Findings Brief

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HCFO Findings Brief: Pay-for-Performance Programs to Reduce Racial/Ethnic Disparities: Limitations of a One-Size-Fits-All Approach

May 2012
HCFO

Pay-for-performance (P4P) programs are broadly defined as performance-based payment arrangements that are designed to promote improvement in health care quality while reducing costs. Often absent in the equation is the issue of disparities. Racial and ethnic disparities in health care persist, and some believe that P4P programs have the potential to exacerbate such inequities in the quality of care received by minority patients.In an HCFO-funded study, Joel S.

Topic: 
Acute Care

HCFO Findings Brief: The Effect of Health Information Technology on Quality in U.S. Hospitals

April 2012
HCFO

Mistakes in the clinical setting are responsible for an estimated $17 billion of direct costs annually to the health care system.Proponents of health information technology (HIT) believe tools like electronic health records (EHRs) and computerized physician order entry (CPOE) could help reduce these errors and related costs by improving communication between providers and encouraging the implementation of standard guidelines and decision-support tools.In a HCFO-funded study, Jeffrey McCullough, Ph.D., University of Minnesota, and colleagues measured the quality and cost effects of clinical

HCFO Findings Brief: Time Is Money: Outpatient Waiting Times and Health Insurance Choices of Elderly Veterans in the United States

Vol. XV, No. 2
March 2012
HCFO

Waiting times are a means to balance supply and demand when prices are fixed at levels that are too low to serve this balancing function. Outside of the United States, patients seeking outpatient care or elective surgery face substantial waiting times for these services. In contrast, the United States, has had relatively short wait times, due to higher health care prices and because a significant fraction of the population lacks health insurance (which reduces demand).

HCFO Findings Brief: Trends in Retail Clinic Use Among the Commercially Insured

Vol. XV, No. 1
February 2012
HCFO

Retail clinics, such as CVS’s Minute Clinics or Walgreen’s TakeCare Clinics, deliver health care that is often less expensive and is available on a drop-in basis as well as in the evening and on weekends. In a HCFO-funded study, researchers led by Ateev Mehrotra, M.D., and J. Scott Ashwood examined how retail clinics are used, what types of patients are likely to utilize their services, and whether a shortage of primary care in a community was associated with greater retail clinic use.

HCFO Findings Brief: Undocumented Immigrants, Left Out of Health Reform, Likely to Continue to Grow as a Share of the Uninsured

Vol. XIV, No. 9
December 2011
HCFO

The issue of health care coverage for undocumented immigrants is complex and politically challenging. Although the flow of undocumented immigrants has slowed in recent years, due in part to the economic recession, they remain an important population for the health policy debate. In a HCFO-funded study, Stephen Zuckerman, Ph.D, Timothy Waidmann, Ph.D., and Emily Lawton of the Urban Institute examined the impact of the undocumented immigrant population on the U.S. health care system. The results of this study were published in the October 2011 issue of Health Affairs.

Compared to Canadians, U.S. Physicians Spend Nearly Four Times as Much Money Interacting with Payers

Vol. XIV No. 8
November 2011
HCFO

As policymakers continue to look for ways to bend the cost curve, many have pointed to the administrative costs of health care in the United States as one potential target for reform. Physicians’ interactions with health plans create an enormous cost burden on the system. In a HCFO funded study led by Lawrence Casalino at the University of Chicago (now at Cornell University), the research team used a survey of U.S. physicians and practice managers to develop a national estimate of the administrative costs for U.S.

Association Between Ambulance Diversion and Survival Among Patients with Acute Myocardial Infarction

Vol. XIV, No. 7
October 2011
HCFO

Emergency department (ED) crowding has become increasingly common in the United States. When EDs are overextended or lack the resources to treat different types of patients, they may initiate ambulance diversion, which temporarily closes the ED to ambulance traffic. For patients suffering from acute, time-sensitive conditions, diversion can cause delays in treatment and potentially worsen the the prognosis.

HCFO Findings Brief: The Individual and Program Impacts of Eliminating Medicaid Dental Benefits in the Oregon Health Plan

Vol. XIV, No. 6
September 2011
HCFO

Medicaid is the primary safety-net insurance system in the United States and covers approximately 60 million Americans. While Medicaid covers medical and long-term care, dental coverage is optional for adults. Due to the optional status of this benefit, it is often one of the first items eliminated when states experience budget shortfalls. In a HCFO-funded study, Neal Wallace, Ph.D., examined a change in Oregon’s Medicaid program that resulted in a natural experiment to explore the impacts of eliminating dental benefits on low-income adults.

HCFO Findings Brief: Consequences of SCHIP Expansions for Household Well-Being

Vol. XIV, No. 5
August 2011
HCFO

In 2008, approximately 7.4 million children in the United States received health insurance coverage through the State Children's Health Insurance Program (SCHIP). SCHIP coverage expansions and widening eligibility standards can lead to the substitution of private coverage for public insurance coverage, a phenomenon known as crowd-out. In a HCFO-funded study, Helen Levy, Ph.D., and her colleagues set out to explore whether the crowd-out effect of SCHIP could result in a financial windfall for families.

HCFO Findings Brief: Does Medication Adherence Lower Medicare Spending Among Beneficiaries with Diabetes?

July 2011
HCFO

Much of the research to date on the effects of medication adherence has focused on health outcomes and medical costs. Analyses of the studies examining the relationship between improved adherence and lower spending have suffered from methodological shortcomings, making findings somewhat controversial. HCFO-funded researcher, Bruce Stuart, Ph.D., University of Maryland at Baltimore, and colleagues designed a medication adherence study with an eye toward addressing prior methodological limitations.

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