Ateev Mehrotra

Overview

Commentary

• 

  Telehealth Alone Won't Increase Health Care Access for the Underserved

  Telehealth can bring care into communities that have limited access to providers or facilities. But it must be integrated into a well-functioning system that can address the added needs that telehealth generates.

  Dec 16, 2016 Health Affairs Blog

• 

  Quick Takes: The Convenience Revolution in the Treatment of Minor Health Problems

  Convenient options for treating minor health problems are an important new feature of the health care landscape. Ateev Mehrotra discusses these options and their implications for the medical marketplace.

  Nov 26, 2013 The RAND Blog

Publications

• 

  Journal Article

  Virtual First Responders: The Role of Direct-to-Consumer Telemedicine in Caring for People Impacted by Natural Disasters

  Using telemedicine in a disaster can tap a pool of out-of-state providers, thus expanding the response workforce quickly and cost-effectively.

  Jun 4, 2018

• Journal Article

  Journal Article

  Americans Support Price Shopping For Health Care, But Few Actually Seek Out Price Information

  A survey of U.S. nonelderly adults found that only 13 percent who had spent money out of pocket in their last health care encounter sought information about expected spending before receiving care, and just 3 percent had compared costs across providers before receiving care.

  Sep 6, 2017

• Journal Article

  Journal Article

  Offering A Price Transparency Tool Did Not Reduce Overall Spending Among California Public Employees And Retirees

  California public employees and retirees who were offered a price transparency tool did not spend less on a set of "shoppable" health care services than others who were not offered the tool.

  Aug 29, 2017

• Journal Article

  Journal Article

  Trends in Visits to Specialist Physicians Involving Nurse Practitioners and Physician Assistants, 2001 to 2013

  While the number of NPs and PAs involved in the care of patients of specialist physicians has increased, visits involving NPs or PAs remain a small proportion of overall specialty visits.

  Aug 2, 2017

• Journal Article

  Journal Article

  High-Price And Low-Price Physician Practices Do Not Differ Significantly On Care Quality Or Efficiency

  Higher-priced providers do not necessarily provide higher-quality care.

  Jun 6, 2017

• Journal Article

  Journal Article

  Rapid Growth In Mental Health Telemedicine Use Among Rural Medicare Beneficiaries, Wide Variation Across States

  The use of mental health telemedicine among rural Medicare patients varies dramatically across states and is highly concentrated both in terms of who receives and who provides this care.

  Jun 6, 2017

• Journal Article

  Journal Article

  The Emergence and Promise of Telelactation

  Telehealth services to support lactation may hold particular promise, but additional research is needed to determine whether the benefits outweigh potential challenges.

  Jun 2, 2017

• Journal Article

  Journal Article

  Family Perspectives on Telemedicine for Pediatric Subspecialty Care

  Innovative uses of telemedicine - such as previsit communication and postvisit follow up - could improve care by optimizing, rather than replacing, in-person visits.

  May 30, 2017

• 

  Journal Article

  Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits

  Retail clinics have not reduced ED visits for low-acuity conditions.

  May 4, 2017

• Journal Article

  Journal Article

  Variation in Dermatologist Visits by Sociodemographic Characteristics

  Medicaid enrollees are less likely than those with private insurance to see a dermatologist or receive care for a skin condition, suggesting that efforts need to be made to increase access to skin specialists.

  Apr 26, 2017

• 

  Journal Article

  Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending

  Direct-to-consumer telehealth may increase access by making care more convenient for certain patients, but it may also increase utilization and health care spending.

  Mar 28, 2017

• Journal Article

  Journal Article

  Leveraging Telehealth to Bring Volunteer Physicians Into Underserved Communities

  Organizations that use telehealth to address safety net clinic needs by recruiting retired or semi-retired doctor volunteers can help improve access to physicians in underserved areas while enriching the professional lives of clinicians.

  Mar 16, 2017

• 

  Report

  Testing New Codes to Capture Post-Operative Care

  This report summarizes RAND's pilot testing of a set of proposed nonpayment codes that physicians would use for post-operative visits. The goal of testing was to assess whether practitioners understood and could correctly apply the codes.

  Jan 11, 2017

• Journal Article

  Journal Article

  Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Readmission Rates: Implications for the Hospital Readmissions Reduction Program

  Hospitals face penalties for excess readmissions among Medicare patients. This study found that adding race/ethnicity and SES factors to the readmission calculation would have modest financial effects on hospitals and Medicare.

  Nov 13, 2016

• Journal Article

  Journal Article

  Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Hospital Readmission Rates Following Hip and Knee Arthroplasty

  Hospital readmission rates after hip or knee replacement did not change significantly when adjusted for race/ethnicity and socioeconomic status.

  Sep 13, 2016

• Journal Article

  Journal Article

  The Impact of Using Mid-Level Providers in Face-To-Face Primary Care on Health Care Utilization

  When working under a physician's supervision, nurse practitioners and physician assistants do not increase utilization and spending.

  Aug 25, 2016

• 

  Report

  Developing Codes to Capture Post-Operative Care

  This report makes recommendations to the Centers for Medicare & Medicaid Services on a set of nonpayment codes that can be used to collect information on the number and level of post-operative visits.

  Jul 19, 2016

• Journal Article

  Journal Article

  Use of Adult-Trained Medical Subspecialists by Children Seeking Medical Subspecialty Care

  Adult-trained medical subspecialists provide care to 1 in 10 children seeking subspecialty care overall, and to 1 in 6 children with a >90- minute travel time to a pediatric referral center; disparities in use of pediatric versus adult-trained subspecialists are also associate with race and neighborhood income.

  Jul 14, 2016

• 

  Journal Article

  Do "Consumer-Directed" Health Plans Bend the Cost Curve Over Time?

  Firms offering consumer-driven health plans spent less on health care over a three-year period relative to firms offering lower-deductible plans.

  Jun 6, 2016

• 

  Journal Article

  Effect of Teledermatology on Access to Dermatology Care Among Medicaid Enrollees

  Offering teledermatology appeared to improve access to dermatology care among Medicaid enrollees and played an especially important role for the newly enrolled.

  May 19, 2016

• Journal Article

  Journal Article

  Using Clinical Vignettes to Assess Quality of Care for Acute Respiratory Infections

  A vignette-based method can help improve estimates of clinician overprescribing of antibiotics for acute respiratory infections.

  May 2, 2016

• Journal Article

  Journal Article

  What Drives Variation in Antibiotic Prescribing for Acute Respiratory Infections?

  Clinicians are more likely to prescribe antibiotics inappropriately when they are feeling rushed, don't feel strongly that antibiotics are overused, and don't think patient demand for antibiotics is a problem in their practice.

  Apr 27, 2016

• 

  Journal Article

  Estimating Surgical Procedure Times Using Anesthesia Billing Data and Operating Room Records

  Anesthesia and operating room (OR) times can be used to estimate surgical time, thereby improving the payment for surgical procedures in the Medicare fee schedule.

  Mar 18, 2016

• 

  Journal Article

  Retail Clinic Visits for Low-Acuity Conditions Increase Utilization and Spending

  Retail clinics may be creating new demand that increases the cost of health care rather than reducing medical spending.

  Mar 14, 2016

• Journal Article

  Journal Article

  The Relative Importance of Post-Acute Care and Readmissions for Post-Discharge Spending

  This study aims to understand what patterns of health care use are associated with higher post-hospitalization spending.

  Feb 19, 2016

• 

  Journal Article

  Access and Quality of Care in Direct-To-Consumer Telemedicine

  Direct-to-consumer (DTC) telemedicine serves millions of patients; however, there is limited research on the care provided.

  Nov 20, 2015

• Journal Article

  Journal Article

  Opportunity Costs of Ambulatory Medical Care in the United States

  Provide abstract text to pubcat@rand.org alias if you wish to add optional text to this extra tag for this metadata record.

  Sep 4, 2015

• 

  Journal Article

  Optimizing Telehealth Strategies for Subspecialty Care: Recommendations from Rural Pediatricians

  Telehealth offers strategies to improve access to subspecialty care for children in rural communities.

  Aug 4, 2015

• 

  Journal Article

  Medicare's Step Back from Global Payments: Unbundling Postoperative Care

  Many experts believe that the U.S. health care system's continued dependence on fee-for-service payments is a key driver of excessive health care spending.

  Jul 16, 2015

• 

  Journal Article

  Early Marketplace Enrollees Were Older and Used More Medication Than Later Enrollees: Marketplaces Pooled Risk

  Little is known about the health status of the 7.3 million Americans who enrolled in insurance plans through the Marketplaces established by the Affordable Care Act in 2014.

  May 29, 2015

• Journal Article

  Journal Article

  Hospital and Regional Variation in Medicare Payment for Inpatient Episodes of Care

  Health care spending varies widely between geographic regions, but there is disagreement regarding the appropriate policy response.

  Apr 22, 2015

• 

  Journal Article

  Including Physicians in Bundled Hospital Care Payments: Time to Revisit an Old Idea?

  Given new payment models and the changing relationship between physicians and hospitals, it is time to reconsider bundling physicians into hospital payments.

  Apr 21, 2015

• Research Brief

  Research Brief

  Prescribing Antibiotics for Acute Respiratory Infections: Practice Doesn't Always Make Perfect

  Physicians who treat a higher volume of patients with acute respiratory infections (ARIs) are more likely to diagnose a condition that calls for antibiotics, rather than one that does not, and they are more likely to prescribe antibiotics for ARIs.

  Apr 1, 2015

• Journal Article

  Journal Article

  The Volume-Quality Relationship in Antibiotic Prescribing: When More Isn't Better

  The impact of volume on more common medical conditions such as acute respiratory infections (ARIs) has not been examined.

  Feb 25, 2015

• 

  Research Brief

  Valuing the Care We Provide Our Elders

  RAND researchers found that Americans spend over 30 billion hours each year providing informal care for the elderly, at a cost of $522 billion. These findings underscore the need for workplace policies that provide paid time off for caregivers.

  Jan 20, 2015

• 

  Report

  Development of a Model for the Validation of Work Relative Value Units for the Medicare Physician Fee Schedule

  The Centers for Medicare & Medicaid Services (CMS) uses the resource-based relative value scale to pay physicians and other practitioners for services. CMS asked RAND to develop a model to validate physician work values using external data sources.

  Jan 16, 2015

• 

  Research Brief

  RAND Modeling Offers Support for Transparent and Consistent CMS Physician Fee Schedules

  The current process used by the Centers for Medicare & Medicaid Services for valuing physician work is based on physician survey responses. RAND researchers examined the feasibility of developing a model based instead on external data sources.

  Jan 16, 2015

• 

  Journal Article

  Antibiotic Prescribing for Acute Respiratory Infections in Direct-to-Consumer Telemedicine Visits

  Patterns of antibiotic prescribing behavior show that both telemedicine and office-based clinicians over-prescribed antibiotics to treat acute respiratory infections, but telemedicine clinicians tended to prescribe broad-spectrum antibiotics.

  2015

• 

  Journal Article

  Disparities in Time Spent Seeking Medical Care in the United States

  The Institute of Medicine identifies timeliness of care as a key aspect of quality.

  2015

• Journal Article

  Journal Article

  How Will Provider-Focused Payment Reform Impact Geographic Variation in Medicare Spending?

  The Institute of Medicine has recently argued against a value index as a mechanism to address geographic variation in spending and instead promoted payment reform targeted at individual providers.

  2015

• 

  Journal Article

  The Opportunity Costs of Informal Elder-Care in the United States: New Estimates from the American Time Use Survey

  Informal caregiving remains a significant phenomenon in the United States with a high opportunity cost, although it remains more economical (in the aggregate) than skilled paid care.

  2015

• Journal Article

  Journal Article

  Patient Use of Cost and Quality Data When Choosing a Joint Replacement Provider in the Context of Reference Pricing

  Despite growing availability of cost and quality information, hip and knee replacement patients almost always focus on the choice of a surgeon, primarily based on reputation, as opposed to a hospital.

  2015

• 

  Journal Article

  Paying for Telemedicine

  Telemedicine offers the potential for better care, lower costs, and increased convenience. Expanding existing fee-for-service payment models to include telemedicine may lead to its overuse.

  Dec 23, 2014

• Testimony

  Testimony

  Expanding the Use of Telehealth: Promise and Potential Pitfalls: Addendum

  Document submitted on June 5, 2014 as an addendum to testimony presented before the House Energy and Commerce Committee, Subcommittee on Health on May 1, 2014.

  Jun 6, 2014

• Journal Article

  Journal Article

  Impact of a Patient Incentive Program on Receipt of Preventive Care

  Patient financial incentives are being promoted as a mechanism to increase receipt of preventive care, encourage healthy behavior, and improve chronic disease management. However, few empirical evaluations have assessed such incentive programs.

  Jun 1, 2014

• 

  Testimony

  Expanding the Use of Telehealth: Promise and Potential Pitfalls

  Testimony presented before the House Energy and Commerce Committee, Subcommittee on Health on May 1, 2014.

  May 1, 2014

• 

  Journal Article

  Analysis of Teladoc Use Seems to Indicate Expanded Access to Care for Patients Without Prior Connection to a Provider

  Despite the potential benefits of telehealth applications, little is known about their overall impact on care. Teladoc appears to be expanding access to patients who are not connected to other providers.

  Feb 1, 2014

• 

  Journal Article

  Geographic Variation in Receipt of Psychotherapy in Children Receiving Attention-Deficit/Hyperactivity Disorder Medications

  In the more than 1500 counties studied, fewer than 25% of children prescribed ADHD drugs received talk therapy in the same year they received medication. The percentage of children who received both drugs and therapy varied across counties and did not always reflect the number of available psychologists.

  2014

• Journal Article

  Journal Article

  Do We Really Need More Physicians? Responses to Predicted Primary Care Physician Shortages

  Predicted primary care shortages have spurred action to increase the number of primary care physicians.

  2014

• Journal Article

  Journal Article

  Response: Effectiveness in Primary Care Is Paramount, but Need Not Come at the Expense of Efficiency

  Effective primary care is vital to sustainable provision of primary care for the US population.

  2014

• 

  Research Brief

  New Approaches for Delivering Primary Care Could Reduce Predicted Physician Shortage

  If the prevalence of two innovative care delivery models — the patient-centered medical home and the nurse-managed health center — increases, projected U.S. physician shortages can be cut in half by 2025 without training a single additional physician.

  Nov 27, 2013

• 

  Journal Article

  Nurse-managed Health Centers and Patient-Centered Medical Homes Could Mitigate Expected Primary Care Physician Shortage

  Numerous forecasts have predicted shortages of primary care providers, particularly in light of an expected increase in patient demand resulting from the Affordable Care Act. Yet these forecasts could be inaccurate because they generally do not allow for changes in the way primary care is delivered.

  Nov 1, 2013

• Journal Article

  Journal Article

  On Call at the Mall: A Mixed Methods Study of U.S. Medical Malls

  The decline of the traditional U.S. shopping mall and a focus on more consumer- centered care have created an opportunity for medical malls.

  Nov 1, 2013

• Journal Article

  Journal Article

  Primary Care Technicians: A Solution to the Primary Care Workforce Gap

  Efforts to close the primary care workforce gap typically employ one of three basic strategies: train more primary care physicians; boost the supply of nurse practitioners or physician assistants, or both; or use community health workers to extend the reach of primary care physicians.

  Nov 1, 2013

• 

  Journal Article

  Accountable Care Organization Formation Is Associated with Integrated Systems but Not High Medical Spending

  We examined where accountable care organizations (ACOs) have formed and what regional factors are predictive of ACO formation.

  Oct 1, 2013

• 

  Journal Article

  Characteristics of Patients Who Seek Care Via Evisits Instead of Office Visits

  There is growing recognition that many physician–patient encounters do not require face-to-face contact.

  Jul 1, 2013

• Journal Article

  Journal Article

  The Convenience Revolution for Treatment of Low-Acuity Conditions

  This perspective piece summarizes recent research on expanding options for consumers who seek treatment for low-acuity medical conditions, such as bronchitis and urinary tract infections.

  Jul 1, 2013

• 

  Journal Article

  Reliability of Utilization Measures for Primary Care Physician Profiling

  Given rising health care costs, there has been a renewed interest in using utilization measures to profile physicians.

  Jun 1, 2013

• 

  Journal Article

  Impact of Socioeconomic Adjustment on Physicians' Relative Cost of Care

  Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES).

  Apr 26, 2013

• 

  Journal Article

  The Association Between Health Care Quality and Cost: A Systematic Review

  A systematic review found that evidence is mixed and inconsistent regarding both the direction and magnitude of the association between health care costs and quality.

  2013

• Journal Article

  Journal Article

  A Comparison of Care at E-Visits and Physician Office Visits for Sinusitis and Urinary Tract Infection

  This study supports the idea that e-visits could lower health care costs.

  2013

• 

  Journal Article

  Emergency Department Visits for Nonurgent Conditions: Systematic Literature Review

  About 37% of ED visits were for nonurgent conditions. Patients using EDs inappropriately tended to be younger, found EDs more convenient, had an ED referral by a physician, or had negative perceptions about providers who might be alternatives to ED care.

  2013

• Journal Article

  Journal Article

  Evaluation of a Center of Excellence Program for Spine Surgery

  The objective of our study was to assess whether hospitals designated as spine surgery centers of excellence by a group of over 25 health plans provided higher quality care.

  2013

• 

  Journal Article

  Evaluation of Centers of Excellence Program for Knee and Hip Replacement

  The costs of knee and hip replacement in designated centers of excellence do not differ from costs in other hospitals. But hip replacements performed in such centers had lower complication rates. Complication rates for knee replacement did not differ.

  2013

• Journal Article

  Journal Article

  Provincial Screening Rates for Chronic Diseases of Lifestyle, Cancers and HIV in a Health-Insured Population

  Screening for asymptomatic diseases can reduce the burden of morbidity and mortality in all population groups.

  2013

• 

  Journal Article

  Retail Clinic Visits and Receipt of Primary Care

  Retail clinics may disrupt two aspects of primary care: whether patients go to a PCP first for new conditions and continuity of care. However, they do not negatively impact preventive care or diabetes management.

  2013

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  Journal Article

  Physicians with the Least Experience Have Higher Cost Profiles Than Do Physicians with the Most Experience

  Health plans and Medicare are using cost profiles to identify which physicians account for more health care spending than others.

  Nov 1, 2012

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  Journal Article

  Visits to Retail Clinics Grew Fourfold from 2007 to 2009, Although Their Share of Overall Outpatient Visits Remains Low

  Retail clinics have rapidly become a fixture of the US health care delivery landscape.

  Sep 1, 2012

• Report

  Report

  Provider-Level Risk-Adjusted Quality Measurement for Inpatient Rehabilitation Facilities

  Develops risk-adjusted quality metrics at the provider level for inpatient rehabilitation facilities (IRFs) and uses these metrics to estimate national trends in IRF quality from 2004 to 2009.

  Jul 31, 2012

• Journal Article

  Journal Article

  Growth of Retail Clinics in Vaccination Delivery in the U.S.

  Retail clinics play a growing role in delivering vaccinations to Americans, and vaccinations constitute a substantial share of retail clinic business.

  Jul 1, 2012

• Research Brief

  Research Brief

  Which Path Leads to Cost Containment: Selection or Reputation?

  Current initiatives to report health care provider costs are unlikely to motivate consumers to select lower-cost providers. Public reports could better engage consumers by focusing on out-of-pocket costs and high-value providers.

  May 31, 2012

• Journal Article

  Journal Article

  Consumers' and Providers' Responses to Public Cost Reports, and How to Raise the Likelihood of Achieving Desired Results

  Public reporting of health care costs is intended to motivate consumers to choose lower cost providers, and motivate providers to lower costs to retain market share. Measures should be chosen based on which pathway policymakers intend to influence.

  Apr 1, 2012

• Journal Article

  Journal Article

  Applying a Natural Language Processing Tool to Electronic Health Records to Assess Performance on Colonoscopy Quality Measures

  Natural language processing programs can "read" dictated reports and measure colonoscopy quality in an inexpensive, automated, and efficient manner.

  2012

• Journal Article

  Journal Article

  Developing a Natural Language Processing Application for Measuring the Quality of Colonoscopy Procedures

  Dec 1, 2011

• Journal Article

  Journal Article

  Trends in Retail Clinic Use Among the Commercially Insured

  Retail clinic use increased 10-fold from 2007 to 2009. By 2009, roughly 7 percent of all visits by commercially insured patients for 11 common acute-care conditions were to a retail clinic. Increased use was especially dramatic among young, healthy, and higher-income individuals.

  Nov 1, 2011

• Report

  Report

  Estimating Reliability and Misclassification in Physician Profiling

  Explains the relationship between reliability measurement and misclassification for physician quality and cost measures in health care. Provides a method to calculate reliability and misclassification from data typically available to health plans.

  Sep 28, 2010

• Research Brief

  Research Brief

  Is Physician Cost Profiling Ready for Prime Time?

  Physician cost profiling is intended to identify physicians with lower spending patterns, but RAND analysts found that common profiling methods result in 22 percent of physicians being assigned to the wrong cost category in a two-tier system.

  Sep 21, 2010

• 

  Report

  Policy Implications of the Use of Retail Clinics

  Retail clinics' quality of care appears comparable to that of other provider types, but we know little about the effects of clinic use on preventive services, care coordination, and care continuity.

  Aug 10, 2010

• Journal Article

  Journal Article

  Cost Profiles: Should the Focus Be on Individual Physicians or Physician Groups?

  Cost profiles of physician groups are statistically more reliable than profiles of individual physicians but they don't predict individual physician performance within the group.

  Aug 1, 2010

• Journal Article

  Journal Article

  Using the Lessons of Behavioral Economics to Design More Effective Pay-for-Performance Programs

  Although pay for performance incentives are increasingly popular, the healthcare literature shows that these have had minimal effect. Design improvements in these programs can enhance their effectiveness.

  Jul 1, 2010

• 

  Journal Article

  The Effect of Different Attribution Rules on Individual Physician Cost Profiles

  The choice of attribution rule affects how costs are assigned to a physician and can substantially affect the cost category to which a physician is assigned.

  May 18, 2010

• Report

  Report

  Physician Cost Profiling -- Reliability and Risk of Misclassification: Detailed Methodology and Sensitivity Analyses

  This report describes the methods and sensitivity analyses used in a New England Journal of Medicine article. A study of claims data from four Massachusetts health plans shows varying reliability in current methods of physician cost profiling.

  Feb 26, 2010

• Journal Article

  Journal Article

  Does Price Transparency Legislation Allow the Uninsured to Shop for Care?

  Assesses the response rate of California hospitals to a patient price request and compares the price estimates received to Medicare reimbursement.

  Feb 1, 2010

• Journal Article

  Journal Article

  Associations Between Physician Characteristics and Quality of Care

  Patients are encouraged to select physicians on the basis of characteristics such as education, board certification, and malpractice history. But such characteristics are poor proxies for performance on clinical quality measures.

  2010

• Journal Article

  Journal Article

  Estimating the Costs of Medicalization

  This study estimated that medicalized conditions, i.e., non-medical problems that become defined and treated as medical problems, accounted for approximately $77 billion in medical spending in 2005, 3.9% of total domestic expenditures on health care.

  2010

• Journal Article

  Journal Article

  The Growth of Retail Clinics and the Medical Home: Two Trends in Concert or in Conflict?

  There has been growing interest in the patient-centered medical home as a way to provide coordinated, high-quality primary care.

  2010

• Journal Article

  Journal Article

  Incorporating Statistical Uncertainty in the Use of Physician Cost Profiles

  Health plans and other payers should address statistical uncertainty when they use physician cost-profiles to categorize physicians into low or high-cost tiers.

  2010

• 

  Journal Article

  Many Emergency Department Visits Could Be Managed at Urgent Care Centers and Retail Clinics

  About 14-27 percent of all emergency department visits could take place at retail clinics and urgent care centers, with a potential cost savings of approximately $4.4 billion annually.

  2010

• 

  Journal Article

  Physician Cost Profiling: Reliability and Risk of Misclassification

  The authors aggregated claims data for the years 2004 and 2005 from four health plans in Massachusetts.

  2010

• Journal Article

  Journal Article

  Why Do Patients Seek Care at Retail Clinics, and What Alternatives Did They Consider?

  This study found that patients were satisfied with the overall experience and were attracted to retail clinics because of their convenient locations and fixed, transparent pricing.

  2010

• Journal Article

  Journal Article

  Comparing Costs and Quality of Care at Retail Clinics with That of Other Medical Settings for 3 Common Illnesses

  Retail clinics are an increasingly popular source for medical care. Concerns have been raised about the effect of these clinics on the cost, quality, and delivery of preventive care. The authors compare the care received at retail clinics for 3 acute conditions with that received at other care settings. Retail clinics provide less costly treatment than physician offices or urgent care centers for 3 common illnesses, with no apparent adverse effect on quality of care or delivery of preventive care.

  Sep 1, 2009

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  Journal Article

  Episode-based Performance Measurement and Payment: Making It a Reality

  Proposals to use episodes of care as a basis for payment and performance measurement are largely conceptual at this stage, with little empirical work or experience in applied settings to guide their design.

  Sep 1, 2009

• Journal Article

  Journal Article

  Reporting Hospitals Antibiotic Timing in Pneumonia: Adverse Consequences for Patients?

  Despite concerns, public reporting of hospital antibiotic timing scores has not led to increased pneumonia diagnosis, antibiotic use, or a change in patient prioritization.

  Feb 1, 2009

• Journal Article

  Journal Article

  Pay for Performance in the Hospital Setting: What Is the State of the Evidence?

  More than 40 private sector hospital pay-for-performance (P4P) programs now exist, and Congress is considering initiating a Medicare hospital P4P program. Given the growing interest in hospital P4P, this systematic review of the literature examines the current state of knowledge about the effect of P4P on clinical process measures, patient outcomes and experience, safety, and resource utilization.

  Jan 15, 2009

• Journal Article

  Journal Article

  Sociodemographic Characteristics of Communities Served by Retail Clinics

  To better understand the potential for retail clinics, the authors describe the sociodemographic characteristics of the communities in which they operate.

  2009

• Journal Article

  Journal Article

  Alternative Vaccination Locations: Who Uses Them and Can They Increase Flu Vaccination Rates?

  Considers the role that alternative vaccination locations (e.g., workplaces and retail clinics) could play in increasing influenza vaccination coverage.

  2009

• Journal Article

  Journal Article

  The Geographic Distribution, Ownership, Prices, and Scope of Practice at Retail Clinics

  Cross-sectional descriptive study describes characteristics of retail clinics, including their location, scope of practice, prices, acceptance of insurance, and ownership, and to estimate the proportion of the U.S. population that lives within a short driving distance of such a clinic.

  2009

• Journal Article

  Journal Article

  Racial and Ethnic Disparities in Pneumonia Treatment and Mortality

  Examine within and between-hospital racial/ethnic disparities in quality indicators and mortality for patients hospitalized for pneumonia.

  2009

• Journal Article

  Journal Article

  Implementing Open-Access Scheduling of Visits in Primary Care Practices: A Cautionary Tale

  Implementation of open-access scheduling improved appointment access in some primary care practices. However, none was able to achieve same-day access, and patient and staff satisfaction and patient no-show rates were unchanged.

  2008

• Journal Article

  Journal Article

  Retail Clinics, Primary Care Physicians, and Emergency Departments: A Comparison of Patients' Visits

  Compares the demographics of and reasons for visits to retail clinics, primary care physicians (PCPs), and emergency departments. Finds that retail clinics appear to be serving a patient population that is underserved by PCPs.

  2008

• Journal Article

  Journal Article

  The Response of Physician Groups to P4P Incentives

  The authors found an association between P4P incentives and the use of quality improvement initiatives.

  May 1, 2007

• Journal Article

  Journal Article

  Congestive Heart Failure Disease Management in Medicare-managed Care

  Describes the use, structure, and content of initiatives from the Centers for Medicare and Medicaid Services to encourage Medicare managed care plans to introduce congestive heart failure (CHF) disease management programs.

  2007

• Journal Article

  Journal Article

  Preventive Health Examinations and Preventive Gynecological Examinations in the United States

  PHEs and PGEs are among the most common reasons adults see a physician.

  2007

• Journal Article

  Journal Article

  Do Integrated Medical Groups Provide Higher-Quality Medical Care Than Individual Practice Associations?

  The association between the organizational structure of physician groups and health care quality has never been evaluated empirically.

  2006