Abstract：
OBJECTIVE:To compare medical care costs and utilization in a consumer-driven health plan (CDHP) to other health insurance plans. STUDY DESIGN:We examine claims and employee demographic data from one large employer that adopted a CDHP in 2001. A quasi-experimental pre-post design is used to assign employees to three cohorts: (1) enrolled in a health maintenance organization (HMO) from 2000 to 2002, (2) enrolled in a preferred provider organization (PPO) from 2000 to 2002, or (3) enrolled in a CDHP in 2001 and 2002, after previously enrolling in either an HMO or PPO in 2000. Using this approach we estimate a difference-in-difference regression model for expenditure and utilization measures to identify the impact of CDHP. PRINCIPAL FINDINGS:By 2002, the CDHP cohort experienced lower total expenditures than the PPO cohort but higher expenditures than the HMO cohort. Physician visits and pharmaceutical use and costs were lower in the CDHP cohort compared to the other groups. Hospital costs and admission rates for CDHP enrollees, as well as total physician expenditures, were significantly higher than for enrollees in the HMO and PPO plans. CONCLUSIONS:An early evaluation of CDHP expenditures and utilization reveals that the new health plan is a viable alternative to existing health plan designs. Enrollees in the CDHP have lower total expenditures than PPO enrollees, but higher utilization of resource-intensive hospital admissions after an initially favorable selection.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Parente ST,Feldman R,Christianson JBdoi
10.1111/j.1475-6773.2004.00282.xkeywords:
subject
Has Abstractpub_date
2004-08-01 00:00:00pages
1189-210issue
4 Pt 2eissn
0017-9124issn
1475-6773pii
HESR282journal_volume
39pub_type
杂志文章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 STUDY DESIGN:Review of published articles and unpublished data on the use of geocoding and surname analyses.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: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 assess the effectiveness and cost-effectiveness of four treatment modalities for substance abuse. DATA SOURCES:The study used data from the Services Research Outcomes Study (SROS), a survey of 3,047 clients in a random sample of 99 drug treatment facilities across the United States. Detailed sociodemograp...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00114
更新日期：2003-02-01 00:00:00
abstract：OBJECTIVE:To quantify between-unit variability in mean length of stay (LoS) between intensive care units (ICUs) after adjusting for differences in case mix using a method that does not require arbitrary trimming of data. SETTING:An analysis of registry data from pediatric ICUs (PICUs) in Australia and New Zealand. ST...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01421.x
更新日期：2012-12-01 00:00:00
abstract：OBJECTIVE:To assess the impact of Enroll America's field outreach activities on the number of individuals enrolled in Marketplace coverage during the first open enrollment period. DATA SOURCES/STUDY SETTING:Marketplace enrollment for the initial open enrollment period linked with data on Enroll America's field activit...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12630
更新日期：2018-02-01 00:00:00
abstract：OBJECTIVE:To assess the impact of hospital affiliation, centralization, and managed care plan ownership on inpatient cost and quality. DATA SOURCES:Inpatient discharges from 3,957 community hospitals in 44 states and American Hospital Association Annual Survey data from 2010 to 2012. STUDY DESIGN:We conducted a retro...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12631
更新日期：2018-02-01 00:00:00
abstract：:A decision to add a new treatment program has widespread and long-lasting implications for both the patient and the organization. Information about the interactions among the institution, the patient, and the treatment modality are seldom available. Cognitive rehabilitation is a relatively new treatment modality that ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：:The strategic behaviors of small multihospital systems have received little attention in the literature despite the fact that small systems are the predominant scale among multihospital systems. This study examines one important aspect of small-system strategic behaviors: the birth-order or evolutionary patterns of ho...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1990-06-01 00:00:00
abstract：OBJECTIVE:We evaluate the effects of the Nursing Home Quality Initiative (NHQI), which introduced quality measures to the Centers for Medicare and Medicaid Services' Nursing Home Compare website, on facility performance and consumer demand for services. DATA SOURCES:The nursing home Minimum Data Set facility reports f...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01298.x
更新日期：2011-12-01 00:00:00
abstract：OBJECTIVE:To evaluate the comparative safety of laparoscopic and open colectomy across surgeons varying in experience with laparoscopy. DATA SOURCES:National Medicare data (2008-2010) for beneficiaries undergoing laparoscopic or open colectomy. STUDY DESIGN:Using instrumental variable methods to address selection bia...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12482
更新日期：2017-02-01 00:00:00
abstract：OBJECTIVE:To examine the effects of varying diagnostic and pharmaceutical criteria on the performance of claims-based algorithms for identifying beneficiaries with hypertension, heart failure, chronic lung disease, arthritis, glaucoma, and diabetes. STUDY SETTING:Secondary 1999-2000 data from two Medicare+Choice healt...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00321.x
更新日期：2004-12-01 00:00:00
abstract：OBJECTIVE:To identify patient characteristics and health care experiences associated with primary care linkage after alcohol or drug detoxification. DATA SOURCES/STUDY SETTING:Primary data collected over two years. Subjects were adults without primary medical care, in an urban residential detoxification program. STUD...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00246.x
更新日期：2004-06-01 00:00:00
abstract：OBJECTIVES:To determine how frequently patients revisit the emergency department after an initial encounter, and to describe revisit capture rates for the same hospital, health system, and geographic region. DATA SOURCES/STUDY SETTING:Florida state data from January 1, 2010, to June 30, 2011, from the Healthcare Cost ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12658
更新日期：2018-04-01 00:00:00
abstract：OBJECTIVES:To examine which components of medical homes affect time families spend arranging/coordinating health care for their children with special health care needs (CSHCNs) and providing health care at home. DATA SOURCES:2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12215
更新日期：2015-04-01 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 determine whether difficulty walking and the strategies persons use to compensate for this deficit influenced downstream Medicare expenditures. DATA SOURCE:Secondary data analysis of Medicare claims data (1999-2000) for age-eligible Medicare beneficiaries (N=4,997) responding to the community portion of t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00509.x
更新日期：2006-06-01 00:00:00
abstract：BACKGROUND:During welfare reform, Congress passed legislation barring legal immigrants who entered the United States after August 1996 from Medicaid for five years after immigration. This legislation intended to bar only new immigrants (post-1996 immigrants) from Medicaid. However it may have also deterred the enrollme...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00301.x
更新日期：2004-10-01 00:00:00
abstract：OBJECTIVE:To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. DATA SOURCES:The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single sp...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00881.x
更新日期：2008-10-01 00:00:00
abstract：OBJECTIVE:This paper analyzes whether the rise in managed care during the 1990s caused the increase in hospital concentration. DATA SOURCES:We assemble data from the American Hospital Association, InterStudy and government censuses from 1990 to 2000. STUDY DESIGN:We employ linear regression analyses on long differenc...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00601.x
更新日期：2007-02-01 00:00:00
abstract：OBJECTIVE:To understand patient loyalty to providers over time, informing effective population health management. STUDY SETTING:Patient care-seeking patterns over a 6-year timeframe in Minnesota, where care systems have a significant portion of their revenue generated by shared-saving contracts with public and private...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12147
更新日期：2014-06-01 00:00:00
abstract：OBJECTIVE:To evaluate episode-based payments for upper respiratory tract infections (URI) and perinatal care in Arkansas's Medicaid population. STUDY SETTING:Upper respiratory infection and perinatal episodes among Medicaid-covered individuals in Arkansas and comparison states from fiscal year (FY) 2011 to 2014. STUD...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13296
更新日期：2020-08-01 00:00:00
abstract：:Uniform hospital discharge abstract data from Maryland were used to examine the homogeneity of trauma-related DRGs with respect to a well-established measure of injury severity, the Injury Severity Score (ISS). Thirty DRGs were identified as including trauma cases with a wide range of severity; for each of these DRGs,...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-04-01 00:00:00
abstract：OBJECTIVE:To demonstrate how a researcher can investigate the appropriateness of a published comorbidity summary measure for use with a given sample. DATA SOURCE:Surveillance, Epidemiology, and End Results linked to Medicare claims data. STUDY DESIGN:We examined Kaplan-Meier estimated survival curves for four disease...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12276
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To examine concordance between member self-reports and the organization's administrative claims data for two key health factors: number of chronic conditions, and number of prescription drugs. DATA:Medicare Advantage plan claims data and member survey data from 2011 to 2012. DESIGN:Mailed surveys to 15,000 ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12356
更新日期：2016-06-01 00:00:00
abstract：:In this paper I propose a methodology for paying short-term general hospitals on the basis of prospective cost-based case-mix revenue budgets. A hospital's budget is divided into patient care--related components and other components. The patient care--related budget is based on the case mix of patients treated by the ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1980-07-01 00:00:00
abstract：:Mr. Zamberlan is one of seven major executives in the Department of Veterans Affairs (VA) Veterans Health Services and Research Administration (VHS&RA), directing health care in a five-state region that includes 21 medical centers, 7 outpatient clinics, and 19 veterans outreach centers. As a medical center director in...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：OBJECTIVES:The Patient Activation Measure (PAM) quantifies the extent to which people are informed about and involved in their health care. Objectives were to determine the psychometric properties of PAM among multimorbid older adults and evaluate a theoretical, four-stage model of patient activation. Methods. A cross-...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01210.x
更新日期：2011-04-01 00:00:00
abstract：RESEARCH OBJECTIVE:To assess the impact of recent Medicare prospective payment system (PPS) changes on efficiency in skilled nursing homes. DATA SOURCE/STUDY SETTING:Medicare Cost Reports (MCR), On-line Survey Certification and Reporting System (OSCAR), Area Resource Files (ARF), a Centers for Medicare and Medicaid Se...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00798.x
更新日期：2008-06-01 00:00:00
abstract：OBJECTIVE:To assess whether participation in a state publicly financed health insurance program, Massachusetts Children's Medical Security Plan (CMSP) , which is open to children regardless of income, was associated with disenrollment from private insurance. DATA SOURCES/STUDY DESIGN:A survey of participants in CMSP w...
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 examine the service experiences and outcomes of low-income Medicaid beneficiaries with disabilities under two different models for organizing home-based personal assistance services: agency-directed and consumer-directed. DATA SOURCE:A survey of a random sample of 1,095 clients, age 18 and over, who recei...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2000-04-01 00:00:00
