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 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.
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.
The aim of this study was to examine the views of key stakeholders in health care payer organizations on the use of practice redesign strategies to improve the delivery of well-child care (WCC) to low-income children aged 0 to 3 years.
We describe overall rates and analyze predictors of unit and item nonresponse for the 695,197 Medicare beneficiaries selected for the 2007 MCAHPS survey (335,249 unit respondents, 49% overall response rate).
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.
Medicare's National Pilot Program on Payment Bundling should use hip fracture and joint replacement as the conditions to include and use longer episodes, capturing a higher percentage of costs and hospital readmissions but adding little financial risk.
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.
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—but the potential revenue recovered from low-value claims may not be worth the reporting costs.
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.
The mix of fee-for-service and Medicare Advantage enrollees, demographic characteristics of populations, and plan-specific factors can all play a role in observed regional variations in CAHPS scores between California and the nation.