Medicare and Medicaid

Medicare and Medicaid are federally sponsored programs designed to provide health care for the elderly, disabled, and poor in the United States. RAND has examined various aspects of the implementation and development of Medicare and Medicaid, including costs, user satisfaction, and quality of service; explored the relationship between the two programs and health care reform efforts; and investigated the services provided to Medicare and Medicaid recipients.

Research conducted by: RAND Health; RAND Labor and Population

Featured at RAND

Policy Options for Addressing Medicare Payment Differentials Across Ambulatory Settings

Medicare's payment for physician work and malpractice liability expenses is the same regardless of where a service is provided, but payments differ for facility-related components of care.

All Items (127)

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BLOG

Attempts by States to Save Money by Locking Medicaid Enrollees out of the ED Are Likely to Backfire — May 21, 2012

A better solution than restricting emergency department use by Medicaid enrollees is to reverse what for many years has been a trend of shrinking access to primary care for Medicaid beneficiaries.

COMMENTARY

Emergency Departments, Medicaid Costs, and Access to Primary Care—Understanding the Link — May 16, 2012

The fact that many ED (emergency department) visits could be managed in primary care settings does not mean that such care is available, write Arthur L. Kellermann and Robin M. Weinick.

Commentary

REPORT

Allowances for Spinal Hardware under California’s Official Medical Fee Schedule: Issues and Options — May 9, 2012

Testimony presented before the California State Senate Labor and Industrial Relations Committee on May 9, 2012.

Testimony

REPORT

Planning for an Aging Nation: New Estimates to Inform Policy Analysis for Senior Health — Apr 12, 2012

Provides insights into the costs and challenges of providing health care to the elderly population.

JOURNAL ARTICLE

Concurrent Mental Health Therapy Among Medicaid-enrolled Youth Starting Antipsychotic Medications — Apr 1, 2012

The authors of this study examined the extent to which youths being prescribed antipsychotic medications were receiving concurrent mental health therapy.

JOURNAL ARTICLE

Use of Anesthesia Providers During Gastroenterology Procedures Has Increased Rapidly, but May Be Unneeded — Mar 20, 2012

The use of dedicated anesthesia providers for routine gastroenterology (GI) procedures is seen as medically justifiable only for high-risk patients. Eliminating these services for low-risk patients could generate $1.1 billion in savings per year.

JOURNAL ARTICLE

Are There Differences in the Medicare Experiences of Beneficiaries in Puerto Rico Compared with Those in the U.S. Mainland? — Mar 1, 2012

The authors compare the experiences of elderly Medicare beneficiaries in Puerto Rico with their English-preferring and Spanish-preferring Medicare counterparts in the U.S. mainland.

JOURNAL ARTICLE

Financial Burden of Prescription Drugs Is Dropping, but Costs Remain a Challenge for Many Families — Feb 8, 2012

The financial burden Americans face paying out-of-pocket costs for prescription drugs has declined, although prescription costs remain a significant challenge for people with lower incomes and those with public insurance.

JOURNAL ARTICLE

Sources of Regional Variation in Medicare Part D Drug Spending — Feb 1, 2012

Regional variation in Medicare Part D spending for prescription drugs results largely from differences in the cost of drugs selected rather than prescription volume.

JOURNAL ARTICLE

Multiple Patient Safety Events Within a Single Hospitalization: A National Profile in US Hospitals — Jan 1, 2012

Examines co-occurrence of iatrogenic events in US hospitals. Using Agency for Healthcare Research and Quality patient safety indicators (PSIs), the authors defined multiple patient safety events (MPSEs) as the occurrence of multiple PSIs during a single hospitalization.

JOURNAL ARTICLE

Today's 'Meaningful Use' Standard for Medication Orders by Hospitals May Save Few Lives; Later Stages May Do More — Sep 30, 2011

Current federal standards for hospital "meaningful use" of health information technology--which requires electronic medication orders for 30 percent of eligible patients--are probably too low to reduce deaths from heart failure and heart attack among hospitalized Medicare beneficiaries.

JOURNAL ARTICLE

How Do the Experiences of Medicare Beneficiary Subgroups Differ Between Managed Care and Original Medicare? — Jul 31, 2011

Quality improvement in Medicare managed care plans should target care for particular subgroups such as beneficiaries who have low incomes, are less healthy, older, female, and who did not complete high school.

REPORT

Collecting on Low-Value Claims Would Provide Medicare with Little Revenue and Substantial Reporting Costs — Jun 21, 2011

Effective January 1, 2012, Medicare will require insurers and self-insured companies to report settlements, awards, and judgments over $5K that involve a Medicare beneficiary. Over three years the $5K threshold will be phased out and all claims will have to be reported—but the potential revenue recovered from low-value claims may not be worth the reporting costs.

JOURNAL ARTICLE

Differential Item Functioning By Survey Language Among Older Hispanics Enrolled in Medicare Managed Care — Apr 30, 2011

Failure to account for language differences in CAHPS survey items may result in misleading conclusions about disparities in health care experiences between Spanish and English speakers.

JOURNAL ARTICLE

The Association Between Care Experiences and Parent Ratings of Care for Different Racial, Ethnic, and Language Groups in a Medicaid Population — Feb 23, 2011

Communication-based interventions may improve experiences and ratings of care for all subgroups, although implementation of these interventions may need to consider preferences associated with race, ethnicity, and language.

JOURNAL ARTICLE

Effect of Usual Source of Care on Depression Among Medicare Beneficiaries: An Application of a Simultaneous-Equations Model — Feb 8, 2011

Having a usual source of care was associated with lower depression prevalence and higher realized access among community-dwelling Medicare beneficiaries.

JOURNAL ARTICLE

Cost-Effectiveness Analysis of a Low-Fat Diet in the Prevention of Breast and Ovarian Cancer — Dec 31, 2010

A low fat diet may be a cost-effective strategy for preventing breast and ovarian cancers.

JOURNAL ARTICLE

Geographic Variation in Physicians' Responses to a Reimbursement Change — Dec 31, 2010

Although there has been considerable discussion of how the changes that the ACA makes in Medicare reimbursement might affect Medicare spending, on average, there has been little to no explicit recognition that the effects may vary geographically.

JOURNAL ARTICLE

Understanding Variations in Medicare Consumer Assessment of Health Care Providers and Systems Scores: California as an Example — Dec 31, 2010

The mix of fee-for-service and Medicare Advantage enrollees, demographic characteristics of populations, and plan-specific factors can all play a role in observed regional variations in CAHPS scores between California and the nation.

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Medicare and Medicaid

Contents:

Featured at RAND

Policy Options for Addressing Medicare Payment Differentials Across Ambulatory Settings

All Items (127)

Attempts by States to Save Money by Locking Medicaid Enrollees out of the ED Are Likely to Backfire — May 21, 2012

Emergency Departments, Medicaid Costs, and Access to Primary Care—Understanding the Link — May 16, 2012

Allowances for Spinal Hardware under California’s Official Medical Fee Schedule: Issues and Options — May 9, 2012

Planning for an Aging Nation: New Estimates to Inform Policy Analysis for Senior Health — Apr 12, 2012

Concurrent Mental Health Therapy Among Medicaid-enrolled Youth Starting Antipsychotic Medications — Apr 1, 2012

Use of Anesthesia Providers During Gastroenterology Procedures Has Increased Rapidly, but May Be Unneeded — Mar 20, 2012

Are There Differences in the Medicare Experiences of Beneficiaries in Puerto Rico Compared with Those in the U.S. Mainland? — Mar 1, 2012

Financial Burden of Prescription Drugs Is Dropping, but Costs Remain a Challenge for Many Families — Feb 8, 2012

Sources of Regional Variation in Medicare Part D Drug Spending — Feb 1, 2012

Multiple Patient Safety Events Within a Single Hospitalization: A National Profile in US Hospitals — Jan 1, 2012

Today's 'Meaningful Use' Standard for Medication Orders by Hospitals May Save Few Lives; Later Stages May Do More — Sep 30, 2011

How Do the Experiences of Medicare Beneficiary Subgroups Differ Between Managed Care and Original Medicare? — Jul 31, 2011

Collecting on Low-Value Claims Would Provide Medicare with Little Revenue and Substantial Reporting Costs — Jun 21, 2011

Differential Item Functioning By Survey Language Among Older Hispanics Enrolled in Medicare Managed Care — Apr 30, 2011

The Association Between Care Experiences and Parent Ratings of Care for Different Racial, Ethnic, and Language Groups in a Medicaid Population — Feb 23, 2011

Effect of Usual Source of Care on Depression Among Medicare Beneficiaries: An Application of a Simultaneous-Equations Model — Feb 8, 2011

Cost-Effectiveness Analysis of a Low-Fat Diet in the Prevention of Breast and Ovarian Cancer — Dec 31, 2010

Geographic Variation in Physicians' Responses to a Reimbursement Change — Dec 31, 2010

Understanding Variations in Medicare Consumer Assessment of Health Care Providers and Systems Scores: California as an Example — Dec 31, 2010

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Medicare and Medicaid

Contents:

Featured at RAND

Policy Options for Addressing Medicare Payment Differentials Across Ambulatory Settings

All Items (127)

Attempts by States to Save Money by Locking Medicaid Enrollees out of the ED Are Likely to Backfire — May 21, 2012

Emergency Departments, Medicaid Costs, and Access to Primary Care—Understanding the Link — May 16, 2012

Allowances for Spinal Hardware under California’s Official Medical Fee Schedule: Issues and Options — May 9, 2012

Planning for an Aging Nation: New Estimates to Inform Policy Analysis for Senior Health — Apr 12, 2012

Concurrent Mental Health Therapy Among Medicaid-enrolled Youth Starting Antipsychotic Medications — Apr 1, 2012

Use of Anesthesia Providers During Gastroenterology Procedures Has Increased Rapidly, but May Be Unneeded — Mar 20, 2012

Are There Differences in the Medicare Experiences of Beneficiaries in Puerto Rico Compared with Those in the U.S. Mainland? — Mar 1, 2012

Financial Burden of Prescription Drugs Is Dropping, but Costs Remain a Challenge for Many Families — Feb 8, 2012

Sources of Regional Variation in Medicare Part D Drug Spending — Feb 1, 2012

Multiple Patient Safety Events Within a Single Hospitalization: A National Profile in US Hospitals — Jan 1, 2012

Today's 'Meaningful Use' Standard for Medication Orders by Hospitals May Save Few Lives; Later Stages May Do More — Sep 30, 2011

How Do the Experiences of Medicare Beneficiary Subgroups Differ Between Managed Care and Original Medicare? — Jul 31, 2011

Collecting on Low-Value Claims Would Provide Medicare with Little Revenue and Substantial Reporting Costs — Jun 21, 2011

Differential Item Functioning By Survey Language Among Older Hispanics Enrolled in Medicare Managed Care — Apr 30, 2011

The Association Between Care Experiences and Parent Ratings of Care for Different Racial, Ethnic, and Language Groups in a Medicaid Population — Feb 23, 2011

Effect of Usual Source of Care on Depression Among Medicare Beneficiaries: An Application of a Simultaneous-Equations Model — Feb 8, 2011

Cost-Effectiveness Analysis of a Low-Fat Diet in the Prevention of Breast and Ovarian Cancer — Dec 31, 2010

Geographic Variation in Physicians' Responses to a Reimbursement Change — Dec 31, 2010

Understanding Variations in Medicare Consumer Assessment of Health Care Providers and Systems Scores: California as an Example — Dec 31, 2010

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