Medicare’s value-based purchasing (VBP) program potentially puts safety-net hospitals at a financial disadvantage compared to other hospitals. In 2014, the second year of program, patient mortality measures were added VBP program’s algorithm for assigning penalties and rewards. We examined whether inclusion in had disproportionate impact on nationally. found that more likely than be penalized under as result their poorer performance process experience scores. 63 percent versus 51 all sample...

Current physical activity guidelines recommend that adults participate weekly in at least 150 minutes of moderate-intensity equivalent aerobic to achieve substantial health benefits. We used a nationally representative sample data US estimate the percentage deaths attributable levels were inadequate meet guideline.Data from 1990 1991 National Health Interview Survey for aged 25 years or older linked with mortality up until December 31, 2011, Death Index (N = 67,762 persons and 18,796...

Medicare's value-based purchasing (VBP) and the Hospital Readmissions Reduction Program (HRRP) could disproportionately affect safety-net hospitals.To determine whether hospitals incur larger financial penalties than other under VBP HRRP.Cross-sectional analysis.United States in 2014.3022 acute care participating HRRP.Safety-net were defined as being top quartile of Medicare disproportionate share hospital (DSH) patient percentage uncompensated (UCC) payments per bed. The differences both...

The Affordable Care Act includes provisions to increase the value obtained from health care spending. A growing concern among policy experts is that new Medicare policies designed improve quality and efficiency of hospital care, such as value-based purchasing (VBP), Hospital Readmissions Reduction Program (HRRP), electronic record (EHR) meaningful-use criteria, will disproportionately affect safety-net hospitals, which are already facing reduced disproportionate-share (DSH) payments under...

Prevention, including routine cancer screening, is key to meeting national goals for the elimination of death and suffering due cancer. Since 1991, U.S. government has invested in programs such as National Breast Cervical Cancer Early Detection Program (NBCCEDP) detect breast cervical early among uninsured low-income women. A concomitant goal reducing racial disparities screening detection, NBCCEDP program targets women who are more often ethnic minorities. This paper analyzes data test...

Objective. To examine how patient and hospital attributes the patient–physician relationship influence choice of rural Medicare beneficiaries. Data Sources. Current Beneficiary Survey (MCBS), Health Care Financing Administration (HCFA) Provider Services (POS) file, American Hospital Association (AHA) Annual Survey, Service Area (HSA) files for 1994 1995. Study Design. The study sample consisted 1,702 hospitalizations McFadden's conditional logit model was used to analyze choices included...

Much of the work on estimating health care costs attributable to smoking has failed capture effects and related during pregnancy. The goal this study is use data behavior, birth outcomes resource utilization estimate neonatal maternal pregnancy.We 1995 from Center for Disease Control's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) database. PRAMS collects representative samples births 13 states (Alabama, Alaska, California, Florida, Georgia, Indiana, Maine, Michigan, New York...

Objective: The objective of this study was to evaluate the association patient satisfaction with type practitioner attending visits in primary care practice a managed organization (MCO). Study Design: We conducted retrospective observational 41,209 surveys randomly sampled from provided by pediatrics and adult medicine departments 1997 2000. Logistic regression, fixed effects, versus dissatisfaction estimated for each 3 scales: interaction, access, overall experience. Models were separately...

To estimate the savings in labor costs per primary care visit that might be realized from increased use of physician assistants (PAs) and nurse practitioners (NPs) practices a managed organization (MCO).

ABSTRACT: As part of a larger study hospital choice, the travel patterns more than 12,000 Medicare beneficiaries residing in three overlapping rural areas were examined. During 1986 these admitted to one 53 hospitals an area that encompassed parts Minnesota, North Dakota, and South Dakota. Information on ZIP code residence, closest hospital, admission used analyze choices elderly this area. Tosummarize their patterns, admitting was categorized based whether it urban or rural, its size not...

Background/Objective: Persistent instability in insurance coverage before and after pregnancy among low-income mothers the United States contributes to delayed prenatal care poor infant outcomes. that expand Medicaid under Affordable Care Act (ACA) make public free for many women regardless of parental or status. Our objective is analyze effects expanding Ohio on enrollment pregnant receipt recommended care. A key state address mortality as ranks above national average racial disparities...

Objective. School-based health services have evolved from primarily controlling communicable disease to comprehensive programs with direct services, education, and improvement of the school environment. clinics (SBHCs), currently 1157 in number, are used reach children for preventive other routine care. Although several studies examined costs effects such programs, few, if any, their potential save Medicaid program outlays. The objective this study was assess effect Whitefoord Elementary...