National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
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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
26 to 37 of 37 Research Studies DisplayedColla CH, Lewis VA, Kao LS
Association between Medicare accountable care organization implementation and spending among clinically vulnerable beneficiaries.
The purpose of this cohort study was to examine the effect of Medicare accountable care organization (ACO) contracts on both spending and high-cost institutional utilization for all Medicare beneficiaries and for clinically vulnerable beneficiaries. The main outcomes and measures for this study were total spending per beneficiary-quarter, spending categories, utilization of hospitals and emergency departments, ambulatory care sensitive admissions, and 30-day readmissions. The study found that total spending decreased by $34 per beneficiary-quarter after implementation of ACO contracts across the overall Medicare population and decreased $114 in clinically vulnerable patients. In the overall Medicare cohort, hospitalizations and emergency department visits decreased by 1.3 and 3.0 events per 1000 beneficiaries per quarter, respectively. Hospitalizations and emergency department visits decreased in the clinically vulnerable cohort by 2.9 and 4.1 events per 1000 beneficiaries per quarter, respectively. Variations in total spending related with ACOs did not differ by clinical condition of beneficiaries.
AHRQ-funded; HS024075.
Citation: Colla CH, Lewis VA, Kao LS .
Association between Medicare accountable care organization implementation and spending among clinically vulnerable beneficiaries.
JAMA Intern Med 2016 Aug;176(8):1167-75. doi: 10.1001/jamainternmed.2016.2827.
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Keywords: Medicare, Policy, Healthcare Costs, Payment, Vulnerable Populations
Sommers BD, Stone J, Kane N
Predictors of payer mix and financial performance among safety net hospitals prior to the Affordable Care Act.
The objective of this study was to use audited hospital financial statements to identify predictors of payer mix and financial performance in safety net hospitals prior to the Affordable Care Act. It found that university governance was the strongest positive predictor of operating margin. Safety net hospital financial performance varied considerably. Academic hospitals had higher operating margins, while more generous Medicaid eligibility and reimbursement policies improved hospitals' ability to recoup costs.
AHRQ-funded; HS021291.
Citation: Sommers BD, Stone J, Kane N .
Predictors of payer mix and financial performance among safety net hospitals prior to the Affordable Care Act.
Int J Health Serv 2016;46(1):166-84. doi: 10.1177/0020731415586408.
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Keywords: Hospitals, Policy, Medicaid, Payment
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
Berenson RA, Rice T
Beyond measurement and reward: methods of motivating quality improvement and accountability.
The article examines public policies designed to improve quality and accountability that do not rely on financial incentives and public reporting of provider performance. It concludes that public policies related to quality improvement should focus more on methods of enhancing professional intrinsic motivation, while recognizing the potential role of organizations to actively promote and facilitate that motivation.
AHRQ-funded
Citation: Berenson RA, Rice T .
Beyond measurement and reward: methods of motivating quality improvement and accountability.
Health Serv Res 2015 Dec;50 Suppl 2:2155-86. doi: 10.1111/1475-6773.12413.
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Keywords: Quality Improvement, Policy, Provider Performance, Quality of Care, Payment
Berdahl C, Schuur JD, Fisher NL
Policy measures and reimbursement for emergency medical imaging in the era of payment reform: proceedings from a panel discussion of the 2015 Academic Emergency Medicine Consensus Conference.
In May 2015, Academic Emergency Medicine convened a consensus conference titled "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." As part of the conference, a panel of health care policy leaders and emergency physicians discussed the effect of the Affordable Casre Act and other quality programs on ED diagnostic imaging. This article discusses the content of the panel's presentations.
AHRQ-funded; HS023498.
Citation: Berdahl C, Schuur JD, Fisher NL .
Policy measures and reimbursement for emergency medical imaging in the era of payment reform: proceedings from a panel discussion of the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1393-9. doi: 10.1111/acem.12829.
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Keywords: Emergency Department, Healthcare Costs, Payment, Policy, Imaging, Policy, Quality Improvement
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)
Schlesinger M, Grob R, Shaller D
Using patient-reported information to improve clinical practice.
The purposes of this study were to assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. It concluded that unless public policies are attentive to patients' perspectives, stronger financial incentives for clinicians can threaten aspects of care that patients most value.
AHRQ-funded.
Citation: Schlesinger M, Grob R, Shaller D .
Using patient-reported information to improve clinical practice.
Health Serv Res 2015 Dec;50 Suppl 2:2116-54. doi: 10.1111/1475-6773.12420.
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Keywords: Quality Improvement, Quality of Care, Patient Experience, Provider Performance, Policy, Payment, Public Reporting
Kawai AT, Calderwood MS, Jin R
Impact of the Centers for Medicare and Medicaid services hospital-acquired conditions policy on billing rates for 2 targeted healthcare-associated infections.
The 2008 Centers for Medicare & Medicaid Services (CMS) hospital-acquired conditions policy limited additional payment for conditions deemed reasonably preventable. This study examined whether this policy was associated with decreases in billing rates for 2 targeted conditions, vascular catheter-associated infections (VCAI) and catheter-associated urinary tract infections (CAUTI). The CMS policy appears to have been associated with immediate reductions in billing rates for VCAI and CAUTI, followed by a slight decreasing trend or leveling-off in rates.
AHRQ-funded; HS018414.
Citation: Kawai AT, Calderwood MS, Jin R .
Impact of the Centers for Medicare and Medicaid services hospital-acquired conditions policy on billing rates for 2 targeted healthcare-associated infections.
Infect Control Hosp Epidemiol 2015 Aug;36(8):871-7. doi: 10.1017/ice.2015.86.
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Keywords: Healthcare-Associated Infections (HAIs), Policy, Medicare, Payment, Hospitals, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare Costs
Schulz J, DeCamp M, Berkowitz SA
Medicare Shared Savings Program: public reporting and shared savings distributions.
The objectives of this paper are to determine if Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) are meeting public reporting requirements related to shared savings plans, to quantitate the composition of shared savings distribution plans, and to investigate whether early ACO success is associated with specific plan or ACO characteristics. The authors found that just over one-half of MSSP ACOs report detailed shared savings distribution plans online, and these plans vary widely. They concluded that there appears to be no single shared savings distribution plan determinate of ACO success.
AHRQ-funded; HS023684.
Citation: Schulz J, DeCamp M, Berkowitz SA .
Medicare Shared Savings Program: public reporting and shared savings distributions.
Am J Manag Care 2015 Aug;21(8):546-53.
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Keywords: Quality of Care, Payment, Policy, Medicare, Public Reporting
Abrahamson K, Miech E, Davila HW
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
The researchers explored ways in which data were collected, thought about and used by nursing home employees as a result of participation in a pay-for-performance (P4P) program. Their findings indicated that participants in the Minnesota Performance-based Incentive Payment Program’s quality improvement (QI) projects perceived a change in the rate and manner in which they gathered, used, and considered data in their QI decisions.
AHRQ-funded; HS018464
Citation: Abrahamson K, Miech E, Davila HW .
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
BMJ Qual Saf. 2015 May;24(5):311-7. doi: 10.1136/bmjqs-2014-003362..
Keywords: Nursing Homes, Long-Term Care, Payment, Provider Performance, Decision Making, Policy, Quality Improvement, Quality of Care
Ridgely MS, de Vries D, Bozic KJ
Bundled payment fails to gain a foothold in California: the experience of the IHA bundled payment demonstration.
This article reports on a meeting convened by California's Integrated Healthcare Association to determine whether bundled payment could be an effective payment model for California. An evaluation of the pilot documented a number of barriers, such as administrative burden, state regulatory uncertainty, and disagreements about bundle definition and assumption of risk; however, the evaluation provides lessons for future bundled payment initiatives.
AHRQ-funded; HS020098.
Citation: Ridgely MS, de Vries D, Bozic KJ .
Bundled payment fails to gain a foothold in California: the experience of the IHA bundled payment demonstration.
Health Aff 2014 Aug;33(8):1345-52. doi: 10.1377/hlthaff.2014.0114.
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Keywords: Payment, Policy
Ryan AM, Mushlin AI
The Affordable Care Act's payment reforms and the future of hospitals.
The author places likely hospital responses to the Affordable Care Act’s payment reforms in the historical context of their previous responses to such reforms as price controls, certificate-of-need laws, and prospective payment systems. He then discusses possible hospital responses to counter readmission penalties, revenue reductions, bundled payment strategies, and accountable care organizations.
AHRQ-funded; HS018546
Citation: Ryan AM, Mushlin AI .
The Affordable Care Act's payment reforms and the future of hospitals.
Ann Intern Med. 2014 May 20;160(10):729-30. doi: 10.7326/M13-2033..
Keywords: Healthcare Costs, Payment, Hospitals, Policy