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.
This report shares results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services.
The authors examine whether care experiences and immunization for racial/ethnic/language minority Medicare beneficiaries vary with the proportion of same-group beneficiaries in Medicare Advantage (MA) contracts.
This report shares research and analyses of claims data related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services.
Describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Centers for Medicare and Medicaid Services' Center for Medicare and Medicaid Innovation.
Although reducing readmissions appears desirable because it may improve older adults' health and reduce costs, how will we know if the Hospital Readmissions Reduction Program (HRRP) policy has, in fact, been successful?
This paper aimed to estimate the effect of tobacco taxes on total mortality and cause-specific mortality in the 50 States plus the District of Columbia, USA, over the period 1970–2005 as well as the net effect on deaths averted in 2010.
This study aims to describe the magnitude of hospital costs among patients undergoing abdominal surgery, and determine whether hospital costs estimates are consistent with clinical expectations of hospital resource use.
Expanded use of clinical process-of-care measures to assess the quality of health care in the context of public reporting and pay-for-performance applications led to a desire to demonstrate its value in terms of improved patient outcomes.
The Centers for Medicare and Medicaid Services uses a resource-based relative value (RBRV) scale to calculate payments for physicians. The values of the scale were validated with predictive modeling, and the result may be helpful in two key applications: flagging codes as potentially misvalued and determining why a code is valued differently than predicted.
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.
RAND researchers tested whether exposing ordering clinicians to appropriateness guidelines for advanced imaging procedures would reduce or eliminate inappropriate orders. The study identified many opportunities to refine decision support systems.
Better patient care experiences are associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, better patient safety within hospitals, and less health care utilization.
Modest improvements in continuity of care correlate with sizable reductions in service use, complications, and costs for Medicare patients with congestive heart failure, chronic obstructive pulmonary disease, and type 2 diabetes mellitus.
Many studies grapple with how to control spending by considering changing how existing technologies are used. But what if the problem could be attacked at its root by changing which drugs and devices are invented in the first place?