Abstract:
BACKGROUND:The Resource-Based Relative Value Scale Update Committee (RUC) submits recommended reimbursement values for physician work (wRVUs) under Medicare Part B. The RUC includes rotating representatives from medical specialties. OBJECTIVE:To identify changes in physician reimbursements associated with RUC rotating seat representation. DATA SOURCES:Relative Value Scale Update Committee members 1994-2013; Medicare Part B Relative Value Scale 1994-2013; Physician/Supplier Procedure Summary Master File 2007; Part B National Summary Data File 2000-2011. STUDY DESIGN:I match service and procedure codes to specialties using 2007 Medicare billing data. Subsequently, I model wRVUs as a function of RUC rotating committee representation and level of code specialization. PRINCIPAL FINDINGS:An annual RUC rotating seat membership is associated with a statistically significant 3-5 percent increase in Medicare expenditures for codes billed to that specialty. For codes that are performed by a small number of physicians, the association between reimbursement and rotating subspecialty representation is positive, 0.177 (SE = 0.024). For codes that are performed by a large number of physicians, the association is negative, -0.183 (SE = 0.026). CONCLUSIONS:Rotating representation on the RUC is correlated with overall reimbursement rates. The resulting differential changes may exacerbate existing reimbursement discrepancies between generalist and specialist practitioners.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Gao YNdoi
10.1111/1475-6773.12857subject
Has Abstractpub_date
2018-12-01 00:00:00pages
4353-4370issue
6eissn
0017-9124issn
1475-6773journal_volume
53pub_type
杂志文章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
pub_type: 杂志文章
doi:10.1111/1475-6773.12178
更新日期:2014-10-01 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 provide guidance on improving the quality of case studies in health services research. DATA SOURCES:Secondary data, drawing from previous case study research. RESEARCH DESIGN:Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (fou...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1999-12-01 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
abstract:OBJECTIVE:As part of a project to estimate physician requirements for the Department of Veterans Affairs, the Institute of Medicine (IOM) developed and tested empirically based models of physician staffing, by specialty, that could be applied to each VA facility. DATA SOURCE/STUDY SETTING:These analyses used selected ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:To study the impact of the number of choices and age on measures of performance in choosing a Medicare prescription drug plan. DATA SOURCE/STUDY SETTING:One hundred ninty-two healthy individuals age 18 and older, half age 65 or older, in Claremont, California. STUDY DESIGN:Participants were randomly assigne...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00981.x
更新日期:2009-08-01 00:00:00
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 co...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00282.x
更新日期:2004-08-01 00:00:00
abstract:RESEARCH OBJECTIVE:This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. STUDY DESIGN:The study uses hospital discharge data of adult (18+) patients in 6 U.S. states for 2009 f...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12401
更新日期:2016-06-01 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: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 summarize the state of the art in quality improvement, review its application to care for children, and define the information that will be needed so that care for children can be further improved. PRINCIPAL FINDINGS:Health services for children exhibit numerous deficiencies in quality of care. The defici...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:To develop and validate a disease-specific automated inpatient mortality risk adjustment system primarily using computerized numerical laboratory data and supplementing them with administrative data. To assess the values of additional manually abstracted data. METHODS:Using 1,271,663 discharges in 2000-2001,...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01126.x
更新日期:2010-12-01 00:00:00
abstract::Does a prepaid group practice relative to comparable fee-for-service plans lead to different mental health outcomes for its beneficiaries? To answer this question, we used data from the RAND Health Insurance Experiment. We observed no statistically significant or clinically meaningful differences in mental health outc...
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:1990-10-01 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::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
abstract:OBJECTIVE:Examination of the extent to which federal surveys provide the data needed to estimate the coverage/cost impacts of policy alternatives to address the problem of uninsurance. DATA SOURCES/STUDY SETTING:Assessment of the major federal household surveys that regularly provide information on health insurance an...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00544.x
更新日期:2006-06-01 00:00:00
abstract::This article reports an evaluation of the impact of three administrative technologies--Admission Scheduling (AS) Systems, Outpatient Surgery (OPS) Programs, and Preadmission Testing (PAT) Programs--on the number of acute care beds required by a hospital. The evaluation mechanism reported here is called the ADTECH Comp...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-04-01 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: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: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 assess the relative impact of clinical factors versus nonclinical factors-such as postacute care (PAC) supply-in determining whether patients receive care from skilled nursing facilities (SNFs) or inpatient rehabilitation facilities (IRFs) after discharge from acute care. DATA SOURCES AND STUDY SETTING:Me...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00365.x
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Racial and ethnic disparities in health and health care have been documented; the elimination of such disparities is currently part of a national agenda. In order to meet this national objective, it is necessary that measures identify accurately the true prevalence of the construct of interest across diverse...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:10.1111/j.1475-6773.2005.00450.x
更新日期:2005-10-01 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:RESEARCH OBJECTIVE:To investigate disenrollment from public insurance at the 6-year transitional birthday when eligibility for many children moves from Medicaid to State Children's Health Insurance Program (S-CHIP). DATA SOURCES:Data from Georgia's S-CHIP (PeachCare) and Medicaid programs from 2000 to 2002. STUDY DES...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00795.x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To illustrate how the analysis of bimodal U-shaped distributed utilization can be modeled with beta-binomial regression, which is rarely used in health services research. DATA SOURCES/STUDY SETTING:Veterans Affairs (VA) administrative data and Medicare claims in 2001-2004 for 11,123 Medicare-eligible VA prim...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12055
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation. DATA SOURCE:We used the Health and Retirement Study (HRS), a national ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00311.x
更新日期:2004-12-01 00:00:00
abstract::Can Medicare beneficiaries make rational and informed decisions about their coverage under the Medicare program? Recent policy developments in the Medicare program have been based on the theory of competition in medical care. One of the key assumptions of the competitive model is the free flow of adequate information,...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:To describe changes in characteristics of directors of outpatient opioid agonist treatment (OAT) programs, and to examine the association between directors' characteristics and low methadone dosage. DATA SOURCE:Repeated cross-sectional surveys of OAT programs in the United States from 1995 to 2011. STUDY DE...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12558
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. DATA SOURCES/STUDY SETTING:Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil sur...
journal_title:Health services research
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1475-6773.2007.00706.x
更新日期:2007-10-01 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