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Grantee Publication

The Effects of Price Competition and Reduced Subsidies for Uncompensated Care on Hospital Mortality [1]

Health Services Research - August 2005
Vol. 40, No. 4
August 2005
Volpp, K.G.M., Ketcham, J.D., and A.J. Epstein
pp. 1056-77

Objective. To determine whether hospital mortality rates changed inNew Jersey after
implementation of a law that changed hospital payment from a regulated system based
on hospital cost to price competition with reduced subsidies for uncompensated care
and whether changes in mortality rates were affected by hospital market conditions.

Data Sources/Study Setting. State discharge data for New Jersey and New York
from 1990 to 1996.

Grants: 
Market-Based Reforms and the Quality of Hospital Care in New Jersey [2]
Topic: 
Legal and Regulatory Environment [3]
Topic: 
Provider Payment and Behavior [4]
Topic: 
Quality of Care [5]

The Quality of Managed Care: The Evidence from the Medical Literature [6]

Law and Contemporary Problems
Vol. 65, No. 4
Autumn 2002
Gottfried, J.D. and F.A. Sloan
pp. 103-37

View full article [7]...

Grants: 
Evaluation of the TennCare Health Reform Plan [8]
Topic: 
Managed Care [9]
Topic: 
Quality of Care [5]

Does Managed Care Affect Quality? Appropriateness, Referral Patterns, and Outcomes of Carotid Endarterectomy [10]

American Journal of Medical Quality-November/December 2008
Vol. 23, No. 6
November/December 2008
Halm, E.A., Press, M.J., Tuhrim, S., Wang, J., Rojas, M., and M.R. Chassin
pp. 448-56

This was a population-based observational study to assess the impact of managed care (MC) on several dimensions of quality of surgical care among Medicare beneficiaries undergoing carotid endarterectomies (CEAs) (N = 9308) in New York. Clinical data were abstracted from medical charts to assess appropriateness and deaths or strokes within 30 days of surgery. Differences in patients, appropriateness, and outcomes were compared using chi-square tests; risk-adjusted outcomes were compared using regression.

Grants: 
The Impact of Managed Care on the Appropriateness and Outcomes of Carotid Endarterectomy [11]
Topic: 
Managed Care [9]
Topic: 
Medicare [12]
Topic: 
Quality of Care [5]

Can We Trust Population Surveys to Count Medicaid Enrollees and the Uninsured? [13]

Health Affairs - July/August 2006
Vol. 25, No. 4
July/August 2006
Kincheloe, J., Brown, E.R., Frates, J., Call, K.T., Yen, W., and J. Watkins
pp. 1163-7

Health foundations, such as the Robert Wood Johnson Foundation (RWJF), make multimillion-dollar investments in programs to expand insurance coverage. These efforts are driven largely by estimates of the number of uninsured people derived from population surveys, which might overestimate the number of uninsured people if they under-count people enrolled in Medicaid.

Grants: 
The Medicaid Undercount: Real or Perceived Bias in Estimates of Coverage in General Population Surveys [14]
Topic: 
Insurance Coverage [15]
Topic: 
Medicaid and SCHIP [16]

How do Patients Choose Physicians? Evidence from a National Survey of Enrollees in Employment-Related Health Plans [17]

Health Services Research--April 2003
Vol. 38, No. 2
April 2003
Harris, K.M.
pp. 711-32

Objective: This study examines the process by which patients search for and choose physicians.

Data Source: A survey to a random sample of individuals between the ages of 21 and 64 with employer-related health benefits, drawn from a nationally representative panel of households. STUDY

Grants: 
The Impact of Quality Information on Consumer Plan Choices: Does Health Status Matter? [18]
Topic: 
Consumer Behavior [19]

The Effect of Health Coverage for Uninsured Pregnant Women on Maternal Health and Use of Cesarean Section [20]

Journal of the American Medical Association
Vol. 240, No. 1
January 1993
Haas, J., Udvarhelyi, S., Morris, C., and A. Epstein
pp. 61-4

OBJECTIVES--Although there has been substantial policy interest in interventions to improve the neonatal outcomes of disadvantaged women, little attention has been paid to the health status of pregnant women themselves. We therefore examined whether the provision of health coverage to uninsured low-income pregnant women affects maternal health status or the use of cesarean section. DESIGN--Natural experiment in Massachusetts. PATIENTS--All in-hospital, single-gestation births in 1984 (N = 57,257) and 1987 (N = 64,346).

Grants: 
Effects of a Statewide Perinatal Program for the Uninsured [21]
Topic: 
Insurance Coverage [15]
Topic: 
Quality of Care [5]
Topic: 
Vulnerable Populations [22]

What Length of Hospice Use Maximizes Reduction in Medical Expenditures Near Death in the US Medicare Program [23]

Social Science & Medicine-July 26, 2007
Vol. 65, No. 7
June 26, 2007
Taylor Jr, D.H., Ostermann, J., Van Houtven, C.H., Tulsky, J.A., and K. Steinhauser
pp. 1466-78

Hospices have been expected to reduce health expenditures since their addition to the US Medicare benefit package in the early-1980s, but the literature on their ability to do so is mixed. The contradictory findings noted in previous studies may be due to selection bias and the period of cost comparison used. Accounting for these, this study focuses on the length of hospice use that maximizes reductions in medical expenditures near death.

Grants: 
Does Hospice Save Medicare Money? [24]
Topic: 
Costs and Cost Containment [25]
Topic: 
End-of-Life Care [26]
Topic: 
Medicare [12]

Purchasing Cooperatives for Small Employers: Performance and Prospects [27]

Milbank Quarterly
Vol. 78, No. 4
December 2000
Wicks, E. and M. Hall
pp. 511-46, iii

Health insurance purchasing cooperatives were established in the early to mid-1990s for the purpose of making health insurance more affordable and accessible for small employers. Extensive interviews at six cooperatives reveal that while some cooperatives enrolled large numbers of small employers, most have won only small market shares and a number have struggled for survival, not always successfully. They have allowed small employers to offer individual employees choice of health plans, but none has been able to sustain lower prices than are available in the conventional market.

Grants: 
An Evaluation of the Primary and Secondary Effects of Insurance Market Reform [28]
Topic: 
Insurance Coverage [15]
Topic: 
Purchasing [29]

Effect of Mergers on Health Maintenance Organization Premiums [30]

Health Care Financing Review
Vol. 17, No. 3
April 1996
Feldman, R., Wholey, D., and J.B. Christianson
pp. 171-89

This study estimated the effect of mergers on health maintenance organization (HMO) premiums, using data on all operational non-Medicaid HMOs in the United States from 1985 to 1993. Two critical issues were examined: whether HMO mergers increase or decrease premiums; and whether the effects of mergers differ according to the degree of competition among HMOs in local markets. The only significant merger effect was found in the most competitive markets, where premiums increased, but only for 1 year after the merger.

Grants: 
HMO Mergers: Analysis of Trends and Public Policy Issues [31]
Topic: 
Costs and Cost Containment [25]
Topic: 
Managed Care [9]
Topic: 
Organization and Supply of Care [32]

Evaluation of the Effect of a Consumer-Driven Health Plan on Medical Care Expenditures and Utilization [33]

Health Services Research-August 2004
Vol. 39, No. 4, Pt. 2
August 2004
Parente, S.T., Feldman, R., and J.B. Christianson
pp. 1189-210..

Objective. To compare medical care costs and utilization in a consumer-driven health plan (CDHP) to other health insurance plans.

Grants: 
Evaluation of Defined Contribution Plans on Health Insurance Choice and Medical Care Use [34]
Topic: 
Benefit Design [35]
Topic: 
Consumer Behavior [19]
Topic: 
Costs and Cost Containment [25]
Topic: 
Insurance Coverage [15]
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[1] http://www.hcfo.org/publications/effects-price-competition-and-reduced-subsideies-uncompensated-care-hospital-mortality
[2] http://www.hcfo.org/grants/market-based-reforms-and-quality-hospital-care-new-jersey
[3] http://www.hcfo.org/topics/legal-and-regulatory-environment
[4] http://www.hcfo.org/topics/provider-payment-and-behavior
[5] http://www.hcfo.org/topics/quality-care
[6] http://www.hcfo.org/publications/quality-managed-care-evidence-medical-literature
[7] http://www.jstor.org/pss/1192281
[8] http://www.hcfo.org/grants/evaluation-tenncare-health-reform-plan
[9] http://www.hcfo.org/topics/managed-care
[10] http://www.hcfo.org/publications/does-managed-care-affect-quality-appropriateness-referral-patterns-and-outcomes-carotid
[11] http://www.hcfo.org/grants/impact-managed-care-appropriateness-and-outcomes-carotid-endarterectomy
[12] http://www.hcfo.org/topics/medicare
[13] http://www.hcfo.org/publications/can-we-trust-population-surveys-count-medicaid-enrollees-and-uninsured
[14] http://www.hcfo.org/grants/medicaid-undercount-real-or-perceived-bias-estimates-coverage-general-population-surveys
[15] http://www.hcfo.org/topics/insurance-coverage
[16] http://www.hcfo.org/topics/medicaid-and-schip
[17] http://www.hcfo.org/publications/how-do-patients-choose-physicians-evidence-national-survey-enrollees-employment-related
[18] http://www.hcfo.org/grants/impact-quality-information-consumer-plan-choices-does-health-status-matter
[19] http://www.hcfo.org/topics/consumer-behavior
[20] http://www.hcfo.org/publications/effect-health-coverage-uninsured-pregnant-women-maternal-health-and-use-cesarean-sectio
[21] http://www.hcfo.org/grants/effects-statewide-perinatal-program-uninsured
[22] http://www.hcfo.org/topics/vulnerable-populations
[23] http://www.hcfo.org/publications/what-length-hospice-use-maximizes-reduction-medical-expenditures-near-death-us-medicare
[24] http://www.hcfo.org/grants/does-hospice-save-medicare-money
[25] http://www.hcfo.org/topics/costs-and-cost-containment
[26] http://www.hcfo.org/topics/end-life-care
[27] http://www.hcfo.org/publications/purchasing-cooperatives-small-employers-performance-and-prospects
[28] http://www.hcfo.org/grants/evaluation-primary-and-secondary-effects-insurance-market-reform
[29] http://www.hcfo.org/topics/purchasing
[30] http://www.hcfo.org/publications/effect-mergers-health-maintenance-organization-premiums
[31] http://www.hcfo.org/grants/hmo-mergers-analysis-trends-and-public-policy-issues
[32] http://www.hcfo.org/topics/organization-and-supply-care
[33] http://www.hcfo.org/publications/evaluation-effect-consumer-driven-health-plan-medical-care-expenditures-and-utilization
[34] http://www.hcfo.org/grants/evaluation-defined-contribution-plans-health-insurance-choice-and-medical-care-use
[35] http://www.hcfo.org/topics/benefit-design
[36] http://www.hcfo.org/taxonomy/term/4/all
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