Abstract：
OBJECTIVE:To investigate whether a performance-based contracting (PBC) system provides incentives for nonprofit providers of substance abuse treatment to select less severe clients into treatment. DATA SOURCES:The Maine Addiction Treatment System (MATS) standardized admission and discharge data provided by the Maine Office of Substance Abuse (OSA) for fiscal years 1991-1995, provides demographic, substance abuse, and social functional information on clients of programs receiving public funding. STUDY DESIGN:We focused on OSA clients (i.e., those patients whose treatment cost was covered by the funding from OSA) and Medicaid clients in outpatient programs. Clients were identified as being "most severe" or not. We compared the likelihood for OSA clients to be "most severe" before PBC and after PBC using Medicaid clients as the control. Multivariate regression analysis was employed to predict the marginal effect of PBC on the probability of OSA clients being most severe after controlling for other factors. PRINCIPAL FINDINGS:The percentage of OSA outpatient clients classified as most severe users dropped by 7 percent (p < = 0.001) after the innovation of performance-based contracting compared to the increase of 2 percent for Medicaid clients. The regression results also showed that PBC had a significantly negative marginal effect on the probability of OSA clients being most severe. CONCLUSIONS:Performance-based contracting gave providers of substance abuse treatment financial incentives to treat less severe OSA clients in order to improve their performance outcomes. Fewer OSA clients with the greatest severity were treated in outpatient programs with the implementation of PBC. These results suggest that regulators, or payers, should evaluate programs comprehensively taking this type of selection behavior into consideration.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Shen Ydoi
10.1111/1475-6773.00132keywords:
subject
Has Abstractpub_date
2003-04-01 00:00:00pages
535-52issue
2eissn
0017-9124issn
1475-6773journal_volume
38pub_type
杂志文章abstract：OBJECTIVE:To examine the psychometric properties of a global physical functioning scale (GPFS) developed as a self-report measure and constructed to scale physical functioning from very poor (1) to excellent (100). DATA SOURCES:Data collection took place between January 1997 and September 1999. It consisted of self-ra...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2001-12-01 00:00:00
abstract：OBJECTIVE:To determine how the inclusion of post-acute evaluation and management (E&M) services as primary care affects assignment of Medicare beneficiaries to accountable care organizations (ACOs). DATA SOURCES:Medicare claims for a random 5 percent sample of 2009 Medicare beneficiaries linked to American Medical Ass...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12032
更新日期：2013-08-01 00:00:00
abstract：:OBJECTIVE. : To determine whether racial/ethnic disparities in colonoscopy use vary by physician availability. DATA SOURCE. : We used 100 percent Texas Medicare claims data for 2003-2007. STUDY DESIGN. : We identified beneficiaries aged 66-79 in 2007, examined racial/ethnic differences in colonoscopy use from 2003 to ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01355.x
更新日期：2012-06-01 00:00:00
abstract：OBJECTIVE:An ecological framework is proposed for assessing factors important to consider in allocating funds to promote sound performance of interorganizational programs. DATA SOURCE/STUDY SETTING:This framework is used to examine the first generation of Community Clinical Oncology Programs (CCOPs) funded by the Nati...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1993-04-01 00:00:00
abstract：OBJECTIVE:To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. DATA SOURCES/STUDY SETTING:Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01280.x
更新日期：2011-10-01 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：:Previous research has confirmed that desirable hospital attributes as well as increased distance, or travel time, have an impact on hospital choice. These studies have become increasingly sophisticated in modeling choice. This study adds to the existing literature by estimating the effect of both hospital and individu...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：OBJECTIVE:To evaluate the effect of partisan political control on financial performance, structure, and outcomes of for-profit and not-for-profit US nursing homes. DATA SOURCES/STUDY SETTING:Nineteen-year panel (1996-2014) of state election outcomes, financial performance data from nursing home cost reports, operation...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13061
更新日期：2019-02-01 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 compare standardized estimates of the true resource costs of outpatient health care to the allowable and billed charges for that care among Medicare Fee for Service (FFS) beneficiaries. DATA SOURCES/STUDY SETTING:Medicare Carrier and Outpatient Standard Analytic (SAF) files linked to participant data in t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12318
更新日期：2016-02-01 00:00:00
abstract：:This article describes a model development process that represents a useful step in classifying populations in terms of risk of institutionalization (Inst-Risk II). A four-category risk classification system--"High risk, Some risk, Low risk, and Very Low Risk"--was developed, based on combinations of measures of funct...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1988-10-01 00:00:00
abstract：OBJECTIVE:Independent freestanding emergency departments (IFEDs) have proliferated over the last decade, largely in Texas. We examined the IFED physician workforce composition and changes in emergency physician workforce supply across states and in rural Texas over the period of IFED proliferation following a 2009 legi...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13587
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVES:(1) To present the Behavioral Model for Vulnerable Populations, a major revision of a leading model of access to care that is particularly applicable to vulnerable populations; and (2) to test the model in a prospective study designed to define and determine predictors of the course of health services utiliz...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2000-02-01 00:00:00
abstract：OBJECTIVE:. To examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer. DATA SOURCES:Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and bene...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00580.x
更新日期：2006-10-01 00:00:00
abstract：OBJECTIVE:To examine factors associated with guideline-concordant adjuvant therapy among breast cancer patients in a rural region of the United States and to present an advancement in quality-of-care assessment in the context of multiple treatments. DATA SOURCES:Chart abstraction on initial therapy received by 868 wom...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12269
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To evaluate the prevalence of seven social factors using physician notes as compared to claims and structured electronic health records (EHRs) data and the resulting association with 30-day readmissions. STUDY SETTING:A multihospital academic health system in southeastern Massachusetts. STUDY DESIGN:An obse...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12670
更新日期：2018-04-01 00:00:00
abstract：OBJECTIVES:To examine organizational structural attributes associated with counselor-client contact. DATA SOURCES:Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs. ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00778.x
更新日期：2008-04-01 00:00:00
abstract：:In a randomized trial of the effects of medical insurance on spending and the health status of the nonaged, we previously reported that patients with limited cost sharing had approximately one-third less use of medical services, similar general self-assessed health, and worse blood pressure, functional far vision, and...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1987-08-01 00:00:00
abstract：OBJECTIVE:To examine the implications of serious and chronic health problems on the willingness of enrollees to switch health plans if they are dissatisfied with their current arrangements. DATA SOURCE:A large (20,283 respondents) survey of employees of three national corporations committed to the model of managed com...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-06-01 00:00:00
abstract：OBJECTIVE:To examine the benefits of a high-performance work environment (HPWE) for employees, patients, and hospitals. STUDY SETTING:Forty-five adult, medical-surgical units in nine hospitals in upstate New York. STUDY DESIGN:Cross-sectional study. DATA COLLECTION:Surveys were collected from 1,527 unit-based hospit...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01438.x
更新日期：2013-02-01 00:00:00
abstract：OBJECTIVE:To evaluate the impact of health professionals' intervention on adherence to statins, the influence on total cholesterol levels, and lifestyle patterns in patients with hypercholesterolemia and analyze the differences according to the center of recruitment. STUDY SETTING:Forty-six community pharmacies and 50...
journal_title：Health services research
pub_type： 杂志文章,随机对照试验
doi：10.1111/1475-6773.13152
更新日期：2019-06-01 00:00:00
abstract：:Over a two-year interval, computerized tomography (CT) scans at an urban, 400-bed Department of Veterans Affairs medical center (VAMC) were obtained in three ways. First, an in-house low-efficiency machine was used. Then, scans were done at another area hospital, in effect duplicating some aspects of regionalizing ser...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：BACKGROUND:Many states have passed legislation mandating that health plans provide direct access to obstetricians/gynecologists (hereinafter "ob/gyns") for women, limiting the ability of plans to require referrals or otherwise restrict access. One benefit of these laws may be improved preventive screening rates, but no...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00646.x
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:This study is designed to assess the cost of services provided to Medicare beneficiaries by nurse practitioners (NPs) billing under their own National Provider Identification number as compared to primary care physicians (PCMDs). DATA SOURCE:Medicare Part A (inpatient) and Part B (office visit) claims for 20...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12425
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVES:To compare different methods for defining screening mammograms with Medicare claims and their impact on estimates of breast cancer screening rates. METHODS:Medicare outpatient facility and physician claims for 61,962 women in 1993 and 59,652 women in 1998 were reviewed for evidence of receipt of screening m...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.10912
更新日期：2002-12-01 00:00:00
abstract：OBJECTIVE:To assess the impact of out-migration of nurses on the health systems in sub-Saharan Africa (SSA). SETTING:The countries of SSA. DESIGN AND METHODS:Review of secondary sources: existing publications and country documents on the health workforce; documents prepared for the Joint Learning Initiative Global Hu...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00712.x
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To assess costs, effectiveness, and cost-effectiveness of inhaled corticosteroids (ICS) augmenting bronchodilator treatment for chronic obstructive pulmonary disease (COPD). DATA SOURCES:Claims between 1997 and 2005 from a large managed care database. STUDY DESIGN:Individual-level, fixed-effects regression ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00879.x
更新日期：2008-12-01 00:00:00
abstract：OBJECTIVE:To determine if members of commercial managed care and Medicaid managed care rate the experience with their health plans differently. DATA SOURCES:Data from both commercial and Medicaid Consumer Assessment of Health Plan Surveys (CAHPS) in New York State. STUDY DESIGN:Regression models were used to determin...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00166
更新日期：2003-08-01 00:00:00
abstract：OBJECTIVE:To examine whether physicians attend to gender prevalence data in diagnostic decision making for coronary heart disease (CHD) and to test the hypothesis that previously reported gender differences in CHD diagnostic certainty are due to discrimination arising from reliance on prevalence data ("statistical disc...
journal_title：Health services research
pub_type： 评论,杂志文章
doi：10.1111/j.1475-6773.2009.01022.x
更新日期：2009-12-01 00:00:00
abstract：:In late 1982, as an alternative to Medicaid, Arizona implemented a prepaid, competitively bid medical care program--the Arizona Health Care Cost Containment System (AHCCCS). Before its introduction, the poor had been cared for primarily by a network of county-supported centers. Impact of the AHCCCS initiative was exam...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1985-08-01 00:00:00
