Abstract:
OBJECTIVE:To assess the issue of nonrepresentative sampling in Medicare Advantage (MA) risk adjustment. DATA SOURCES:Medicare enrollment and claims data from 2008 to 2011. DATA EXTRACTION:Risk adjustment predictor variables were created from 2008 to 2010 Part A and B claims and the Medicare Beneficiary Summary File. Spending is based on 2009-2011 Part A and B, Durable Medical Equipment, and Home Health Agency claims files. STUDY DESIGN:A propensity-score matched sample of Traditional Medicare (TM) beneficiaries who resembled MA enrollees was created. Risk adjustment formulas were estimated using multiple techniques, and performance was evaluated based on R2 , predictive ratios, and formula coefficients in the matched sample and a random sample of TM beneficiaries. PRINCIPAL FINDINGS:Matching improved balance on observables, but performance metrics were similar when comparing risk adjustment formula results fit on and evaluated in the matched sample versus fit on the random sample and evaluated in the matched sample. CONCLUSIONS:Fitting MA risk adjustment formulas on a random sample versus a matched sample yields little difference in MA plan payments. This does not rule out potential improvements via the matching method should reliable MA encounter data and additional variables become available for risk adjustment.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Bergquist SL,McGuire TG,Layton TJ,Rose Sdoi
10.1111/1475-6773.13046subject
Has Abstractpub_date
2018-12-01 00:00:00pages
4204-4223issue
6eissn
0017-9124issn
1475-6773journal_volume
53pub_type
杂志文章abstract:OBJECTIVES:To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. DATA SOURCES/STUDY SETTING:County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12680
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To examine financial and nonfinancial access to care and utilization of primary health care services among children of working low-income families earning below 200 percent of the federal poverty level in California, and to compare them to children in nonworking low-income families and in families earning ove...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-06-01 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 examine the predictors of unit and item nonresponse, the magnitude of nonresponse bias, and the need for nonresponse weights in the Consumer Assessment of Health Care Providers and Systems (CAHPS) Hospital Survey. METHODS:A common set of 11 administrative variables (41 degrees of freedom) was used to pred...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00476.x
更新日期:2005-12-01 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 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 examine the feasibility of soliciting outcomes from adults who received chemotherapy treatment for cancer and describe the patterns and correlates of patient-reported toxicities. DATA SOURCES:Patient survey data from 29 Michigan ambulatory oncology practices collected in 2017. STUDY DESIGN:Secondary anal...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13574
更新日期:2020-12-01 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 estimate the effect of a nursing home's share of residents with a serious mental illness (SMI) on the quality of care. DATA SOURCES:Secondary nursing home level data over the period 2000 through 2008 obtained from the Minimum Data Set, OSCAR, and Medicare claims. STUDY DESIGN:We employ an instrumental va...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12023
更新日期:2013-08-01 00:00:00
abstract::In this research, we examine the relative importance of different structural units in a professional organization, the hospital, as they affect organizational effectiveness. The difficulties of measuring effectiveness in a complex professional organization are discussed, and an adjusted measure of surgical outcome is ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1982-01-01 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: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::Despite frequent reference to the Health Belief Model (HBM), few studies address the internal consistency (within questionnaires) or the stability across populations of scales used to measure HBM variables. As part of a 1983 Michigan statewide blood pressure survey, trained interviewers administered 32 health belief q...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1987-02-01 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:Our research compares health care use by Medicaid beneficiaries with that of the uninsured and the privately insured to measure the program's effect on access to care. DATA SOURCES/STUDY SETTING:Data include the 1987 National Medical Expenditure Survey and the Survey of Income and Program Participation for 1...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:To estimate the total hours of paid and unpaid personal assistance of daily living provided to adults living at home in the United States using nationally representative household survey data. DATA SOURCES:The Disability Followback Survey of the National Health Interview Survey on Disability (NHIS-D) conduct...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.029
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. DATA SOURCES:Secondary analysis of 2003-2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly avail...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01206.x
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The extent to which patient experiences with hospital care are related to other measures of hospital quality and safety is unknown. METHODS; We examined the relationship between Hospital Consumer Assessment of Healthcare Providers and Systems scores and technical measures of quality and safety using service-...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01122.x
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To examine the source of observed lower risk-adjusted mortality for blacks than whites within the Veterans Affairs (VA) system by accounting for hospital site where treated, potential under-reporting of black deaths, discretion on hospital admission, quality improvement efforts, and interactions by age group....
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00688.x
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model. DATA SOURCES:Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002. STUDY DESIGN:Di...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00270.x
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVES:To assess the ability of an Adjusted Clinical Group (ACG)-based morbidity measure to assess the overall health service needs of populations. Data Sources/Study Setting. Three population-based secondary data sources: registration and health service utilization data from fiscal year 1995-1996; mortality data f...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.01029
更新日期:2002-10-01 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 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: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...
journal_title:Health services research
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
abstract:OBJECTIVE:To examine whether disparities in health care experiences of Medicare beneficiaries differ between managed care (Medicare Advantage [MA]) and traditional fee-for-service (FFS) Medicare. DATA SOURCES:132,937 MA and 201,444 FFS respondents to the 2007 Medicare Consumer Assessment of Health Care Providers and S...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01245.x
更新日期:2011-08-01 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...
journal_title:Health services research
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::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 test the effects of state prescription contraception insurance mandates on unintended, mistimed, and unwanted births in a sample of privately insured recent mothers. DATA:We pooled Pregnancy Risk Assessment Monitoring System (PRAMS) data from 1997 to 2012 to study 209,964 privately insured recent mothers ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12792
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To determine if sufficient nurse staffing reduced in-hospital fractures in acute care hospitals. DATA SOURCES/STUDY SETTING:The Japanese Diagnosis Procedure Combination inpatient (DPC) database from July 2010 to March 2014 linked with the Surveys for Medical Institutions. STUDY DESIGN:We conducted a retrosp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12529
更新日期:2017-06-01 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