Abstract：
OBJECTIVE:To examine implementation of the Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) programs, enacted in 1988. The article summarizes the origin of the QMB and SLMB programs, describes what we have learned about QMB and SLMB enrollment in state Medicaid programs and, despite some encouraging news on the federal front, identifies policy issues that remain in assuring access to health care for the low-income elderly. SOURCE:Based in part on research that assessed state variations in Medicaid QMB and SLMB enrollment of low-income Medicare beneficiaries and identified best practices among states in administration of the QMB and SLMB programs. STUDY DESIGN:Telephone interviews were conducted with officials in ten states to elicit qualitative information about how state Medicaid programs have implemented federal protections for low-income Medicare beneficiaries. PRINCIPAL FINDINGS:The QMB and SLMB programs fail to reach a sizable proportion of potentially eligible individuals in most states. Fragmentation of Medicare and Medicaid benefits, complex Medicaid eligibility and income verification processes, and rigid federal and state administrative and data systems, impede efforts to achieve promised protection for low-income elderly persons. CONCLUSIONS:For low-income Medicare beneficiaries, obtaining financial protection against their high out-of-pocket health care costs remains an important issue. The complexities associated with aligning Medicare and Medicaid to deliver health benefits to low-income older persons makes improved coordination across federal and state agencies uncertain.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Lamphere JA,Rosenbach MLkeywords:
subject
Has Abstractpub_date
2000-04-01 00:00:00pages
207-17issue
1 Pt 2eissn
0017-9124issn
1475-6773journal_volume
35pub_type
杂志文章abstract：:All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were screened to identify 171 terminally ill patients with informal caregivers who were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or customary care (N = 86). Patient functioning, and patient and caregiver morale ...
journal_title：Health services research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1992-02-01 00:00:00
abstract：:Cost-benefit analyses are routinely included in evaluations of acute care programs. In the case of long-term care, it is frequently alleged that cost-benefit analysis cannot be fruitfully applied. This article demonstrates the utility of applying cost-benefit analysis to evaluations of long-term care programs. A case ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1981-04-01 00:00:00
abstract：OBJECTIVE:Evidence supporting the use of public reporting of quality information to improve health care quality is mixed. While public reporting may improve reported quality, its effect on quality of care more broadly is uncertain. This study tests whether public reporting in the setting of nursing homes resulted in im...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.00967.x
更新日期：2009-08-01 00:00:00
abstract：OBJECTIVE:To determine factors associated with ruptured appendicitis among children, using administrative databases. Insurance-related differences in the risk of ruptured appendix among adults in California have previously been described (Braveman, Schaaf, Egerter, et al. 1994). DATA SOURCES/STUDY SETTING:State of Mar...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2001-04-01 00:00:00
abstract：OBJECTIVE:To explore why and how health systems are engaging in care delivery redesign (CDR)-defined as the variety of tools and organizational change processes health systems use to pursue the Triple Aim. STUDY SETTING:A purposive sample of 24 health systems across 4 states as part of the Agency for Healthcare Resear...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13585
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:To develop a taxonomy of governing board roles in U.S. hospitals. DATA SOURCES:2005 AHA Hospital Governance Survey, 2004 AHA Annual Survey of Hospitals, and Area Resource File. STUDY DESIGN:A governing board taxonomy was developed using cluster analysis. Results were validated and reviewed by industry exper...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00835.x
更新日期：2008-08-01 00:00:00
abstract：OBJECTIVE:To explore state patterns in the racial life expectancy gap. DATA SOURCES:The 1997-2004 Multiple Cause of Death PUF, 2000 U.S. Census. STUDY DESIGN:We calculated life expectancy at birth for black and white men and women. DATA EXTRACTION METHODS:Data were obtained by the NCHS and U.S. Census Bureau. PRINC...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01345.x
更新日期：2012-02-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis that health systems provide better care to patients with high needs by comparing differences in quality between system-affiliated and nonaffiliated physician organizations (POs) and to examine variability in quality across health systems. DATA SOURCES:2015 Medicare Data on Provider Pra...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13570
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:The design of health insurance, and the role out-of-pocket (OOP) payments play in it, is a key policy issue as rising health costs have encouraged greater cost-sharing measures. This paper compares the percentage of Americans spending large amounts OOP to meet their health needs with percentages in eight othe...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12444
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:This study describes the derivation and validation of the Patient Management Category (PMC) Severity Scale, which provides a method of assessing the overall severity of a hospitalized patient's illnesses, based on the patient's unique clinical conditions, their interaction, and the resultant, combined risk of...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-08-01 00:00:00
abstract：:We examined the expansion of Veterans Administration (now Department of Veterans Affairs--VA) inpatient psychiatric services from 1963 to 1984. Aggregate national trends in VA inpatient episodes between 1963 and 1984 document not only increased use of inpatient services but also "decentralization," or a shift to provi...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：:The concepts of class, race, and ethnicity figure prominently in health services research in Britain. Occupational class has been employed for nearly a century to investigate social inequalities in health and access to care. More recently, researchers have identified differences in health status and utilization betwee...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1995-04-01 00:00:00
abstract：:Using existing data sources, we developed three risk-adjusted measures of hospital quality: the risk-adjusted mortality index (RAMI), the risk-adjusted readmissions index (RARI), and the risk-adjusted complication index (RACI). We describe the construction and validation of each of these indexes. After these measures ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-10-01 00:00:00
abstract：OBJECTIVE:To measure the effects of race/ethnicity, area measures of socioeconomic status (SES) and geographic residency status, and health care supply (HCS) characteristics on breast cancer (BC)-related outcomes. DATA SOURCES/STUDY SETTING:Female patients in Georgia diagnosed with BC in the years 2000-2009. STUDY DE...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12096
更新日期：2014-04-01 00:00:00
abstract：OBJECTIVE:To examine facility variation in data quality of the level of pain documented in the minimum data set (MDS) as a function of level of hospice enrollment in nursing homes (NHs). DATA SOURCE:Clinical assessments on 3,469 nonhospice residents from 178 NHs were merged with On-line Survey Certification and Report...
journal_title：Health services research
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1475-6773.2005.00400.x
更新日期：2005-08-01 00:00:00
abstract：OBJECTIVE:To examine the relationship of services for post-acute care (PAC) to stroke patient outcomes. DATA SOURCES/STUDY SETTING:Veterans Health Administration (VHA) hospitals from two facility-level surveys and extant data files. STUDY DESIGN:Cross-sectional study of veterans hospitalized with acute stroke during ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2001-02-01 00:00:00
abstract：OBJECTIVE:To estimate the total hours of paid and unpaid personal assistance of daily living provided to adults living at home in the United States using nationally representative household survey data. DATA SOURCES:The Disability Followback Survey of the National Health Interview Survey on Disability (NHIS-D) conduct...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.029
更新日期：2002-04-01 00:00:00
abstract：OBJECTIVES:Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. PRINCIPAL FINDINGS:Grantees faced common challenges, including recr...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12330
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To examine measures of need for health care and their relationship to utilization of health services in different racial and ethnic groups in California. DATA SOURCE:Telephone interviews obtained by random-digit dialing and conducted between April 1993 and July 1993 in California, with 7,264 adults (ages 18-...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1996-12-01 00:00:00
abstract：OBJECTIVE:To assess the influence of relational climate on quality of diabetes care. DATA SOURCES/STUDY SETTING:The study was conducted at the Department of Veterans Affairs (VA). The VA All Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA adminis...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12675
更新日期：2018-04-01 00:00:00
abstract：OBJECTIVE:To assess the impact of substance abuse claims redaction on Medicare spending estimates for beneficiaries with serious mental illness. DATA SOURCES:The 2012 claims and unredacted beneficiary-level Medicare spending totals from CMS's Chronic Conditions Warehouse. STUDY DESIGN:We identified beneficiaries with...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12528
更新日期：2017-06-01 00:00:00
abstract：OBJECTIVE:To determine if the incidence of psychiatric emergencies involving drugs or alcohol supports the argument that mentally ill persons contribute to elevated mortality during the days following disbursement of private earnings and public income transfers. STUDY DESIGN:Interrupted time-series using Box-Jenkins m...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2000-10-01 00:00:00
abstract：OBJECTIVES:To examine the effects of changes in payment and risk adjustment on (1) the annual enrollment and switching behavior of Medicare Advantage (MA) beneficiaries, and (2) the relative costliness of MA enrollees and disenrollees. DATA:From 1999 through 2008 national Medicare claims data from the 5 percent longit...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12006
更新日期：2013-06-01 00:00:00
abstract：OBJECTIVES:To assess the relative abilities of clinical and administrative data to predict mortality and to assess hospital quality of care for CABG surgery patients. DATA SOURCES/STUDY SETTING:1991-1992 data from New York's Cardiac Surgery Reporting System (clinical data) and HCFA's MEDPAR (administrative data). STUD...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1997-02-01 00:00:00
abstract：OBJECTIVE:To examine the association between dialysis facility chain affiliation and patient mortality. STUDY SETTING:Medicare dialysis population. STUDY DESIGN:Data from the United States Renal Data System (USRDS) were used to identify 3,601 free-standing dialysis facilities and 34,914 Medicare patients' incidence t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01219.x
更新日期：2011-06-01 00:00:00
abstract：OBJECTIVE:To understand reasons why California has lower Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores than the rest of the country, including differing patterns of CAHPS scores between Medicare Advantage (MA) and fee-for-service, effects of additional demographic characteristics of beneficiari...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01279.x
更新日期：2011-10-01 00:00:00
abstract：:Alternative delivery systems, such as HMOs, PPOs, and primary care case-management programs, have a long history in rural America despite significant impediments to their development. However, little is known about the effect of these systems on rural communities and their medical care delivery systems. Existing studi...
journal_title：Health services research
pub_type： 历史文章,杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：OBJECTIVE:To review two indirect methods, geocoding and surname analysis, for estimating race/ethnicity as a means for health plans to assess disparities in care. STUDY DESIGN:Review of published articles and unpublished data on the use of geocoding and surname analyses. PRINCIPAL FINDINGS:Few published studies have ...
journal_title：Health services research
pub_type： 杂志文章,评审
doi：10.1111/j.1475-6773.2006.00551.x
更新日期：2006-08-01 00:00:00
abstract：OBJECTIVE:To investigate disparities in mental health care episodes, aligning our analyses with decisions to start or drop treatment, and choices made during treatment. STUDY DESIGN:We analyzed whites, blacks, and Latinos with probable mental illness from Panels 9-13 of the Medical Expenditure Panel Survey, assessing ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12095
更新日期：2014-02-01 00:00:00
abstract：:The purpose of this study was to evaluate the applicability of a multiattribute utility model for measuring the severity of a patient's illness. A single medical problem (an analysis of the costs and benefits of different burn care systems) was used to test the model. Physicians estimated the relative importance of an...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1975-04-01 00:00:00
