National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Blood Thinners (1)
- Cardiovascular Conditions (2)
- Elderly (4)
- Healthcare Cost and Utilization Project (HCUP) (1)
- (-) Healthcare Costs (13)
- Healthcare Delivery (2)
- Healthcare Utilization (2)
- Health Insurance (2)
- Heart Disease and Health (1)
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- (-) Hospitalization (13)
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- Long-Term Care (2)
- (-) Medicare (13)
- Medication (1)
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- Provider Performance (1)
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- Stroke (1)
- 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 13 of 13 Research Studies DisplayedCarey K, Dor A
Hospital response to CMS public reports of hospital charge information.
This study examined trends in charge increases for Medicare inpatients treated in approximately 3400 hospitals after the Centers for Medicare and Medicaid Services (CMS) began reporting charges online in 2013 for Medicare inpatients. The investigators applied difference-in-differences analysis to comprehensive inpatient charge data from New York and Florida for the years 2011-2016. After public reporting was implemented the growth in reported charges in New York hospitals was 4-9% lower than unreported diagnosis-related groups and in Florida it was 2-8% lower.
AHRQ-funded; HS025074.
Citation: Carey K, Dor A .
Hospital response to CMS public reports of hospital charge information.
Med Care 2020 Jan;58(1):70-73. doi: 10.1097/mlr.0000000000001232..
Keywords: Hospitals, Healthcare Costs, Public Reporting, Medicare, Hospitalization
Kaye DR, Luckenbaugh AN, Oerline M
Understanding the costs associated with surgical care delivery in the Medicare population.
This study’s objective was to quantify the costs of inpatient and outpatient surgery in the Medicare population. Claims data from a 20% national sample of Medicare beneficiaries was used. Results showed that, while spending on inpatient surgery contributed the most to total surgical payments, it declined over the study period, driven by decreases in index hospitalization and readmissions payments. In contrast, spending on outpatient surgery increased across all sites of care (hospital outpatient department, physician office, and ambulatory surgery center). Ophthalmology and hand surgery witnessed the greatest growth in surgical spending over the study period. Surgical care accounts for half of all Medicare spending.
AHRQ-funded; HS024525; HS024728.
Citation: Kaye DR, Luckenbaugh AN, Oerline M .
Understanding the costs associated with surgical care delivery in the Medicare population.
Ann Surg 2020 Jan;271(1):23-28. doi: 10.1097/sla.0000000000003165..
Keywords: Surgery, Healthcare Delivery, Healthcare Costs, Medicare, Elderly, Hospitalization
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
Regenbogen SE, Cain-Nielsen AH, Syrjamaki JD
Spending on postacute care after hospitalization in commercial insurance and Medicare around age sixty-five.
Postacute care costs are the primary determinant of episode spending around hospitalization. Yet there is little evidence that greater spending on postacute care improves readmission rates or functional recovery. In a population-based, statewide collaborative of Michigan hospitals, the investigators used regression discontinuity design among propensity-weighted, age-adjusted cohorts to compare postacute care spending between patients with commercial insurance and those with Medicare around age sixty-five. This paper describes the study.
AHRQ-funded; HS024698.
Citation: Regenbogen SE, Cain-Nielsen AH, Syrjamaki JD .
Spending on postacute care after hospitalization in commercial insurance and Medicare around age sixty-five.
Health Aff 2019 Sep;38(9):1505-13. doi: 10.1377/hlthaff.2018.05445..
Keywords: Healthcare Costs, Health Insurance, Medicare, Hospitalization
Colla CH, Lewis VA, Stachowski C
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
In this study, researchers examined changes in more and less discretionary condition-specific postacute care use associated with Medicare accountable care organization (ACO) implementation. They found that ACOs decreased spending on postacute care by decreasing use of discretionary services. In addition, ACO implementation was associated with reduced length of stay in skilled nursing facilities, while hip fracture patients used institutional postacute settings at higher rates. The authors also observed decreases in spending, readmission days, and mortality among pneumonia patients.
AHRQ-funded; HS024698.
Citation: Colla CH, Lewis VA, Stachowski C .
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
Med Care 2019 Jun;57(6):444-52. doi: 10.1097/mlr.0000000000001121..
Keywords: Injuries and Wounds, Healthcare Costs, Healthcare Utilization, Hospitalization, Medicare, Pneumonia, Stroke
Nuti SV, Li SX, Xu X
Association of in-hospital resource utilization with post-acute spending in Medicare beneficiaries hospitalized for acute myocardial infarction: a cross-sectional study.
This study compared costs among Medicare fee-for-service beneficiaries aged 65 and over hospitalized with acute myocardial infarction (AMI) from 2010 to 2013 in the Premiere Healthcare Database. The association of in-hospital and post-acute care resource utilization and outcomes was examined. Researchers concluded that greater resource utilization during hospitalization was not associated with meaning differences in costs or mortality rates after hospitalization.
AHRQ-funded; HS023000.
Citation: Nuti SV, Li SX, Xu X .
Association of in-hospital resource utilization with post-acute spending in Medicare beneficiaries hospitalized for acute myocardial infarction: a cross-sectional study.
BMC Health Serv Res 2019 Mar 25;19(1):190. doi: 10.1186/s12913-019-4018-0..
Keywords: Cardiovascular Conditions, Elderly, Healthcare Costs, Hospitalization, Medicare
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
Henke RM, Karaca Z, Gibson TB
AHRQ Author: Karaca Z, Wong HS
Medicare Advantage penetration and hospital costs before and after the Affordable Care Act.
This study investigated the relationship between Medicare Advantage (MA) program growth and inpatient hospital costs and utilization before and after the ACA. Its results suggest that MA enrollment growth is associated with diminished spillover reductions in hospital admission costs after the ACA. Researchers did not observe a strong relationship between MA enrollment and inpatient days per enrollee
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicare Advantage penetration and hospital costs before and after the Affordable Care Act.
Med Care 2018 Apr;56(4):321-28. doi: 10.1097/mlr.0000000000000885.
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Keywords: Healthcare Costs, Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medicare
Adrion ER, Kocher KE, Nallamothu BK
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Using multipayer commercial claims for the period 2009-13, the investigators evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In their study period, the use of observation care increased relative to that of short-stay hospitalizations. In addition, total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly--and at rates much higher than spending in the inpatient setting--over the study period.
AHRQ-funded; HS000053.
Citation: Adrion ER, Kocher KE, Nallamothu BK .
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Health Aff 2017 Dec;36(12):2102-09. doi: 10.1377/hlthaff.2017.0774..
Keywords: Health Insurance, Healthcare Costs, Healthcare Delivery, Healthcare Utilization, Hospitalization, Hospitals, Medicare
Vaughan Sarrazin MS, Jones M, Mazur A
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
The purpose of this study was to examine the impact of anticoagulant choice on inpatient costs in patients with nonvalvular atrial fibrillation (AF). Analysis used 3-way propensity matching to create groups from AF patients taking dabigatran, rivaroxaban, or warfarin, and were plausible candidates for all 3 anticoagulants. Predicted values from two models were multiplied together to estimate expected costs per patient-year. The study concludes from its data that patients with newly diagnosed AF taking 150 mg dabigatran or 20 mg rivaroxaban experience lower annual inpatient costs than patients taking warfarin, due to fewer hospital admissions for stroke, non-gastrointestinal-related hemorrhages, and heart failure events.
AHRQ-funded; HS023104.
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
J Am Coll Cardiol 2017 Jan 24;69(3):360-62. doi: 10.1016/j.jacc.2016.11.023..
Keywords: Blood Thinners, Heart Disease and Health, Medication, Healthcare Costs, Medicare, Hospitalization, Cardiovascular Conditions
Das A, Norton EC, Miller DC
Association of postdischarge spending and performance on new episode-based spending measure.
The Centers for Medicare and Medicaid Services recently added the Medicare Spending per Beneficiary (MSPB) metric to its Hospital Value-Based Purchasing (HVBP) program. The researchers evaluated whether hospital performance was driven by spending before, during, or after hospitalization. They found that compared with low-cost hospitals, high-cost hospitals had significantly higher preadmission and index admission spending, but the largest differences were in postdischarge spending.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Association of postdischarge spending and performance on new episode-based spending measure.
JAMA Intern Med 2016 Jan;176(1):117-9. doi: 10.1001/jamainternmed.2015.6261.
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Keywords: Healthcare Costs, Medicare, Hospitals, Provider Performance, Hospitalization, Payment, Hospital Discharge
Keohane LM, Grebla RC, Mor V
Medicare Advantage members' expected out-of-pocket spending for inpatient and skilled nursing facility services.
In 2011, new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in Medicare Advantage (MA) plans. The authors found that some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing.
AHRQ-funded; HS000011.
Citation: Keohane LM, Grebla RC, Mor V .
Medicare Advantage members' expected out-of-pocket spending for inpatient and skilled nursing facility services.
Health Aff 2015 Jun;34(6):1019-27. doi: 10.1377/hlthaff.2014.1146.
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Keywords: Healthcare Costs, Hospitalization, Policy, Medicare, Nursing Homes
O'Donnell BE, Schneider KM, Brooks JM
Standardizing Medicare payment information to support examining geographic variation in costs.
This paper describes a method for standardizing claim payments, and demonstrates the difference in actual versus standardized payments by geographic region. It found that without standardization of payments, certain areas of the country are mischaracterized as either high or low healthcare resource-consuming areas.
AHRQ-funded; HS019574; HS019440.
Citation: O'Donnell BE, Schneider KM, Brooks JM .
Standardizing Medicare payment information to support examining geographic variation in costs.
Medicare Medicaid Res Rev 2013 Sep 10;3(3). doi: 10.5600/mmrr.003.03.a06..
Keywords: Medicare, Healthcare Costs, Hospitalization, Hospitals