RAND Research Topic: Medicare and Medicaid 2012-05-24T14:16:51Z Copyright (c) 2012, The RAND Corporation RAND Corporation http://www.rand.org/topics/medicare-and-medicaid.html Policy Options for Addressing Medicare Payment Differentials Across Ambulatory Settings http://www.rand.org/pubs/technical_reports/TR979.html Oct 12, 2011 Oct 12, 2011 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. Attempts by States to Save Money by Locking Medicaid Enrollees out of the ED Are Likely to Backfire http://www.rand.org/blog/2012/05/attempts-by-states-to-save-money-by-locking-medicaid.html May 21, 2012 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. Emergency Departments, Medicaid Costs, and Access to Primary Care&mdash;Understanding the Link http://www.rand.org/commentary/2012/05/16/NEJM.html May 16, 2012 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. Allowances for Spinal Hardware under California&rsquo;s Official Medical Fee Schedule: Issues and Options http://www.rand.org/pubs/testimonies/CT375.html May 9, 2012 May 9, 2012 Testimony presented before the California State Senate Labor and Industrial Relations Committee on May 9, 2012. Planning for an Aging Nation: New Estimates to Inform Policy Analysis for Senior Health http://www.rand.org/pubs/rgs_dissertations/RGSD293.html Apr 12, 2012 Apr 12, 2012 Provides insights into the costs and challenges of providing health care to the elderly population. Concurrent Mental Health Therapy Among Medicaid-enrolled Youth Starting Antipsychotic Medications http://www.rand.org/pubs/external_publications/EP20120033.html Apr 1, 2012 Apr 1, 2012 The authors of this study examined the extent to which youths being prescribed antipsychotic medications were receiving concurrent mental health therapy. Use of Anesthesia Providers During Gastroenterology Procedures Has Increased Rapidly, but May Be Unneeded http://www.rand.org/pubs/external_publications/EP20120073.html Mar 20, 2012 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. Are There Differences in the Medicare Experiences of Beneficiaries in Puerto Rico Compared with Those in the U.S. Mainland? http://www.rand.org/pubs/external_publications/EP20120036.html Mar 1, 2012 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. Financial Burden of Prescription Drugs Is Dropping, but Costs Remain a Challenge for Many Families http://www.rand.org/pubs/external_publications/EP20120039.html Feb 8, 2012 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. Sources of Regional Variation in Medicare Part D Drug Spending http://www.rand.org/pubs/external_publications/EP20120031.html Feb 1, 2012 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. Multiple Patient Safety Events Within a Single Hospitalization: A National Profile in US Hospitals http://www.rand.org/pubs/external_publications/EP20120096.html Jan 1, 2012 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. Today's 'Meaningful Use' Standard for Medication Orders by Hospitals May Save Few Lives; Later Stages May Do More http://www.rand.org/pubs/external_publications/EP201100190.html Sep 30, 2011 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. How Do the Experiences of Medicare Beneficiary Subgroups Differ Between Managed Care and Original Medicare? http://www.rand.org/pubs/external_publications/EP20110025.html Jul 31, 2011 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. Collecting on Low-Value Claims Would Provide Medicare with Little Revenue and Substantial Reporting Costs http://www.rand.org/pubs/occasional_papers/OP332.html Jun 21, 2011 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&mdash;but the potential revenue recovered from low-value claims may not be worth the reporting costs. Differential Item Functioning By Survey Language Among Older Hispanics Enrolled in Medicare Managed Care http://www.rand.org/pubs/external_publications/EP20110043.html Apr 30, 2011 Apr 30, 2011 <p>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.</p> The Association Between Care Experiences and Parent Ratings of Care for Different Racial, Ethnic, and Language Groups in a Medicaid Population http://www.rand.org/pubs/external_publications/EP20110018.html Feb 23, 2011 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. Effect of Usual Source of Care on Depression Among Medicare Beneficiaries: An Application of a Simultaneous-Equations Model http://www.rand.org/pubs/external_publications/EP20110031.html Feb 8, 2011 Feb 8, 2011 Having a usual source of care was associated with lower depression prevalence and higher realized access among community-dwelling Medicare beneficiaries. Cost-Effectiveness Analysis of a Low-Fat Diet in the Prevention of Breast and Ovarian Cancer http://www.rand.org/pubs/external_publications/EP20110063.html Dec 31, 2010 Dec 31, 2010 A low fat diet may be a cost-effective strategy for preventing breast and ovarian cancers. Geographic Variation in Physicians' Responses to a Reimbursement Change http://www.rand.org/pubs/external_publications/EP201100240.html Dec 31, 2010 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.