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Social and Behavioral Sciences Commons™
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Articles 1 - 8 of 8
Full-Text Articles in Social and Behavioral Sciences
Effects Of Medicare Payment Reform: Evidence From The Home Health Interim And Prospective Payment Systems, Peter Huckfeldt, Neeraj Sood, Jose Escarce, David Grabowski, Joseph Newhouse
Effects Of Medicare Payment Reform: Evidence From The Home Health Interim And Prospective Payment Systems, Peter Huckfeldt, Neeraj Sood, Jose Escarce, David Grabowski, Joseph Newhouse
Peter J. Huckfeldt
Medicare continues to implement payment reforms that shift reimbursement from fee-for-service towards episode-based payment, affecting average and marginal reimbursement. We contrast the effects of two reforms for home health agencies. The Home Health Interim Payment System in 1997 lowered both types of reimbursement; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The Home Health Prospective Payment System in 2000 raised average but lowered marginal reimbursement with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality.
Price-Shopping In Consumer Directed Health Plans, Neeraj Sood, Zach Wagner, Peter Huckfeldt, Amelia Haviland
Price-Shopping In Consumer Directed Health Plans, Neeraj Sood, Zach Wagner, Peter Huckfeldt, Amelia Haviland
Peter J. Huckfeldt
No abstract provided.
The Effect Of Prospective Payment On Admission And Treatment Policy: Evidence From Inpatient Rehabilitation Facilities, Neeraj Sood, Peter Huckfeldt, David Grabowski, Joe Newhouse, Jose Escarce
The Effect Of Prospective Payment On Admission And Treatment Policy: Evidence From Inpatient Rehabilitation Facilities, Neeraj Sood, Peter Huckfeldt, David Grabowski, Joe Newhouse, Jose Escarce
Peter J. Huckfeldt
We examine provider responses to the Medicare inpatient rehabilitation facility (IRF) prospective payment system (PPS), which simultaneously reduced marginal reimbursement and increased average reimbursement. IRFs could respond to the PPS by changing the number of patients admitted, admitting different types of patients, or changing the intensity of care. We use Medicare claims data to separately estimate each type of provider response. We also examine changes in patient outcomes and spillover effects on other post-acute care providers. We find that costs of care initially fell following the PPS, which we attribute to changes in treatment decisions rather than the characteristics of …
Medicare Payment Reform And Provider Entry And Exit, Peter Huckfeldt, Neeraj Sood, John Romley, Alessandro Malchiodi, Jose Escarce
Medicare Payment Reform And Provider Entry And Exit, Peter Huckfeldt, Neeraj Sood, John Romley, Alessandro Malchiodi, Jose Escarce
Peter J. Huckfeldt
Objective. To understand the impacts of Medicare payment reform on the entry and exit of post-acute providers. Data Sources. Medicare Provider of Services data, Cost Reports, and Census data from 1991 through 2010. Study Design. We examined market-level changes in entry and exit after payment reforms relative to a preexisting time trend. We also compared changes in high Medicare share markets relative to lower Medicare share markets and for freestanding relative to hospital-based facilities. Data Extraction Methods. We calculated market-level entry, exit, and total stock of home health agencies, skilled nursing facilities, and inpatient rehabilitation facilities from Provider of Services …
Quantifying The Value Of Personalized Medicines: Evidence From Cox-2 Inhibitors, Neeraj Sood, Tomas Philipson, Peter Huckfeldt
Quantifying The Value Of Personalized Medicines: Evidence From Cox-2 Inhibitors, Neeraj Sood, Tomas Philipson, Peter Huckfeldt
Peter J. Huckfeldt
No abstract provided.
Diabetes Management For Low-Income Patients In Los Angeles: Two Strategies Improved Disease Control In The Short Term, Peter Huckfeldt, Daniella Meeker, Anne Peters, Jeffrey Guterman, Guillermo Diaz, Dana Goldman
Diabetes Management For Low-Income Patients In Los Angeles: Two Strategies Improved Disease Control In The Short Term, Peter Huckfeldt, Daniella Meeker, Anne Peters, Jeffrey Guterman, Guillermo Diaz, Dana Goldman
Peter J. Huckfeldt
Health care providers serving vulnerable patients in Los Angeles have developed programs intended to increase diabetes control through more-intensive patient education and engagement. We examined two programs, the first using a short-term intensive intervention by a care team including nurses and a specialist, and the second integrating case management and clinical pharmacy programs into primary care in a community clinic. We show evidence that both models improved short-term disease control, as measured by reductions in HbA1c and low-density lipoprotein (sometimes referred to as “bad” cholesterol). However, integrating case management and clinical pharmacy programs into a primary care setting was less …
Medicare’S Bundled Payment Pilot For Acute And Postacute Care: Analysis And Recommendations On Where To Begin, Neeraj Sood, Peter Huckfeldt, Jose Escarce, David Grabowski, Joseph Newhouse
Medicare’S Bundled Payment Pilot For Acute And Postacute Care: Analysis And Recommendations On Where To Begin, Neeraj Sood, Peter Huckfeldt, Jose Escarce, David Grabowski, Joseph Newhouse
Peter J. Huckfeldt
In the National Pilot Program on Payment Bundling, a subset of Medicare providers will receive a single payment for an episode of acute care in a hospital, followed by postacute care in a skilled nursing or rehabilitation facility, the patient’s home, or other appropriate setting. This article examines the promises and pitfalls of bundled payments and addresses two important design decisions for the pilot: which conditions to include, and how long an episode should be. Our analysis of Medicare data found that hip fracture and joint replacement are good conditions to include in the pilot because they exhibit strong potential …
Pharmaceutical Use Following Generic Entry: Paying Less And Buying Less, Peter Huckfeldt, Christopher Knittel
Pharmaceutical Use Following Generic Entry: Paying Less And Buying Less, Peter Huckfeldt, Christopher Knittel
Peter J. Huckfeldt
We study the effects of generic entry on prices and utilization using both event study models that exploit the differential timing of generic entry across drug molecules and cast studies. Our analysis examines drugs treating hypertension, high blood pressure, type 2 diabetes, and depression using price and utilization data from the Medical Expenditure Panel Survey. We find that utilization of drug molecules starts decreasing in the two years prior to generic entry and continues to decrease in the years following generic entry, despite decreases in prices offered by generic versions of a drug. This decrease coincides with the market entry …