Prices for Physician Services in Medicare Advantage Versus Traditional Medicare
For a set of common physician services, employer-sponsored Medicare Advantage plans are found to pay prices that are similar to traditional Medicare rates.
The Development of Diabetes Complications in GP-Centered Healthcare
This study compared general practitioner–centered healthcare (Hausarztzentrierte Versorgung [HZV]) with non-HZV healthcare in Germany regarding the development of diabetes complications. HZV is associated with reduced risk of diabetes complications.
Examining Differential Performance of 3 Medical Home Recognition Programs
We examine utilization, quality, and expenditures among Medicare beneficiaries receiving care at federally qualified health centers and compare outcomes among those attributed to 1 of 3 recognition programs versus none.
Insights on Site-of-Care Cancer Research: Both Quality and Cost Information Are Necessary to Guide Policy
The implementation of alternative payment models that successfully capture clinical heterogeneity—without adding unacceptable levels of administrative complexity—may be equally (if not more) important than site-neutral payment policies.
Differences in Spending on Provider-Administered Chemotherapy by Site of Care in Medicare
Spending on chemotherapy drugs was lower among Medicare beneficiaries who received chemotherapy in hospital outpatient departments than among comparable beneficiaries receiving chemotherapy in physician offices.
Value-Based Health Insurance Design: How Much Does Socioeconomic Status Matter?
Socioeconomic status may significantly influence enrollee response to value-based benefit design approaches. Evaluating the association of wage status with claims experience may yield actionable insights.
Inpatient Placement: Associations With Mortality, Cost, and Length of Stay
Placement of patients in an inpatient hospital setting is associated with lower length of stay and mortality at the expense of higher costs.
Trends in Primary Care Encounters Across Professional Roles in PCMH
A metric of primary care delivery by non–primary care provider clinicians demonstrated increasing trends in patient encounters by nurses and social workers and was responsive to patient-centered medical home implementation.
ACOs With Risk-Bearing Experience Are Likely Taking Steps to Reduce Low-Value Medical Services
Experience with risk-based contracting best predicts active engagement of accountable care organizations in reducing low-value medical services, mainly through physician education and encouraging shared decision making.
Postdischarge Engagement Decreased Hospital Readmissions in Medicaid Populations
Postdischarge engagement of at-risk Medicaid beneficiaries in 6 health plans resulted in significant reductions in hospital readmissions at rates proportional to the frequency of engagement.
Forgotten Patients: ACO Attribution Omits Those With Low Service Use and the Dying
This article compares clinical and utilization profiles of Medicare patients who are attributed to provider groups with those of patients unattributed to any provider group in accountable care organization models.
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