-Acquired Conditions (HACs) Initiative in October 2008; the CMS no longer reimbursed hospitals for fall injury. The aim of this study was to examine the effects of the 2008 HACs Initiative on the rates of falls, injurious falls, and physical restraint use. The investigators concluded that since the HACs Initiative, there was at best a modest decline in the rates of falls and injurious falls observed primarily in larger, major teaching hospitals. An increase in restraint use was not observed.
AHRQ-funded; HS020627.
Citation: Shorr RI, Staggs VS, Waters TM .
Impact of the hospital-acquired conditions initiative on falls and physical restraints: a longitudinal study.
J Hosp Med 2019 Sep 6;14:E31-E36. doi: 10.12788/jhm.3295..
Keywords: Falls, Adverse Events, Hospitals, Payment, Policy, Elderly
Makam AN, Nguyen OK, Kirby B
Effect of site-neutral payment policy on long-term acute care hospital use.
The purpose of this study was to assess the projected effect of the Centers for Medicare and Medicaid Services new site-neutral payment policy, which aims to decrease unnecessary long-term acute care hospital (LTACH) admissions by reducing reimbursements for less-ill individuals by 2020. The investigators concluded that the site-neutral payment policy may limit LTACH access in existing LTAC-scarce markets, with potential adverse implications for recovery of hospitalized older adults.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Kirby B .
Effect of site-neutral payment policy on long-term acute care hospital use.
J Am Geriatr Soc 2018 Nov;66(11):2104-11. doi: 10.1111/jgs.15539..
Keywords: Policy, Hospitalization, Payment, Long-Term Care, Healthcare Costs, Medicare, Elderly, Hospitals
Thompson MP, Cabrera L, Strobel RJ
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Postoperative pneumonia is the most common healthcare-associated infection in cardiac surgical patients, yet their impact across a 90-day episode of care remains unknown. The objective of this study was to examine the relationship between pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery. The investigators concluded that postoperative pneumonia was associated with significantly higher 90-day episode payments and inferior outcomes at the patient and hospital level.
AHRQ-funded; HS022535.
Citation: Thompson MP, Cabrera L, Strobel RJ .
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Circ Cardiovasc Qual Outcomes 2018 Sep;11(9):e004818. doi: 10.1161/circoutcomes.118.004818..
Keywords: Elderly, Surgery, Medicare, Cardiovascular Conditions, Heart Disease and Health, Pneumonia, Payment, Healthcare Costs, Outcomes, Healthcare-Associated Infections (HAIs), Health Insurance
Koroukian SM, Basu J, Schiltz NK
AHRQ Author: Basu J
Changes in case-mix and health outcomes of Medicare fee-for-service beneficiaries and managed care enrollees during the years 1992-2011.
This study examined changes in differentials between managed care enrollees (MCEs) and fee-for-service beneficiaries (FFSBs) both in case-mix and health outcomes over time. It found that the case-mix differential between MCEs and FFSBs persisted over time. Both MCEs and FFSBs were as likely to die within 2 years from the Health and Retirement Study interview.
AHRQ-authored; AHRQ-funded; HS023113.
Citation: Koroukian SM, Basu J, Schiltz NK .
Changes in case-mix and health outcomes of Medicare fee-for-service beneficiaries and managed care enrollees during the years 1992-2011.
Med Care 2018 Jan;56(1):39-46. doi: 10.1097/mlr.0000000000000847.
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Keywords: Elderly, Payment, Medicare, Health Insurance, Outcomes
Berry SD, Zullo AR, McConeghy K
Defining hip fracture with claims data: outpatient and provider claims matter.
Medicare claims are commonly used to identify hip fractures, but there is no universally accepted definition. The authors of this study found that a definition using inpatient claims identified fewer fractures than a definition including outpatient and provider claims. Few additional fractures were identified by including inconsistent diagnostic and procedural codes at contiguous sites. The authors recommend that future studies publish their definition of fracture and specify if diagnostic codes from contiguous fracture sites were used.
AHRQ-funded; HS022998.
Citation: Berry SD, Zullo AR, McConeghy K .
Defining hip fracture with claims data: outpatient and provider claims matter.
Osteoporos Int 2017 Jul;28(7):2233-37. doi: 10.1007/s00198-017-4008-1..
Keywords: Elderly, Injuries and Wounds, Payment
Kim N, Bernheim SM, Ott LS
An administrative claims measure of payments made for Medicare patients for a 30-day episode of care for acute myocardial infarction.
The authors developed a method for profiling hospitals by 30-day episode-of-care costs for acute myocardial infarction (AMI). Their final model included 30 variables and resulted in predictive ratios close to 1. When combined with quality measures, they think that their payment measure will help profile high-value care.
AHRQ-funded; HS016929.
Citation: Kim N, Bernheim SM, Ott LS .
An administrative claims measure of payments made for Medicare patients for a 30-day episode of care for acute myocardial infarction.
Med Care 2015 Jun;53(6):542-9. doi: 10.1097/mlr.0000000000000361.
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Keywords: Elderly, Payment, Medicare, Heart Disease and Health