Authors
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Provider-Owned Insurers in the Individual MarketProvider-owned insurers sell individual policies in areas that cover 62% of the US population and have premiums similar to policies of traditional insurers.
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Factors Associated With Timeliness in Academic General Surgery Clinics: A Prospective Quality AssessmentThe participation of residents and physician assistants significantly increased patient wait time without reducing the attending surgeon’s consultation length in outpatient surgery clinics.
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A Cost-Effectiveness Analysis of Cardiology eConsults for Medicaid PatientsA randomized trial of eConsults for cardiology referrals from primary care resulted in significant reductions in total cost of care compared with traditional face-to-face consultations.
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Examining Differential Performance of 3 Medical Home Recognition ProgramsWe examine utilization, quality, and expenditures among Medicare beneficiaries receiving care at federally qualified health centers and compare outcomes among those attributed to 1 of 3 recognition programs versus none.
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Low Screening and Follow-up for Unhealthy Alcohol Use Among Health Plan BeneficiariesScreening and follow-up for unhealthy alcohol use are low among plan members. Use of standardized screening tools, documentation, and care for alcohol misuse need improvement.
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Healthcare Reform With a Safety Net: Lessons From San FranciscoSan Francisco is attempting to expand health insurance coverage and access to care while also supporting its healthcare safety net.
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Factors Associated With Timeliness in Academic General Surgery Clinics: A Prospective Quality AssessmentThe participation of residents and physician assistants significantly increased patient wait time without reducing the attending surgeon’s consultation length in outpatient surgery clinics.
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Impact of Therapeutic Switching in Long-Term CareSwitching medications for nonmedical (formulary) reasons in long-term care settings may increase Medicare Part D resident adverse effects and raise facility downstream costs.
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ED-Based Care Coordination Reduces Costs for Frequent ED UsersResults of our pilot randomized controlled intervention involving emergency department (ED)-based care coordination and community health workers demonstrated a trend toward fewer ED visits, fewer hospitalizations, and lower costs among intervention patients.
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Dental Care Coverage TransitionsThis study examines dental insurance transition dynamics in the context of changing employment and retirement status.
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Bridges to Excellence—Recognizing High-Quality Care: Analysis of Physician Quality and Resource UsePhysicians recognized as high quality by Bridges to Excellence performed better than their peers on claimsbased quality measures and, in some cases, on resource use measures.
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Quality of Anticoagulation Control Among Patients With Atrial FibrillationPatients with atrial fibrillation receiving routine medical care within a large managed care organization were found to have suboptimal anticoagulation control.
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Cost Comparison of Peritoneal Dialysis Versus Hemodialysis in End-Stage Renal DiseasePatients with end-stage renal disease who began peritoneal dialysis had lower 1-year hospitalization rates and lower total healthcare costs than those who began therapy with hemodialysis.
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Creating Peer Groups for Assessing and Comparing Nursing Home PerformanceA methodologically sound, empirically based approach to creating peer groupings can and should be adapted to fit the setting of nursing homes.
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Using the Lessons of Behavioral Economics to Design More Effective Pay-for-Performance ProgramsThe authors describe several simple changes that health plans can make in the design of pay-for-performance programs that may improve their effectiveness.
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Medicare Inpatient and Postdischarge Outcomes of Elective Percutaneous Coronary InterventionsAn understanding of risk-adjusted outcomes for percutaneous coronary interventions for both inpatient and 90-day postdischarge events is necessary for the redesign of care outcomes.
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Geographic Variation in Surgical Outcomes and Cost Between the United States and JapanCompared with Japan, the United States has substantially less geographic variation in surgical outcomes, but it has higher variation in cost.
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Delivery System Performance as Financial Risk VariesOne delivery system’s healthcare utilization in its Medicare Advantage product was notably less than in its Pioneer accountable care organization or in a traditional Medicare comparison group.
