National Healthcare Quality and Disparities Report
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Search All Research Studies
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- Healthcare Costs (1)
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- (-) Health Services Research (HSR) (7)
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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 7 of 7 Research Studies DisplayedSanghavi P, Jena AB, Newhouse JP
Identifying outlier patterns of inconsistent ambulance billing in Medicare.
The objective of this study was to illustrate a method that accounts for sampling variation in identifying suppliers and counties with outlying rates of a particular pattern of inconsistent billing for ambulance services to Medicare. The investigators concluded that health care fraud and abuse were frequently asserted but could be difficult to detect. They suggested that their data-driven approach may be a useful starting point for further investigation.
AHRQ-funded; 6HS022798; HS025720.
Citation: Sanghavi P, Jena AB, Newhouse JP .
Identifying outlier patterns of inconsistent ambulance billing in Medicare.
Health Serv Res 2021 Apr;56(2):188-92. doi: 10.1111/1475-6773.13622..
Keywords: Medicare, Payment, Health Services Research (HSR)
Wood SJ, Albertson EM, Conrad DA
Accountable care program implementation and effects on participating health care systems in Washington state: a conceptual model.
This study used key informant interviews with health care executives representing 5 large health systems contracted with the Washington State Health Care Authority to provide accountable care network services under the State Innovation Model initiative. Two rounds of semistructured interviews were conducted, and results indicated the need to present a modified conceptual model aligned better with accountable care program (ACP) implementation.
AHRQ-funded; HS013853.
Citation: Wood SJ, Albertson EM, Conrad DA .
Accountable care program implementation and effects on participating health care systems in Washington state: a conceptual model.
J Ambul Care Manage 2019 Oct/Dec;42(4):321-36. doi: 10.1097/jac.0000000000000302..
Keywords: Health Systems, Provider Performance, Organizational Change, Health Services Research (HSR), Payment, Health Insurance, Implementation
Holmgren AJ, Adler-Milstein J, Chen LM
Participation in a voluntary bundled payment program by organizations providing care after an acute hospitalization
This research letter addresses spending on post–acute care (PAC), or care provided after a stay in an acute care hospital. PAC is the largest driver of variation in total per capita Medicare spending. To address this, Medicare has targeted PAC spending in payment reforms including voluntary bundled payment programs. This letter discusses participation in these voluntary payment programs.
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AHRQ-funded; HS024698
Citation: Holmgren AJ, Adler-Milstein J, Chen LM .
Participation in a voluntary bundled payment program by organizations providing care after an acute hospitalization
JAMA 2018 Jul 24;320(4):402-04. doi: 10.1001/jama.2018.8666..
Keywords: Payment, Health Services Research (HSR), Health Services Research (HSR), Hospitalization, Medicare
Colla CH, Morden NE, Sequist TD
Payer type and low-value care: comparing Choosing Wisely services across commercial and Medicare populations.
This study compared low-value health service use among commercially insured and Medicare populations and explored the influence of payer type on the provision of low-value care. In measuring use of seven Choosing Wisely-identified low-value services, it concluded that low-value care appears driven by factors unrelated to payer type or anticipated reimbursement.
AHRQ-funded; HS023812.
Citation: Colla CH, Morden NE, Sequist TD .
Payer type and low-value care: comparing Choosing Wisely services across commercial and Medicare populations.
Health Serv Res 2018 Apr;53(2):730-46. doi: 10.1111/1475-6773.12665.
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Keywords: Payment, Healthcare Utilization, Health Services Research (HSR), Medicare
Kronick R, Casalino LP, Bindman AB
AHRQ Author: Kronick R
Apple pickers or federal judges: strong versus weak incentives in physician payment.
The authors provide an introduction for five papers commissioned by AHRQ focusing on incentives for physicians that are featured in this special issue of Health Services Research. These papers concentrate on suggesting a conceptual framework for the use of financial incentives in health care, key implications of the evidence to date on pay for performance and public reporting in health care and several related topics.
AHRQ-authored.
Citation: Kronick R, Casalino LP, Bindman AB .
Apple pickers or federal judges: strong versus weak incentives in physician payment.
Health Serv Res 2015 Dec;50 Suppl 2:2049-56. doi: 10.1111/1475-6773.12424.
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Keywords: Payment, Provider Performance, Policy, Health Services Research (HSR), Quality of Care, Healthcare Costs, Quality Improvement
Layton TJ, Ryan AM
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
The researchers evaluated the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. They concluded that at great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings.
AHRQ-funded; HS018546.
Citation: Layton TJ, Ryan AM .
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
Health Serv Res 2015 Dec;50(6):1810-28. doi: 10.1111/1475-6773.12409..
Keywords: Medicare, Payment, Provider Performance, Health Services Research (HSR), Quality Improvement, Quality of Care
Luft HS
Policy-oriented research on improved physician incentives for higher value health care.
Policy makers (both public and private) are seeking ways to improve the value delivered within our health care system. To inform such policy changes, this paper identifies areas in which little is known about the effects of specific incentives (FFS, salary, etc.) on the two components of value: resource use and quality. Specific suggestions are offered focusing on fundamental "building block" studies.
AHRQ-funded.
Citation: Luft HS .
Policy-oriented research on improved physician incentives for higher value health care.
Health Serv Res 2015 Dec;50 Suppl 2:2187-215. doi: 10.1111/1475-6773.12423.
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Keywords: Policy, Health Insurance, Payment, Health Services Research (HSR)