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 Association Group Practice data identifying provider groups sufficiently large to be eligible for ACO program participation. STUDY DESIGN:We calculated the fraction of community-dwelling beneficiaries whose assignment shifted, as a consequence of including post-acute E&M services, from the group providing their outpatient primary care to a different group providing their inpatient post-acute care. PRINCIPAL FINDINGS:Assignment shifts occurred for 27.6 percent of 25,992 community-dwelling beneficiaries with at least one post-acute skilled nursing facility stay, and they were more common for those incurring higher Medicare spending. Those whose assignment shifted constituted only 1.3 percent of all community-dwelling beneficiaries cared for by large ACO-eligible organizations (n = 535,138), but they accounted for 8.4 percent of total Medicare spending for this population. CONCLUSIONS:Under current Medicare assignment rules, ACOs may not be accountable for an influential group of post-acute patients, suggesting missed opportunities to improve care coordination and reduce inappropriate readmissions.
journal_name
Health Serv Resjournal_title
Health services researchauthors
McWilliams JM,Chernew ME,Zaslavsky AM,Landon BEdoi
10.1111/1475-6773.12032subject
Has Abstractpub_date
2013-08-01 00:00:00pages
1526-38issue
4eissn
0017-9124issn
1475-6773journal_volume
48pub_type
杂志文章abstract：OBJECTIVE:To examine whether parental beliefs about routine checkups are associated with children's receipt of timely preventive care. DATA SOURCES:The 2001 United Way Outcomes and Community Impact Program telephone survey of San Diego County, including 918 households with children between 3 and 19 years of age, where...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00759.x
更新日期：2008-02-01 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：OBJECTIVE:To assess the effects of an alternative method of paying home health agencies for services to Medicare beneficiaries, based on a demonstration program. DATA SOURCES/STUDY SETTING:Primary and secondary data collected on participating home health agencies in five states and their patients during the three-year...
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：1997-10-01 00:00:00
abstract：OBJECTIVE:To assess the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. STUDY SETTING:A total of 219 small primary care p...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13571
更新日期：2020-12-01 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：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
abstract：OBJECTIVE:To develop a scale to measure patients' trust in health insurers, including public and private insurers and both indemnity and managed care. A scale was developed based on our conceptual model of insurer trust. The scale was analyzed for its factor structure, internal consistency, construct validity, and othe...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2002-02-01 00:00:00
abstract：OBJECTIVE:To compare response rate and nonresponse bias across two mixed-mode survey designs and two single-mode designs. DATA SOURCES:This experiment was embedded in a clinician survey of knowledge and attitudes regarding HPV vaccination (n = 275). STUDY DESIGN:Clinicians were randomly assigned one of two mixed-mode...
journal_title：Health services research
pub_type： 杂志文章,随机对照试验
doi：10.1111/1475-6773.12827
更新日期：2018-08-01 00:00:00
abstract：OBJECTIVE:To examine the impact of pay for performance in Medicaid on the quality and utilization of care. DATA SOURCES:Medicaid claims and encounter data in three intervention states (Pennsylvania, Minnesota, and Alabama) and three comparison states. STUDY DESIGN:Difference-in-difference analysis with propensity sco...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12426
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:To determine the extent to which the elimination of behavioral health benefits for selected beneficiaries of Oregon's Medicaid program affected general medical expenditures among enrollees using outpatient mental health and substance abuse treatment services. DATA SOURCE/STUDY SETTING:Twelve months of claims...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00844.x
更新日期：2008-08-01 00:00:00
abstract：OBJECTIVE:To evaluate the role of health plan benefit design and price on consumers' decisions to purchase health insurance in the nongroup market and their choice of plan. DATA SOURCES AND STUDY SETTING:Administrative data from the three largest nongroup insurers in California and survey data about those insured in t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00726.x
更新日期：2007-12-01 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：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：OBJECTIVES:In response to rising demand and increased costs for home care services for frail elderly and disabled Medicaid clients, New York City implemented cluster care, a shared-aide model of home care. Our objective: to evaluate the effects of cluster care on home care hours and costs, client functioning, depressiv...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1996-10-01 00:00:00
abstract：OBJECTIVE:To examine the impact of mandatory HMO enrollment for Medicaid-covered pregnant women on prenatal care use, smoking, Cesarean section (C-section) use, and birth weight. DATA SOURCES/STUDY SETTING:Linked birth certificate and Medicaid enrollment data from July 1993 to June 1998 in 10 Ohio counties, 6 that imp...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00260.x
更新日期：2004-08-01 00:00:00
abstract：OBJECTIVE:To examine differences between the general medical and mental health specialty sectors in the expenditure and treatment patterns of aged and disabled Medicare beneficiaries with a physician diagnosis of psychiatric disorder. DATA SOURCES:Based on 1991-1993 Medicare Current Beneficiary Survey data, linked to ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-08-01 00:00:00
abstract：OBJECTIVE:To efficiently estimate race/ethnicity using administrative records to facilitate health care organizations' efforts to address disparities when self-reported race/ethnicity data are unavailable. DATA SOURCE:Surname, geocoded residential address, and self-reported race/ethnicity from 1,973,362 enrollees of a...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00854.x
更新日期：2008-10-01 00:00:00
abstract：OBJECTIVE:To examine whether nurse practitioner (NP)-assigned patients exhibited differences in utilization, costs, and clinical outcomes compared to medical doctor (MD)-assigned patients. DATA SOURCES:Veterans Affairs (VA) administrative data capturing characteristics, outcomes, and provider assignments of 806 434 VA...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13246
更新日期：2020-04-01 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: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 simplify the decision-making process, we propose and implement an approach to assess the stability of health plan performance over time when multiple indicators of performance exist. DATA SOURCE:National Committee for Quality Assurance Health Care Effectiveness Data and Information Set data for childhood ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00890.x
更新日期：2008-12-01 00:00:00
abstract：OBJECTIVE:Patients discharged from a self-managed nursing unit are compared with patients from traditionally managed units on postdischarge outcomes. DATA SOURCES AND STUDY SETTING:Primary data were collected on patients discharged from eight nursing units in three clinical areas in one hospital from August through No...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-10-01 00:00:00
abstract：OBJECTIVE:This study explores the impact of multiple-site practices on the distribution of physician services within a medical service region. DATA SOURCES AND STUDY SETTING:A questionnaire was mailed to all urologists (100 percent response rate) practicing in north central Connecticut (the Hartford medical service ar...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1993-10-01 00:00:00
abstract：OBJECTIVE:To test how Certificate of Need laws affect all-cause mortality in the United States. DATA SOURCES:The data of 1992-2011 all-cause mortality are from the Center for Disease Control's Compressed Mortality File; control variables are from the Current Population Survey, Behavioral Risk Factor Surveillance Syste...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12619
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：BACKGROUND:Patients are treated using observation services (OS) when their care needs exceed standard outpatient care (i.e., clinic or emergency department) but do not qualify for admission. Medicare and other private payers seek to limit this care setting to 48 hours. DATA SOURCE/STUDY SETTING:Healthcare Cost and Uti...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12143
更新日期：2014-06-01 00:00:00
abstract：OBJECTIVE:To extend recent conceptual and methodological advances in disparities research to include the incorporation of genomic information in analyses of racial/ethnic disparities in health care and health outcomes. DATA SOURCES:Published literature on human genetic variation, the role of genetics in disease and re...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01413.x
更新日期：2012-06-01 00:00:00
abstract：:One method used to determine utilization rates of cervical screening is women's self-report. Few studies have assessed the accuracy of this measure--none has been conducted in Australia--although there are a number of reasons for suspecting its validity. This study examined and quantified the accuracy of self-report o...
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 compare safety climate between diverse U.S. hospitals and Veterans Health Administration (VA) hospitals, and to explore the factors influencing climate in each setting. DATA SOURCES:Primary data from surveys of hospital personnel; secondary data from the American Hospital Association's 2004 Annual Survey ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.00994.x
更新日期：2009-10-01 00:00:00
abstract：OBJECTIVE:To investigate how changes in insurer participation and composition as well as state policies affect health plan affordability for individual market enrollees. DATA SOURCES:2014-2019 Qualified Health Plan Landscape Files augmented with supplementary insurer-level information. STUDY DESIGN:We measured plan a...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13190
更新日期：2019-08-01 00:00:00
