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Grantee Publication

Saving Billions of Dollars—And Physicians’ Time—By Streamlining Billing Practices [1]

Health Affairs Web Exclusive
Vol. 29, No. 6
April 29, 2010
Blanchfield, B.B., Heffernan, J.L., Osgood, B., Sheehan, R.R., and G.S. Meyer

Grants: 
Administrative Simplification Challenges and Opportunities: A Physician Organization's Perspective [2]
Topic: 
Costs and Cost Containment [3]
Topic: 
Provider Payment and Behavior [4]

Medicare Part D's Exclusion of Benzodiazepines and Fracture Risk in Nursing Homes [5]

Archives of Internal Medicine
Vol. 170, No. 8
April 26, 2010
Briesacher, B.A., Soumerai, S.B., Field, T.S., Fouayzi, H., and J.H. Gurwitz
pp. 693-8

Background: Medicare Part D excludes benzodiazepine medications from coverage, and some state Medicaid programs also limit coverage. We assessed whether such policies decrease the risk of fractures in elderly individuals living in nursing homes. Methods: This is a quasi-experimental study with interrupted time-series estimation and extended Cox proportional hazards models comparing changes in outcomes before and after implementation of Medicare Part D in a nationwide sample of nursing home residents in 48 states.

Grants: 
Impact of MMA Part D on Medicare Residents in Nursing Homes [6]
Topic: 
Benefit Design [7]
Topic: 
Long-Term Care [8]
Topic: 
Medicare [9]
Topic: 
Prescription Drugs [10]
Topic: 
Quality of Care [11]

Strategies Used by Local Health Departments to Better Serve Diverse Communities [12]

Social and Scientific Systems, Inc.
April 15, 2010
Schur, C. and J. Lucado

Grants: 
Local Public Health Capacities to Address the Needs of Culturally and Linguistically Diverse Populations [13]
Topic: 
Disparities [14]
Topic: 
Organization and Supply of Care [15]
Topic: 
Public Health Systems [16]
Topic: 
Vulnerable Populations [17]

Using HMOs to Serve the Medicaid Population: What Are the Effects on Utilization and Does the Type of HMO Matter? [18]

Health Economics
Published Online
April 11, 2010
Herring, B. and E.K. Adams

Grants: 
Market-Level Effects of Medicaid HMOs on Physician Participation, Enrollee Access, and Program Costs [19]
Topic: 
Access [20]
Topic: 
Costs and Cost Containment [3]
Topic: 
Managed Care [21]
Topic: 
Medicaid and SCHIP [22]

Low-Value Services in Value-Based Insurance Design [23]

The American Journal of Managed Care
Vol. 16, No. 4
April 2010
Neumann, P.J., Auerbach, H.R., Cohen, J.T., and D. Greenberg
pp. 280-6

Objectives: To identify potentially low-value services for inclusion in value-based insurance design (VBID) programs and to discuss challenges involved in incorporating such information. Methods: We searched the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org [24]) to identify examples of low-value services, defined as interventions that make health worse without saving money or those that cost at least $100,000 per quality-adjusted lifeyear gained. We restricted our attention to papers published since 2000.

Topic: 
Benefit Design [7]
Topic: 
Costs and Cost Containment [3]

Journal Article: The Effect of Health Information Technology on Quality in U.S. Hospitals [25]

Health Affairs
Vol. 29, No. 4
April 2010
McCullough, J.S., Casey, M., Moscovice, I. and S. Prasad
pp. 647-54

Health information technology (IT), such as computerized physician order entry and electronic health records, has potential to improve the quality of health care. But the returns from widespread adoption of such technologies remain uncertain. We measured changes in the quality of care following adoption of electronic health records among a national sample of U.S. hospitals from 2004 to 2007. The use of computerized physician order entry and electronic health records resulted in significant improvements in two quality measures, with larger effects in academic than nonacademic hospitals.

Grants: 
The Costs and Benefits of Health Information Technology: Computerized Physician Order Entry [26]
Topic: 
Acute Care [27]
Topic: 
Health Information Technology [28]
Topic: 
Quality of Care [11]

Physician Cost Profiling—Reliability and Risk of Misclassification, Detailed Methodology and Sensitivity Analyses [29]

RAND Technical Report
2010
Adams, J.L., Mehrotra, A., Thomas, J.W., and E.A. McGlynn

Grants: 
Evaluating Cost Efficiency of Specialist Physicians [30]
Topic: 
Costs and Cost Containment [3]
Topic: 
Insurance Coverage [31]
Topic: 
Provider Payment and Behavior [4]

Physician Cost Profiling—Reliability and Risk of Misclassification [32]

New England Journal of Medicine
Vol. 362, No. 11
March 18, 2010
Adams, J.L., Mehrotra, A., Thomas, J.W., and E.A. McGlynn
pp. 1014-21

BACKGROUND: Insurance products with incentives for patients to choose physicians classified as offering lower-cost care on the basis of cost-profiling tools are increasingly common. However, no rigorous evaluation has been undertaken to determine whether these tools can accurately distinguish higher-cost physicians from lower-cost physicians. METHODS: We aggregated claims data for the years 2004 and 2005 from four health plans in Massachusetts.

Grants: 
Evaluating Cost Efficiency of Specialist Physicians [30]
Topic: 
Costs and Cost Containment [3]
Topic: 
Insurance Coverage [31]
Topic: 
Provider Payment and Behavior [4]

Incorporating Statistical Uncertainty in the Use of Physician Cost-Profiles [33]

BMC Health Services Research
Vol. 10, No. 57
March 5, 2010
Adams, J.L., McGlynn, E.A., Thomas, J.W., and A. Mehrotra

Grants: 
Evaluating Cost Efficiency of Specialist Physicians [30]
Topic: 
Benefit Design [7]
Topic: 
Costs and Cost Containment [3]
Topic: 
Provider Payment and Behavior [4]

Flexible Spending Accounts and Adverse Selection [34]

Journal of Risk and Insurance
Vol. 77, No. 1
March 2010
Cardon, J.H.
pp. 145-53

I model the interaction of flexible spending accounts (FSAs) and conventional insurance in a simple discrete loss setting with asymmetric information. I show that FSA availability can break a separating equilibrium, even when one would otherwise exist, because high-risk types might prefer the lower-coverage contract supplemented with FSA funds. In this case there may exist a Pareto-inferior separating equilibrium. It is also shown that FSA availability alters the optimal pooling contract.

Grants: 
Health Savings Accounts, High Deductible Policies, and the Uninsured: Simulating the Effects of HSA Tax Policy [35]
Topic: 
Benefit Design [7]
Topic: 
Insurance Coverage [31]
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Links:
[1] http://www.hcfo.org/publications/saving-billions-dollars%E2%80%94and-physicians%E2%80%99-time%E2%80%94-streamlining-billing-practices
[2] http://www.hcfo.org/grants/administrative-simplification-challenges-and-opportunities-physician-organizations-perspectiv
[3] http://www.hcfo.org/topics/costs-and-cost-containment
[4] http://www.hcfo.org/topics/provider-payment-and-behavior
[5] http://www.hcfo.org/publications/medicare-part-ds-exclusion-benzodiazepines-and-fracture-risk-nursing-homes
[6] http://www.hcfo.org/grants/impact-mma-part-d-medicare-residents-nursing-homes
[7] http://www.hcfo.org/topics/benefit-design
[8] http://www.hcfo.org/topics/long-term-care
[9] http://www.hcfo.org/topics/medicare
[10] http://www.hcfo.org/topics/prescription-drugs
[11] http://www.hcfo.org/topics/quality-care
[12] http://www.hcfo.org/publications/strategies-used-local-health-departments-better-serve-diverse-communities
[13] http://www.hcfo.org/grants/local-public-health-capacities-address-needs-culturally-and-linguistically-diverse-population
[14] http://www.hcfo.org/topics/disparities
[15] http://www.hcfo.org/topics/organization-and-supply-care
[16] http://www.hcfo.org/topics/public-health-systems
[17] http://www.hcfo.org/topics/vulnerable-populations
[18] http://www.hcfo.org/publications/using-hmos-serve-medicaid-population-what-are-effects-utilization-and-does-type-hmo-mat
[19] http://www.hcfo.org/grants/market-level-effects-medicaid-hmos-physician-participation-enrollee-access-and-program-costs
[20] http://www.hcfo.org/topics/access
[21] http://www.hcfo.org/topics/managed-care
[22] http://www.hcfo.org/topics/medicaid-and-schip
[23] http://www.hcfo.org/publications/low-value-services-value-based-insurance-design
[24] http://www.cearegistry.org
[25] http://www.hcfo.org/publications/effect-health-information-technology-quality-us-hospitals
[26] http://www.hcfo.org/grants/costs-and-benefits-health-information-technology-computerized-physician-order-entry
[27] http://www.hcfo.org/topics/acute-care
[28] http://www.hcfo.org/topics/health-information-technology
[29] http://www.hcfo.org/publications/physician-cost-profiling%E2%80%94reliability-and-risk-misclassification-detailed-methodology-an
[30] http://www.hcfo.org/grants/evaluating-cost-efficiency-specialist-physicians
[31] http://www.hcfo.org/topics/insurance-coverage
[32] http://www.hcfo.org/publications/physician-cost-profiling%E2%80%94reliability-and-risk-misclassification
[33] http://www.hcfo.org/publications/incorporating-statistical-uncertainty-use-physician-cost-profiles
[34] http://www.hcfo.org/publications/flexible-spending-accounts-and-adverse-selection
[35] http://www.hcfo.org/grants/health-savings-accounts-high-deductible-policies-and-uninsured-simulating-effects-hsa-tax-pol
[36] http://www.hcfo.org/taxonomy/term/4
[37] http://www.hcfo.org/taxonomy/term/4?page=17
[38] http://www.hcfo.org/taxonomy/term/4?page=14
[39] http://www.hcfo.org/taxonomy/term/4?page=15
[40] http://www.hcfo.org/taxonomy/term/4?page=16
[41] http://www.hcfo.org/taxonomy/term/4?page=19
[42] http://www.hcfo.org/taxonomy/term/4?page=20
[43] http://www.hcfo.org/taxonomy/term/4?page=21
[44] http://www.hcfo.org/taxonomy/term/4?page=22
[45] http://www.hcfo.org/taxonomy/term/4?page=48