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Grantee Publication

Impact of Policy Changes on Emergency Department Use by Medicaid Enrollees in Oregon [1]

Medical Care
Vol. 48, No. 7
July 2010
Lowe, R.A., Fu, R., and C. Gallia
pp. 619-627

Objective: In 2003, Oregon's Medicaid expansion program, the Oregon Health Plan (OHP), implemented premiums and copayments and eliminated outpatient behavioral health services. We ascertained whether these changes, including $50 copayments for emergency department (ED) visits, affected ED use. Methods: This study used statewide administrative data on 414,009 adult OHP enrollees to compare ED utilization rates (adjusted for patient characteristics) in 3 time periods: (1) before the cutbacks, (2) after the cutbacks, and (3) after partial restoration of benefits.

Grants: 
Surviving the Perfect Storm: Impacts of Benefit Reductions and Increased Cost Sharing in a Medicaid Program [2]
Topic: 
Access [3]
Topic: 
Benefit Design [4]
Topic: 
Consumer Behavior [5]
Topic: 
Medicaid and SCHIP [6]
Topic: 
Vulnerable Populations [7]

Journal Article: Consequences of SCHIP Expansions for Household Well-Being [8]

Forum for Health Economics & Policy
Vol. 13, No. 1
June 2010
Leininger, L., Levy, H., and D. Schanzenbach
Article 3

About 7.4 million children were covered by the State Children’s Health Insurance Program (SCHIP) at some point during fiscal year 2008. Many of these children would probably have had private coverage in the absence of SCHIP; recent estimates of the extent of “crowd-out” associated with SCHIP are about 60 percent (Gruber and Simon 2008). The high rate of crowd-out means that the program is not as effective as it could be at reducing the number of uninsured children and has been a political liability for the program.

Grants: 
Consequences of SCHIP for Household Well-Being [9]
Topic: 
Benefit Design [4]
Topic: 
Consumer Behavior [5]
Topic: 
Medicaid and SCHIP [6]
Topic: 
Vulnerable Populations [7]

How Medicare’s Payment Cuts For Cancer Chemotherapy Drugs Changed Patterns Of Treatment [10]

Health Affairs
Vol. 29, No. 7
June 2010
Jacobson, M., Earle, C.C., Price, M., and J. Newhouse
Web First

The Medicare Prescription Drug, Improvement, and Modernization Act, enacted in 2003, substantially reduced payment rates for chemotherapy drugs administered on an outpatient basis starting in January 2005. We assessed how these reductions affected the likelihood and setting of chemotherapy treatment for Medicare beneficiaries with newly diagnosed lung cancer, as well as the types of agents they received. Contrary to concerns about access, we found that the changes actually increased the likelihood that lung cancer patients received chemotherapy.

Grants: 
Reimbursement Policy and Cancer Chemotherapy Treatment and Outcomes [11]
Topic: 
Medicare [12]
Topic: 
Prescription Drugs [13]
Topic: 
Provider Payment and Behavior [14]

Cross-Payer Effects on Medicare Resource Use: Lessons for Medicaid Administrators [15]

The Hilltop Institute, UMBC
May 2010
Tucker, A. and K. Johnson


This report is the fourth and final report in a series that explores the cross-payer effects of providing Medicaid long-term supports and services (LTSS) on Medicare acute care resource use. The report provides a summary of the initial work of a study, described more fully in the first three reports, with an emphasis on lessons that state Medicaid administrators should consider as they move toward more formal programs of integrated care for persons dually eligible for Medicare and Medicaid (or duals, for short).

Grants: 
Medicaid Long-Term Care Programs: Simulating Rate Setting and Cross-Payer Effects [16]
Topic: 
Acute Care [17]
Topic: 
Long-Term Care [18]
Topic: 
Medicaid and SCHIP [6]
Topic: 
Medicare [12]

Malpractice Crisis and Reform [19]

Clinics in Perinatology
Vol. 32, No. 1
March 2005
Bovbjerg, R.R.
pp. 203-33

Medical liability coverage has become increasingly expensive and scarce since 2001, especially for obstetrics and other high-risk specialties. Physicians, whose own fees are constrained, see this as a crisis needing tort reform to cap payouts. Plaintiffs' lawyers fight caps; they blame insurance trends and call for stronger regulation of insurers and physicians.

Grants: 
Liability Problems and Transparent Disclosure to Patients as a Solution [20]
Topic: 
Legal and Regulatory Environment [21]
Topic: 
Provider Payment and Behavior [14]

Accreditation Outcomes: Getting to the Right Indicators [22]

North Carolina Institute for Public Health, UNC Gillings School of Global Public Health
June 14, 2010
Davis, M.V., and Cannon, M.

Grants: 
The Influence of Accreditation on Local Health Department Performance in NC [23]
Topic: 
Public Health Systems [24]
Topic: 
Quality of Care [25]

The Effect of Different Attribution Rules on Individual Physician Cost Profiles [26]

Annals of Internal Medicine
Vol. 152, No. 10
May 18, 2010
Mehrotra, A., Adams, J.L., Thomas, J.W., and E.A. McGlynn
pp. 649-54

Background: Some health plans profile physicians on the basis of their relative costs and use these profiles to assign physicians to cost categories. Physician organizations have questioned whether the rules used to attribute costs to a physician affect the cost category to which that physician is assigned. Objective: To evaluate the effect of 12 different attribution rules on physician cost profiles.

Grants: 
Evaluating Cost Efficiency of Specialist Physicians [27]
Topic: 
Costs and Cost Containment [28]
Topic: 
Provider Payment and Behavior [14]

Clarifying Sources of Geographic Differences in Medicare Spending [29]

The New England Journal of Medicine
Online First
May 12, 2010
Zuckerman, S., Waidmann, D., Berenson, R., and J. Hadley

Grants: 
Medical Spending and Health of the Elderly [30]
Topic: 
Costs and Cost Containment [28]
Topic: 
Medicare [12]
Topic: 
Purchasing [31]

Racial and Ethnic Disparities within and between Hospitals for Inpatient Quality of Care: An Examination of Patient-Level Hospital Quality Alliance Measures [32]

Journal of Health Care for the Poor and Underserved
Vol. 21, No. 2
May 2010
Hasnain-Wynia, R., Kang, R., Landrum, M.B., Vogeli, C., Baker, D.W., and J.S. Weissman
pp. 629-48

Background. Little is known about whether disparities occur within or between hospitals for national Hospital Quality Alliance (HQA) measures. Methods. We examined patient-level data from 4,450 non-federal hospitals in the U.S. for over 2.3 million Black, Hispanic, Asian, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander patients who received care for acute myocardial infarction, heart failure, or pneumonia in 2005. Results. There were 37 out of 95 findings of disparities after adjusting for patient characteristics.

Grants: 
Examining the Quality of Hospital Care and Simulating the Impact of Several Pay-for-Performance Scoring Methods on Hospital Rankings [33]
Topic: 
Acute Care [17]
Topic: 
Disparities [34]
Topic: 
Quality of Care [25]

Monitoring Technology and Firm Boundaries: Physician-Hospital Integration and Technology Utilization [35]

Journal of Health Economics
Vol. 29, No. 3
May 2010
McCullough, J.S. and E.M. Snir
pp. 457-7

We study the relationship between physician–hospital integration and its relation to monitoring IT utilization. We develop a theoretical model in which monitoring IT may complement or substitute for integration and test these relationships using a novel data source. Physician labor market heterogeneity identifies the empirical model. We find that monitoring IT utilization is increasing in integration, implying that expanded firm boundaries complement monitoring IT adoption.

Grants: 
The Costs and Benefits of Health Information Technology: Computerized Physician Order Entry [36]
Topic: 
Health Information Technology [37]
Topic: 
Organization and Supply of Care [38]
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Links:
[1] http://www.hcfo.org/publications/impact-policy-changes-emergency-department-use-medicaid-enrollees-oregon
[2] http://www.hcfo.org/grants/surviving-perfect-storm-impacts-benefit-reductions-and-increased-cost-sharing-medicaid-progra
[3] http://www.hcfo.org/topics/access
[4] http://www.hcfo.org/topics/benefit-design
[5] http://www.hcfo.org/topics/consumer-behavior
[6] http://www.hcfo.org/topics/medicaid-and-schip
[7] http://www.hcfo.org/topics/vulnerable-populations
[8] http://www.hcfo.org/publications/consequences-schip-expansions-household-well-being
[9] http://www.hcfo.org/grants/consequences-schip-household-well-being
[10] http://www.hcfo.org/publications/how-medicare%E2%80%99s-payment-cuts-cancer-chemotherapy-drugs-changed-patterns-treatment
[11] http://www.hcfo.org/grants/reimbursement-policy-and-cancer-chemotherapy-treatment-and-outcomes
[12] http://www.hcfo.org/topics/medicare
[13] http://www.hcfo.org/topics/prescription-drugs
[14] http://www.hcfo.org/topics/provider-payment-and-behavior
[15] http://www.hcfo.org/publications/cross-payer-effects-medicare-resource-use-lessons-medicaid-administrators
[16] http://www.hcfo.org/grants/medicaid-long-term-care-programs-simulating-rate-setting-and-cross-payer-effects
[17] http://www.hcfo.org/topics/acute-care
[18] http://www.hcfo.org/topics/long-term-care
[19] http://www.hcfo.org/publications/malpractice-crisis-and-reform
[20] http://www.hcfo.org/grants/liability-problems-and-transparent-disclosure-patients-solution
[21] http://www.hcfo.org/topics/legal-and-regulatory-environment
[22] http://www.hcfo.org/publications/influence-accreditation-local-health-department-performance
[23] http://www.hcfo.org/grants/influence-accreditation-local-health-department-performance-nc
[24] http://www.hcfo.org/topics/public-health-systems
[25] http://www.hcfo.org/topics/quality-care
[26] http://www.hcfo.org/publications/effect-different-attribution-rules-individual-physician-cost-profiles
[27] http://www.hcfo.org/grants/evaluating-cost-efficiency-specialist-physicians
[28] http://www.hcfo.org/topics/costs-and-cost-containment
[29] http://www.hcfo.org/publications/clarifying-sources-geographic-differences-medicare-spending
[30] http://www.hcfo.org/grants/medical-spending-and-health-elderly
[31] http://www.hcfo.org/topics/purchasing
[32] http://www.hcfo.org/publications/racial-and-ethnic-disparities-within-and-between-hospitals-inpatient-quality-care-exami
[33] http://www.hcfo.org/grants/examining-quality-hospital-care-and-simulating-impact-several-pay-performance-scoring-methods
[34] http://www.hcfo.org/topics/disparities
[35] http://www.hcfo.org/publications/monitoring-technology-and-firm-boundaries-physician-hospital-integration-and-technology
[36] http://www.hcfo.org/grants/costs-and-benefits-health-information-technology-computerized-physician-order-entry
[37] http://www.hcfo.org/topics/health-information-technology
[38] http://www.hcfo.org/topics/organization-and-supply-care
[39] http://www.hcfo.org/taxonomy/term/4
[40] http://www.hcfo.org/taxonomy/term/4?page=16
[41] http://www.hcfo.org/taxonomy/term/4?page=13
[42] http://www.hcfo.org/taxonomy/term/4?page=14
[43] http://www.hcfo.org/taxonomy/term/4?page=15
[44] http://www.hcfo.org/taxonomy/term/4?page=18
[45] http://www.hcfo.org/taxonomy/term/4?page=19
[46] http://www.hcfo.org/taxonomy/term/4?page=20
[47] http://www.hcfo.org/taxonomy/term/4?page=21
[48] http://www.hcfo.org/taxonomy/term/4?page=48