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 2009-2010. STUDY DESIGN:Retrospective cohort design using propensity score weighted regression. DATA EXTRACTION METHODS:Beneficiaries cared for by a random sample of NPs and primary care physicians. PRINCIPAL FINDINGS:After adjusting for demographic characteristics, geography, comorbidities, and the propensity to see an NP, Medicare evaluation and management payments for beneficiaries assigned to an NP were $207, or 29 percent, less than PCMD assigned beneficiaries. The same pattern was observed for inpatient and total office visit paid amounts, with 11 and 18 percent less for NP assigned beneficiaries, respectively. Results are similar for the work component of relative value units as well. CONCLUSIONS:This study provides new evidence of the lower cost of care for beneficiaries managed by NPs, as compared to those managed by PCMDs across inpatient and office-based settings. Results suggest that increasing access to NP primary care will not increase costs for the Medicare program and may be cost saving.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Perloff J,DesRoches CM,Buerhaus Pdoi
10.1111/1475-6773.12425subject
Has Abstractpub_date
2016-08-01 00:00:00pages
1407-23issue
4eissn
0017-9124issn
1475-6773journal_volume
51pub_type
杂志文章abstract:OBJECTIVES:Methodologically sound mixed methods research can improve our understanding of health services by providing a more comprehensive picture of health services than either method can alone. This study describes the frequency of mixed methods in published health services research and compares the presence of meth...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01344.x
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To examine the effect of worker heterogeneity, firm size, and establishment size on the breadth of employer health insurance offerings. DATA SOURCES:The data were drawn from the 1993 Robert Wood Johnson Foundation Employer Health Insurance Survey of 22,000 business establishments selected randomly from ten s...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00
abstract::This article examines factors related to hospital closures, using a longitudinal sample of surviving and closed hospitals. The hospitals are drawn from three states with different regulatory programs. Size of hospital and occupancy rate are shown to be related to likelihood of closure, while ownership, length of stay,...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1983-01-01 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 examine how plan premiums are associated with physician network breadth, hospital network breadth, and hospital network quality on the Affordable Care Act's Health Insurance Marketplaces in all 50 states and the DC in 2016. DATA SOURCES:Data on plan premiums and characteristics came from 2016 Robert Wood ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13447
更新日期:2020-08-13 00:00:00
abstract:OBJECTIVE:To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa. DATA SOURCES:Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004-2007(n = 890). STUDY DE...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01321.x
更新日期:2012-04-01 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:BACKGROUND:In 2004, the State of Wisconsin introduced a change to their Medicaid Policy allowing medical care providers to be reimbursed for fluoride varnish treatment provided to Medicaid enrolled children. OBJECTIVE:To determine the extent by which a state-level policy change impacted access to fluoride varnish trea...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00975.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To describe the insurance status of workers at small businesses, and to describe the status of uninsured persons by the employment characteristics (employment status, firm size, and whether the employer offers insurance) of the head of household. DATA SOURCES:Data from the March and February 2001 Current Pop...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00467.x
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of a locally adapted evidence-based quality improvement (EBQI) approach to implementation of smoking cessation guidelines into routine practice. DATA SOURCES/STUDY SETTING:We used patient questionnaires, practice surveys, and administrative data in Veterans Health Administration (VA) p...
journal_title:Health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1475-6773.2008.00865.x
更新日期:2008-10-01 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:PURPOSE:We report the validation of an instrument to measure mistrust of health care organizations and examine the relationship between mistrust and health care service underutilization. METHODS:We conducted a telephone survey of a random sample of households in Baltimore City, MD. We surveyed 401 persons and followed...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.01017.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:We evaluate the impact of membership in a staff-model health maintenance organization (HMO) on hospital admission rates for patients presenting to an emergency department with acute chest pain. DATA SOURCES AND STUDY SETTING:Primary prospective data were gathered from all 3,006 patients presenting with a chi...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:To estimate the effects of competition for both Medicare and HMO patients on the quality decisions of hospitals in Southern California. DATA SOURCE:Secondary discharge data from the Office of Statewide Health Planning and Development for the State of California for the period 1989-1993. STUDY DESIGN:Outcome...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2003.00185.x
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To determine how the addition of generalist care managers and collaborative information technology to an ambulatory team affects the care of patients with diabetes. STUDY SETTING:Multiple ambulatory clinics within Intermountain Health Care (IHC), a large integrated delivery network. STUDY DESIGN:A retrospec...
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00423.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:This study examines whether parents' reports and ratings of pediatric health care vary by race/ethnicity and language in Medicaid managed care. DATA SOURCES:The data analyzed are from the National Consumer Assessment of Health Plans (CAHPS) Benchmarking Database 1.0 and consist of 9,540 children enrolled in ...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:
更新日期:2001-07-01 00:00:00
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: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 O...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00132
更新日期:2003-04-01 00:00:00
abstract::The concept of validity as it applies to measures of health and health status is examined in the context of a set of standard, widely accepted definitions of validity. Criterion validity is shown to be irrelevant to health status measures because of the lack of a single specific, directly observable measure of health ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:To analyze hospitalization patterns of persons with AIDS (PWAs) in a multi-state/multi-episode continuous time duration framework. DATA SOURCES:PWAs on Medicaid identified through a match between the state's AIDS Registry and Medicaid eligibility files; hospital admission and discharge dates identified throu...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1999-02-01 00:00:00
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doi:10.1111/1475-6773.13023
更新日期:2018-12-01 00:00:00
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doi:10.1111/1475-6773.13570
更新日期:2020-12-01 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...
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doi:10.1111/1475-6773.00114
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To compare utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. DATA SOURCES:A nationally representative sample of adults from the Medical Expenditure Panel Survey (2004-2008). STUDY DESIGN:HC patients were defined as those wit...
journal_title:Health services research
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doi:10.1111/1475-6773.12178
更新日期:2014-10-01 00:00:00
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 the determinants of postsurgery length of stay (LOS) and inpatient mortality in the United States (California and Massachusetts) and Canada (Manitoba and Quebec). DATA SOURCES/STUDY SETTING:Patient discharge abstracts from the Agency for Health Care Policy and Research Nationwide Inpatient Sample ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:We estimate long-term health care costs of former smokers compared with continuing and never smokers using a retrospective cohort study of HMO enrollees. Previous research on health care costs associated with former smokers has suggested that quitters may incur greater health care costs than continuing smoker...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00142
更新日期:2003-04-01 00:00:00
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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 investigate the role of smoking cessation in body weight. DATA SOURCES:2004-2005 and 2009-2010 Behavioral Risk Factor Surveillance Surveys (BRFSS) (N = 349,000), Centers for Disease Control and Prevention; Tax Burden on Tobacco (Orzechowski and Walker 2010). STUDY DESIGN:The Gaussian treatment effect mod...
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01380.x
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To determine whether Medicaid managed care is associated with lower hospitalization rates for ambulatory care sensitive conditions than Medicaid fee-for-service. We also explored whether there was a differential effect of Medicaid managed care by patient's race or ethnicity on the hospitalization rates for am...
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00340.x
更新日期:2005-02-01 00:00:00