Allowing Americans aged 50 to 64 to buy into Medicare would lower health care premiums for the group. But it would also drive up costs for younger people who buy health insurance on Affordable Care Act exchanges.
Medicare appears to be overpaying surgeons for many medical procedures. Federal officials should incorporate ways to more objectively measure the amount of postoperative care surgeons provide to patients.
The authors developed new claims-based frailty algorithms that were validated using patient assessment data from post-acute care providers. They then compared the performance of the new algorithms with existing claims-based frailty algorithms.
Presents findings from a test of the Million Hearts model for CMS through a large, randomized trial, including hundreds of thousands of beneficiaries across the United States of the Million Hearts model from 2017 to 2021.
RAND researchers are conducting a multiyear evaluation of the VBID Model test using a mixed-methods approach that involves surveys, interviews, and quantitative analyses of the relationship between VBID implementation and a variety of outcomes.
This study aims to create Medicare-based algorithms for predicting functional impairment, crucial for mortality and care use. Using machine learning and PAC data, memory and activity limitations were assessed with moderate success. While promising for PAC, broader older adult application is uncertain.
A new Medicare policy may have improved access to methadone and buprenorphine treatment for Medicare beneficiaries with a diagnosed opioid use disorder (OUD) during the COVID-19 pandemic, but further research is needed to determine its impact.
The use of methadone among Medicare beneficiaries to treat opioid use disorder increased sharply after the program began covering the drug, with evidence suggesting the change created new treatment rather than displacing use of other medications.
The results of this study provide some assurance that Medicare's onboarding process is effective, and that the care experiences of new enrollees with health care services are broadly similar to those with longer experience in the Medicare program.
We estimate the average direct medical expenditures for essential tremor using Medicare claims data. Beneficiaries have $1068 more annual expenditures relative to comparisons. This aggregates to $1.5–$5.4 billion in additional annual costs.
Low income is associated with lower performance on behavioral health measures, but associations differ across racial groups. Improving care integration and addressing barriers to care may improve equity across income levels.
Researchers used Medicaid claims during the period 2006–2013 to investigate the relationship between buprenorphine prior authorization requirements and changes in treatment in the years following policy implementation.
In this study, we used 2013-2018 OASIS assessment data linked to Medicare inpatient data to estimate trends in the prevalence of infection in hospital transfers among home health care patients and subsequent 30-day mortality.
This cross-sectional study assessed the relationship between self-rated mental health (SRMH) and infrequent routine care among Medicare beneficiaries and investigated the roles of managed care and having a personal doctor.
Increases in vertical integration were not associated with changes in medication adherence rates. However, adherence rates after vertical integration declined for non-Whites, patients over 80 years old, and patients with greater comorbidities.