The RAND Hospital Data tool is an effort to enhance data from the Centers for Medicare & Medicaid Services Healthcare Provider Cost Reporting Information System to make them more useful and accessible to a broad audience.
National baseline data on nursing home infection control programs will aid evaluations of a Centers for Medicare & Medicaid Services rule requiring facilities to include an antibiotic stewardship and employ an infection preventionist.
In 2008, the Indian Health Service launched a patient-centered medical home (PCMH) initiative to improve the quality of care in its clinics. RAND researchers identified barriers and strategies to assist clinics on the path to PCMH recognition.
Expanding home- based primary care to American Indian Reservations and other rural communities increased access to long term care and enrollment for health care benefits; outcomes were similar for Indian Health Service and non-Indian Health Service populations.
Hospital incentives for investing in patient safety vary by payer and payment configuration. Higher payments provide resources to improve patient safety, but current payment structures may also reduce the willingness of hospitals to invest in patient safety.
This report proposes alternative methodologies for determining the practice expense (PE) component of the Medicare Physician Fee Schedule in order to avoid misvalued payment rates. A main concern is the allocation of indirect practice costs.
Results suggest that AUD and other drug use disorder are more problematic than marijuana use disorder in terms of repeated hospital admissions for SSD. Marijuana use disorder does not appear to be associated with shorter times until readmission.
Following Medicaid expansion, non safety-net hospitals experienced a greater percentage increase in Medicaid stays than did safety-net hospitals, which may reflect patient choice or a crowd-out of private insurance.
Outpatient guidelines can help hospitalists evaluate inpatients on long-term opioid therapy, but more work is needed to help providers make decisions for inpatients that balance effective pain treatment and opioid risk reduction.
Patients of community health clinics who screen positive for alcohol or opioid misuse have a high probability of an alcohol- or substance-use disorder and a slightly higher prevalence of mental illness than the overall clinic population.
Employers paid 3.5 times what Medicare would have paid for the same hospital outpatient services in Indiana — and 2.1 times the Medicare rate for inpatient care. Price transparency nationwide could help employers become better-informed purchasers of health care and stronger advocates for their employees.
The average American's likelihood of using a nursing home is much greater than previous research has suggested. Among people age 57 to 61, 56 percent will stay in a nursing home at least one night in their lifetime.