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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 25 of 120 Research Studies DisplayedBakre S, Hollingsworth JM, Yan PL
Accountable care organizations and spending for patients undergoing long-term dialysis.
This study analyzed Medicare data to examine time trends in long-term dialysis beneficiary alignment to Accountable Care Organizations (ACOs) and differences in spending for those who were Accountable Care Organization aligned versus nonaligned. Beneficiaries on long-term dialysis between 2009 and 2016 were identified using a 20% random sample of Medicare beneficiaries. Trends in alignment to an ACO alignment were compared with alignment of the general Medicare population. The cohort included 135,152 beneficiaries during the study period. Alignment to an ACO of long-term dialysis beneficiaries increased from 6% to 23% from 2012 to 2016. In the time series analysis, ACO spending was $143 less per beneficiary-quarter than spending for non-aligned beneficiaries. This savings was limited to care by a primary care physician.
AHRQ-funded; HS024525; HS026908; HS024728.
Citation: Bakre S, Hollingsworth JM, Yan PL .
Accountable care organizations and spending for patients undergoing long-term dialysis.
Clin J Am Soc Nephrol 2020 Dec 7;15(12):1777-84. doi: 10.2215/cjn.02150220..
Keywords: Healthcare Costs, Dialysis, Kidney Disease and Health, Medicare
Caram MEV, Oerline MK, Dusetzina S
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
The authors investigated coping and material measures of the financial hardship of abiraterone and enzalutamide among patients with advanced prostate cancer with Medicare Part D coverage. They found substantial variations in the adherence rate and out-of-pocket payments, with sociodemographic patient and regional factors found to be associated with both aspects.
AHRQ-funded; HS025707.
Citation: Caram MEV, Oerline MK, Dusetzina S .
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
Cancer 2020 Dec 1;126(23):5050-59. doi: 10.1002/cncr.33176..
Keywords: Patient Adherence/Compliance, Medicare, Cancer: Prostate Cancer, Cancer, Medication, Healthcare Costs
Hsuan C, Braun TM, Ponce NA
Are improvements still needed to the modified hospital readmissions reduction program: a health and retirement study (2000-2014)?
This study examined whether modifications to the Medicare Hospital Readmissions Reduction Program (HRRP) addressed concerns that it unfairly penalized safety net hospitals treating patients with high social and functional risks. Data from 2000-2014 Medicare hospital discharge, Health and Retirement Study, and other community-level data was used. The authors estimated risk-standardized readmission rates (RSRRs) for peer groups and by safety net status using four hierarchical logistic regression models. Patient data used was from 20,255 fee-for-service Medicare beneficiaries (65+) with eligible index hospitalizations. Hospitals were categorized by peer group, with 1 having the lowest number of at-risk patients, and 5 categorized as a safety-net hospital. Under the modifications fewer safety-net hospitals were penalized, but worsened for those in peer groups 1,2, and 3.
AHRQ-funded; HS025838.
Citation: Hsuan C, Braun TM, Ponce NA .
Are improvements still needed to the modified hospital readmissions reduction program: a health and retirement study (2000-2014)?
J Gen Intern Med 2020 Dec;35(12):3564-71. doi: 10.1007/s11606-020-06222-1..
Keywords: Hospital Readmissions, Hospitals, Medicare
Ganguli I, Lupo C, Mainor AJ
Assessment of prevalence and cost of care cascades after routine testing during the Medicare annual wellness visit.
This observational cohort study looked at the prevalence and cost of care cascades after routine tests considered low value in fee-for-service Medicare patients from January 2013 through March 2015 who had gone for an annual wellness visit (AWV). Among the 75,275 AWV recipients identified, 18.6% received at least 1 low-value test including an ECG, urinalysis, or thyrotropin tests. Patients who were younger, White, and lived in urban, high-income areas were most likely to receive those tests. The cost-cascade was considered notable but of modest cost.
AHRQ-funded; HS023812.
Citation: Ganguli I, Lupo C, Mainor AJ .
Assessment of prevalence and cost of care cascades after routine testing during the Medicare annual wellness visit.
JAMA Netw Open 2020 Dec;3(12):e2029891. doi: 10.1001/jamanetworkopen.2020.29891..
Keywords: Elderly, Medicare, Healthcare Costs, Diagnostic Safety and Quality
Dinan MA, Wilson LE, Reed SD
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
This study looked at trends in the association of 21-gene assay testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption from 2001 to 2011. The investigators looked at updated SEER-Medicare data from 2004 and 2011. The cohort included 26,009 patients who met inclusion criteria. Assay use was associated with a decrease in absolute percentage use of chemotherapy by 4.5%, which became even more pronounced from 2008-2011 with a decrease of 6.8%.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
Clin Breast Cancer 2020 Dec;20(6):487-94.e1. doi: 10.1016/j.clbc.2020.05.010..
Keywords: Cancer: Breast Cancer, Cancer, Treatments, Genetics, Medicare, Women, Healthcare Utilization
Kranz AM, DeYoreo M, shete-Roesler B
Health system affiliation of physician organizations and quality of care for Medicare beneficiaries who have high needs.
The goal of this study was to test the hypothesis that health systems provide better care to patients with high needs compared to nonaffiliated physician organizations (POs). The 2015 Medicare Data on Provider Practice and Specialty linked physicians’ database was linked to POs Medicare Provider Enrollment, Chain, and Ownership System (PECOS) and IRS Form 990 data to identify health system affiliations. Among 2,323,301 beneficiaries with high needs, 52.3% received care from system-affiliated practices. The emergency department (ED) visit rate was statistically significantly different in system-affiliated POs and nonaffiliated POs. There were small differences for the remaining five of six quality measures examined: continuity of care, follow-up visits, all-cause readmissions, and ambulatory care-sensitive hospitalizations. Within systems there was substantial variation for rates of continuity of care and follow-up after ED visits.
AHRQ-funded; HS024067.
Citation: Kranz AM, DeYoreo M, shete-Roesler B .
Health system affiliation of physician organizations and quality of care for Medicare beneficiaries who have high needs.
Health Serv Res 2020 Dec;55(Suppl 3):1118-28. doi: 10.1111/1475-6773.13570..
Keywords: Health Systems, Medicare, Quality of Care, Healthcare Delivery
Nazareno J, Zhang W, Silver B
Home health utilization in assisted living settings.
The authors explored the growth in the delivery of home health agency (HHA) services to Medicare beneficiaries in assisted living (AL) compared with other home settings between 2012 and 2014. Their findings suggested that there was a slight growth in the share of HHA services being delivered in AL. HHA recipients in AL were more likely to have cognitive and activities of daily living impairments than those receiving HHA services in other settings. This study is among the first of those to examine HHA utilization in AL.
AHRQ-funded; HS000011.
Citation: Nazareno J, Zhang W, Silver B .
Home health utilization in assisted living settings.
Med Care Res Rev 2020 Dec;77(6):620-29. doi: 10.1177/1077558719835049..
Keywords: Elderly, Home Healthcare, Medicare, Healthcare Utilization
Everson J, Adler-Milstein J, Ryan AM
Hospitals strengthened relationships with close partners after joining accountable care organizations.
This study tested the hypothesis that hospitals participating in Medicare Accountable Care Organizations (ACOs) try to influence where their patients receive care in order to achieve quality and cost containment goals. The authors studied hospitals participating in ACO from 2010 to 2014. ACO hospitals shared patients 4.4% more than non-ACO hospitals. This occurred disproportionately at hospitals that already shared a high proportion of their patients prior to participation and among hospitals in ACOs characterized as physician-hospital collaborations.
AHRQ-funded; HS024525; HS024728.
Citation: Everson J, Adler-Milstein J, Ryan AM .
Hospitals strengthened relationships with close partners after joining accountable care organizations.
Med Care Res Rev 2020 Dec;77(6):549-58. doi: 10.1177/1077558718818336..
Keywords: Hospitals, Medicare, Policy, Health Insurance
Jacobs PD, Basu J
AHRQ Author: Jacobs PD, Basu J
Medicare Advantage and postdischarge quality: evidence from hospital readmissions.
This study compared relative readmission rates for beneficiaries enrolled in Medicare Advantage (MA) and traditional Medicare (TM). HCUP State Inpatient Databases data for 4 states was used from 2009 and 2014. The outcome compared was the probability of a hospital readmission within 30 days of an index admission. There were significantly lower all-cause readmission rates among MA enrollees relative to those in TM in both 2009 and 2014, but MA enrollment was not associated with an increased reduction in readmission rates relative to TM during that time period.
AHRQ-authored
Citation: Jacobs PD, Basu J .
Medicare Advantage and postdischarge quality: evidence from hospital readmissions.
Am J Manag Care 2020 Dec;26(12):524-29. doi: 10.37765/ajmc.2020.88540..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Hospital Readmissions, Hospitals, Quality of Care, Provider Performance
Colla C, Yang W, Mainor AJ
Organizational integration, practice capabilities, and outcomes in clinically complex Medicare beneficiaries.
This study examines the association between clinical integration and financial integration, quality-focused care delivery processes, and beneficiary utilization and outcomes. Data was used from multiphysician practices in the 2017-2018 National Survey of Healthcare Organizations and Systems and 2017 Medicare claims data. Out of 1.6M fee-for-service Medicare beneficiaries aged 66 or older attributed to 2113 practices, 414,209 were considered clinically complex (frailty or 2 or more chronic conditions). Financial and clinical integration were weakly correlated. Clinical integration was significantly associated with greater adoption of quality-focused care delivery processes, while financial integration was associated with the opposite. Integration was not associated with reduced utilization or better beneficiary-level health-related outcomes, but both integration types were associated with lower spending.
AHRQ-funded; HS024075.
Citation: Colla C, Yang W, Mainor AJ .
Organizational integration, practice capabilities, and outcomes in clinically complex Medicare beneficiaries.
Health Serv Res 2020 Dec;55(Suppl 3):1085-97. doi: 10.1111/1475-6773.13580..
Keywords: Medicare, Health Systems, Healthcare Delivery
Konetzka RT, Jung DH, Gorges RJ
Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles.
This study measured the outcomes of dual-eligible recipients of Medicaid home- and community-based long-term services (HCBS) compared to nursing home residents. The authors used the 2005 and 2012 Medicaid Analytic eXtract (MAX) database, a national compilation of Medicaid claims which merges Medicare claims to identify hospital admissions. A cohort of 1,312,498 older adults dually enrolled in Medicaid and Medicare and using long-term care was tracked. HCBS users were found to have 10 percent points higher annual rates of hospitalization than their nursing home counterparts when selection bias is addressed. The differences persisted across races, dementia status, and intensity of HCBS spending.
AHRQ-funded; HS000084.
Citation: Konetzka RT, Jung DH, Gorges RJ .
Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles.
Health Serv Res 2020 Dec;55(6):973-82. doi: 10.1111/1475-6773.13573..
Keywords: Elderly, Long-Term Care, Nursing Homes, Medicaid, Medicare, Outcomes
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
Timbie JW, Kranz AM, DeYoreo M
Racial and ethnic disparities in care for health system-affiliated physician organizations and non-affiliated physician organizations.
The purpose of this study was to assess racial and ethnic disparities in care for Medicare fee-for-service (FFS) beneficiaries and whether disparities differ between health system-affiliated physician organizations (POs) and nonaffiliated POs. The investigators found no evidence that system-affiliated POs had smaller racial and ethnic disparities than nonaffiliated POs. Where differences existed, disparities were slightly larger in affiliated POs.
AHRQ-funded; HS024067.
Citation: Timbie JW, Kranz AM, DeYoreo M .
Racial and ethnic disparities in care for health system-affiliated physician organizations and non-affiliated physician organizations.
Health Serv Res 2020 Dec;55(Suppl 3):1107-17. doi: 10.1111/1475-6773.13581..
Keywords: Racial and Ethnic Minorities, Disparities, Medicare, Health Systems
Short MN, Ho V
Weighing the effects of vertical integration versus market concentration on hospital quality.
Provider organizations are increasing in complexity, as hospitals acquire physician practices and physician organizations grow in size. At the same time, hospitals are merging with each other to improve bargaining power with insurers. In this study, the investigators analyzed 29 quality measures reported to the Center for Medicare and Medicaid Services' Hospital Compare database for 2008 to 2015 to test whether vertical integration between hospitals and physicians or increases in hospital market concentration influenced patient outcomes.
AHRQ-funded; HS024727.
Citation: Short MN, Ho V .
Weighing the effects of vertical integration versus market concentration on hospital quality.
Med Care Res Rev 2020 Dec;77(6):538-48. doi: 10.1177/1077558719828938.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient Experience, Hospitals, Medicare, Provider Performance, Health Systems
Makam AN, Nguyen OK, Miller ME
Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
This study compared the effectiveness of long-term acute care hospital (LTACH) use versus skilled nursing facility (SNF) transfer after hospitalization. Medicare claims linked to electronic health record (EHR) data from six Texas hospitals between 2009 and 2010 were used to conduct a retrospective cohort study of hospitalized patients transferred to either an LTACH or SNF and followed for one year. Out of 3505 patients, 18% were transferred to an LTACH and overall were younger, less likely to be female, and white, but sicker than transfers to an SNF. Patients transferred to an LTACH were less likely to survive (59 vs. 65%) or recover (62.5 vs 66%). Adjusting for demographic and clinical confounders found in Medicare claims and EHR data, transfer location was not significantly associated with differences in mortality but was associated with greater Medicare spending.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Miller ME .
Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
BMC Health Serv Res 2020 Nov 11;20(1):1032. doi: 10.1186/s12913-020-05847-6..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Long-Term Care, Elderly, Medicare, Transitions of Care, Nursing Homes, Hospitals
Romman AN, Hsu CM, Chou LN
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
This study looked at trends in opioid prescribing frequency to Medicare Part D enrollees from 2013 to 2017 by medical specialty and provider type. The authors analyzed opioid claims and prescribing trends for specialties accounting for ≥1% of all opioid claims. Pain management specialists increased Medicare Part D opioid claims by 27.3% to 1,140 mean claims per provider in 2017. Physical medicine and rehabilitation providers increased claims by 16.9% to 511 mean claims per provider in 2017. All other medical specialties decreased opioid claims during this period, with emergency medicine decreasing the most (-19.9%) and orthopedic surgery (-16%) dropping opioid claims the most of all the other specialties. Overall physician decrease was -5.2%. However opioid claims among dentists (+5.6%) and nonphysician providers (+10.2%) increased during this period.
AHRQ-funded; HS020642.
Citation: Romman AN, Hsu CM, Chou LN .
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
Pain Med 2020 Nov 7;21(7):1400-07. doi: 10.1093/pm/pnz344..
Keywords: Elderly, Opioids, Medication, Medicare, Pain, Chronic Conditions, Practice Patterns
Ibrahim AM, Nuliyalu U, Lawton EJ
Evaluation of US hospital episode spending for acute inpatient conditions after the Patient Protection and Affordable Care Act.
This study evaluated the association between enactment of Affordable Care Act (ACA) reforms and 30-day price standardized hospital episode spending for Medicare patients. Reforms to reduce spending were targeted to acute care hospitals and often focused on specific diagnoses such as acute myocardial infarction, heart failure, and pneumonia. The policy evaluation included index discharges between January 2008 and August 31, 2015 from a random 20% sample of Medicare beneficiaries. Three different estimation approaches were used to evaluate the association between reforms and episode spending: difference-in-difference (DID) analysis among acute care hospitals; a DID analysis comparing acute care hospitals and critical care hospitals; and a generalized synthetic control analysis, comparing acute care and critical access hospitals. A total of 7,634,242 index discharges were included. All 3 approaches found that ACA-associated spending reforms were associated with a significant reduction in episode spending.
AHRQ-funded; HS024525; HS024728.
Citation: Ibrahim AM, Nuliyalu U, Lawton EJ .
Evaluation of US hospital episode spending for acute inpatient conditions after the Patient Protection and Affordable Care Act.
JAMA Netw Open 2020 Nov 2;3(11):e2023926. doi: 10.1001/jamanetworkopen.2020.23926..
Keywords: Elderly, Policy, Hospitals, Medicare, Healthcare Costs
Roberts ET, McGarry BE, Glynn A
Cognition and take-up of the Medicare Savings Programs.
In this study, the investigators examined the association between cognition and Medicare Savings Program (MSP) enrollment among elderly Medicare beneficiaries who qualified for these programs. They also examined enrollment in the Low-Income Subsidy (LIS), a separate program that provides premium and cost-sharing assistance in Medicare Part D that Medicare beneficiaries automatically received if they are enrolled in an MSP.
AHRQ-funded; HS026727.
Citation: Roberts ET, McGarry BE, Glynn A .
Cognition and take-up of the Medicare Savings Programs.
JAMA Intern Med 2020 Nov;180(11):1529-31. doi: 10.1001/jamainternmed.2020.2783..
Keywords: Elderly, Medicare, Health Insurance, Healthcare Costs, Low-Income, Dementia, Neurological Disorders
Soylu TG, Goldberg DG, Cuellar AE
Medicare access and CHIP reauthorization act in small to medium-sized primary care practices.
Despite major efforts to transition to a new physician payment system under the Medicare Access and CHIP Reauthorization Act (MACRA), little is known about how well practices are prepared. This study aimed to understand how small and medium-sized primary care practices in the Heart of Virginia Healthcare (https://www.vahealthinnovation.org/hvh/) perceived their quality incentives under MACRA.
AHRQ-funded; HS023913.
Citation: Soylu TG, Goldberg DG, Cuellar AE .
Medicare access and CHIP reauthorization act in small to medium-sized primary care practices.
J Am Board Fam Med 2020 Nov-Dec;33(6):942-52. doi: 10.3122/jabfm.2020.06.200142..
Keywords: Children's Health Insurance Program (CHIP), Medicare, Primary Care, Health Insurance
Hill SC, Miller GE, Ding Y
AHRQ Author: Hill SC, Miller GE, Ding Y
Net spending on retail specialty drugs grew rapidly, especially for private insurance and Medicare Part D.
This study examined net spending trends on retail specialty drugs from 2010 to 2017. Spending has been difficult to measure due to proprietary rebate payments by manufacturers by insurers, pharmacy benefit managers and state Medicaid agencies. The authors incorporated those rebates into their research. They found that specialty drugs accounted for 37.7% of retail and mail-order prescription spending net of rebates in 2016-17. The spending net of rebates tripled for Medicare Part D beneficiaries and more than doubled for people with private insurance from 2010 to 2017. Medicaid net spending of rebates had a slower increase.
AHRQ-authored.
Citation: Hill SC, Miller GE, Ding Y .
Net spending on retail specialty drugs grew rapidly, especially for private insurance and Medicare Part D.
Health Aff 2020 Nov;39(11):1970-76. doi: 10.1377/hlthaff.2019.01830..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Medication, Medicare, Health Insurance
Groeneveld PW, Yang L, Segal AG
The effects of market competition on cardiologists' adoption of transcatheter aortic valve replacement.
This study examined the effects of market competition and unique regulations on cardiologists’ adoption of transcatheter aortic valve replacement (TAVR). This new technology was introduced around 2012. This retrospective cohort study looked at physician group practices (n=5116) from May 2012 through December 2014. Medicare claim data was used to indicate first usage. The Herfindahl-Hirschman Index was used to show that every 1000 point increase was associated with a 26% relative increase in the rate of TAVR adoption. This was most true in concentrated markets, and adoption of TAVR was favored by physician groups with greater market power.
AHRQ-funded; HS023615.
Citation: Groeneveld PW, Yang L, Segal AG .
The effects of market competition on cardiologists' adoption of transcatheter aortic valve replacement.
Med Care 2020 Nov;58(11):996-1003. doi: 10.1097/mlr.0000000000001391..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medicare
Fung V, Price M, Nierenberg AA
Assessment of behavioral health services use among low-income Medicare beneficiaries after reductions in coinsurance fees.
This study looked at outcomes from reducing behavioral health care Medicare coinsurance from 50% to 20% from 2009 to 2013. The sample of patients looked at included some diagnosed with SMI (serious mental illness) including schizophrenia, bipolar, or major depressive disorder). Data analysis was performed on 793,275 beneficiaries with SMI in 2008 and compared them with costs in 2013. The mean adjusted out-of-pocket costs for outpatient behavioral care decreased from $132 annually to $64, but the number of visits only increased slightly. No association was found between cost-sharing reductions and changes in behavioral health care visits.
AHRQ-funded; HS024725.
Citation: Fung V, Price M, Nierenberg AA .
Assessment of behavioral health services use among low-income Medicare beneficiaries after reductions in coinsurance fees.
JAMA Netw Open 2020 Oct;3(10):e2019854. doi: 10.1001/jamanetworkopen.2020.19854..
Keywords: Medicare, Health Insurance, Depression, Behavioral Health, Low-Income, Healthcare Costs, Healthcare Utilization
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Ganguli I, Lupo C, Mainor AJ
Association between specialist compensation and Accountable Care Organization performance.
This study’s objective was to determine whether Medicare Shared Savings Program Accountable Care Organizations (ACOs) using cost reduction measures in specialist compensation demonstrated better performance. National cross-sectional survey data on ACOs from 2013-2015 was linked to public-use data on ACO performance from 2014-2016. Out of 160 ACOs surveys, 26% reported using cost reduction measures to help determine specialist compensation. However, these ACOs did not have savings in the short term.
AHRQ-funded; HS023812.
Citation: Ganguli I, Lupo C, Mainor AJ .
Association between specialist compensation and Accountable Care Organization performance.
Health Serv Res 2020 Oct;55(5):722-28. doi: 10.1111/1475-6773.13323..
Keywords: Provider Performance, Healthcare Costs, Payment, Medicare
Nicholas LH, Wu S
Do Medicare Advantage rebates reduce enrollees' out-of-pocket spending?
Researchers used survey data on Medicare Advantage (MA) beneficiaries' actual out-of-pocket spending linked to MA payment information to test whether higher plan payments and rebates lowered enrollee out-of-pocket spending. They found that beneficiaries recovered only $0.65 of every $1.00 in payments exceeding fee-for-service spending through lower out-of-pocket spending but more than fully recovered the value of the rebates supporting supplemental benefits.
AHRQ-funded; HS000029.
Citation: Nicholas LH, Wu S .
Do Medicare Advantage rebates reduce enrollees' out-of-pocket spending?
Med Care Res Rev 2020 Oct;77(5):474-82. doi: 10.1177/1077558718807847..
Keywords: Healthcare Costs, Medicare, Health Insurance