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Corrigendum.
Authors: Abstract [This corrects the article DOI: 10.5600/mmrr.004.04.a02.]. PMID: 25639538 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - December 16, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Emergency department utilization in the Texas Medicaid emergency waiver following Hurricane Katrina.
CONCLUSIONS: As very little is known about Medicaid emergency waivers, our analysis may provide important information to policymakers who have to react quickly following a disaster. Our findings may help providers estimate potential increases in ED utilization and prepare for relatively common diagnoses. Furthermore, the analysis across racial/ethnic groups may help government officials identify important areas for outreach among vulnerable populations. PMID: 24800134 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Methodological issues in using multiple years of the medicare current beneficiary survey.
CONCLUSION: There is a variety of methodological approaches when using multiple years of the MCBS, and some of them provide biased results. Research needs to improve in describing the methods and preferred approaches for using these complex data. PMID: 24800135 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Effect of cost-sharing reductions on preventive service use among Medicare fee-for-service beneficiaries.
CONCLUSIONS: Elimination of cost sharing may be an effective strategy for increasing preventive service use, but the impact could depend on the characteristics of the procedure, its cost, and the disease and populations it targets. These historical findings suggest that, with implementation of Section 4104, the greatest increases in utilization will be seen for preventive services that screen for diseases with high incidence or prevalence rates that increase with age, that are expensive, and that are performed on a frequent basis. PMID: 24800136 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Medicare managed care plan performance: a comparison across hospitalization types.
CONCLUSION: While MA plans were associated with reductions in preventable hospitalizations in all three states, the effects on referral-sensitive admissions varied, with California experiencing lower relative risk of referral-sensitive admissions for MA plan enrollees. The lower relative risk of preventable admissions for MA plan enrollees in New York and Florida became more pronounced after accounting for selection bias. PMID: 24800137 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Assessing measurement error in Medicare coverage from the national health interview survey.
CONCLUSIONS: Increased accuracy of the Medicare coverage status of NHIS participants was achieved with the Medicare probe question. Though some misclassification remains, data users interested in Medicare coverage as an outcome or correlate can use this survey measure with confidence. PMID: 24800138 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Cancer outcomes in low-income elders: is there an advantage to being on Medicaid?
CONCLUSION: Enrollment of low-income Medicare beneficiaries in Medicaid is not associated with favorable treatment patterns or survival outcomes. Differences in health and functional status between community-dwelling duals and non-duals might help explain the observed disparities. PMID: 24800139 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Wisconsin's experience with Medicaid auto-enrollment: lessons for other states.
Authors: DeLeire T, Leininger L, Dague L, Mok S, Friedsam D Abstract The Patient Protection and Affordable Care Act (ACA) relies heavily on the expansion of Medicaid eligibility to cover uninsured populations. In February 2008, Wisconsin expanded and reformed its Medicaid/CHIP program and, as part of program implementation, automatically enrolled a set of newly eligible parents and children. This process of "auto-enrollment" targeted newly eligible parents and older children whose children/siblings were already enrolled in the state's Medicaid/CHIP program. Auto-enrollment brought over 44,000 individuals i...
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Enhancing Medicare's hospital-acquired conditions policy to encompass readmissions.
CONCLUSIONS: Limiting the current HAC policy focus to complications identified during the index admission omits consideration of many complications only identified in a subsequent admission. Non-payment for HAC-related readmissions would enhance incentives for prevention by increasing the frequency with which hospitals are held accountable for HACs. PMID: 24800141 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Financial performance of health plans in Medicaid managed care.
This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly traded, and provider-sponsored. DATA AND METHODS: National Association of Insurance Commissioners (NAIC) financial data, coupled with selected state financial data, were analyzed for 170 Medicaid health plans for 2009. A mean test compared the mean values for medical loss, administrative cost, and operating margin ratios across these plan traits. Medicaid dominant plans are plans with 75 percent of their total enrollment in the Medicaid line of business. ...
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

The national market for Medicare clinical laboratory testing: implications for payment reform.
Authors: Gass Kandilov AM, Pope GC, Kautter J, Healy D Abstract Current Medicare payment policy for outpatient laboratory services is outdated. Future reforms, such as competitive bidding, should consider the characteristics of the laboratory market. To inform payment policy, we analyzed the structure of the national market for Medicare Part B clinical laboratory testing, using a 5-percent sample of 2006 Medicare claims data. The independent laboratory market is dominated by two firms--Quest Diagnostics and Laboratory Corporation of America. The hospital outreach market is not as concentrated as the indepe...
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Applying the 2003 beers update to elderly Medicare enrollees in the Part D program.
CONCLUSIONS: Part D data can be successfully used to monitor Beers drug use. With adjustments for several important and easily measured demographic, health, and prescription drug use covariates, Beers drug use appears to be as common among non-dual enrollees as it is among dual enrollees in the Part D program. New Part D drug utilization policies that apply to all beneficiaries may need to be enacted to reduce Beers drug use. PMID: 24800144 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Evaluating comorbidity scores based on health service expenditures.
CONCLUSIONS: Relatively simple models provide quite adequate discrimination compared to more sophisticated models. Our proposed and more sophisticated model, which added in expenditure information, did not perform as well as much more easily executed methods. PMID: 24800145 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Volume of home- and community-based services and time to nursing-home placement.
CONCLUSIONS: Future policies and practices that are focused on optimizing long-term care outcomes should consider that a greater volume of HCBS for an individual is associated with reduced risk of nursing-home placement. PMID: 24800146 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research

Linkages between utilization of prostate surgical pathology services and physician self-referral.
CONCLUSIONS: The findings show that urologist self-referral of prostate surgical pathology services results in increased utilization and higher Medicare spending. The results suggest that exceptions in federal and state self-referral prohibitions need to be reevaluated. PMID: 24800147 [PubMed - in process] (Source: Medicare and Medicaid Research Review)
Source: Medicare and Medicaid Research Review - June 3, 2015 Category: Health Management Tags: Medicare Medicaid Res Rev Source Type: research