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Full-Text Articles in Health Policy
Financial Alignment Initiative: New York Fully Integrated Duals Advantage For Individuals With Intellectual And Developmental Disabilities: Preliminary Third Evaluation Report, Kimberly I. Snow Mhsa, Elizabeth Gattine Jd, Amy Kandilow Phd, Matthew Toth Phd, Amy Chepaitis Phd
Financial Alignment Initiative: New York Fully Integrated Duals Advantage For Individuals With Intellectual And Developmental Disabilities: Preliminary Third Evaluation Report, Kimberly I. Snow Mhsa, Elizabeth Gattine Jd, Amy Kandilow Phd, Matthew Toth Phd, Amy Chepaitis Phd
Disability & Aging
The New York FIDA-IDD demonstration was launched in 2016 in nine downstate counties and was the first comprehensive managed care demonstration exclusively serving individuals with intellectual and developmental disabilities (IDD) in the nation. Due at least in part to a lack of provider participation, less than 8 percent of eligible beneficiaries enrolled. Beneficiaries who did enroll reported high levels of satisfaction, especially with care coordination and the ease of obtaining durable medical equipment. The MedicareMedicaid Plan’s (MMP) assessment and care coordination model provided person-centered care planning that identified goals and helped to achieve them, improving enrollees’ quality of life. The …
Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph
Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph
Access / Insurance
The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:
- socioeconomic and health characteristics that may inform health care use;
- trends in health care use, including use of inpatient and emergency department (ED) care; …
Health Care Use And Access Among Rural And Urban Nonelderly Adult Medicare Beneficiaries, Erika C. Ziller Phd, Amanda Burgess Mppm, Deborah Thayer Mba
Health Care Use And Access Among Rural And Urban Nonelderly Adult Medicare Beneficiaries, Erika C. Ziller Phd, Amanda Burgess Mppm, Deborah Thayer Mba
Access / Insurance
Little is known about the characteristics and health care use of rural residents with disabilities. Using the Medicare Current Beneficiary Survey (2009-2013), we compared access to and use of health services among rural and urban nonelderly Medicare beneficiaries with a disability, and examined their health and functional status along with sociodemographic characteristics. We found that the characteristics of nonelderly Medicare beneficiaries with a disability reflected the differences observed between rural and urban populations overall: rural recipients were more likely than their urban peers to be older, non-Hispanic white, and have a lower level of educational attainment. Although self-reported access to …
Rural Health Clinic Costs And Medicare Reimbursement, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd
Rural Health Clinic Costs And Medicare Reimbursement, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd
Rural Health Clinics
The Rural Health Clinic (RHC) Program is one of the nation’s oldest rural primary care programs. A key feature of the RHC Program is Medicare and Medicaid volume-appropriate, cost-based reimbursement, which is designed to sustain these vulnerable rural primary care providers. Medicare currently pays RHCs for the lesser of reasonable costs (expressed as an adjusted cost per visit) for a defined package of RHC services or a per-visit reimbursement cap, from which provider-based RHCs owned by hospitals with fewer than 50 beds are exempt. Although the per-visit cap is updated periodically, RHC administrators, policymakers, and stakeholders question whether the updates …
The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd
The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd
Disability & Aging
This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.
Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.
Searching For The Fulcrum: Can Accountable Care Organizations Lower Spending By Balancing Specialists-To-Primary Care Providers?, Vishal Shetty
Searching For The Fulcrum: Can Accountable Care Organizations Lower Spending By Balancing Specialists-To-Primary Care Providers?, Vishal Shetty
Masters Theses
Background:
While value-based payment models emphasizing care coordination have been widely implemented to improve quality and lower expenditures, supporting empirical evidence is sparse. Our objective was to quantify the impact of specialist-to-primary care physician involvement within accountable care organization (ACO) and its association with lower spending.
Methods:
We conducted a retrospective cohort study of Medicare Shared Savings Program ACOs from 2012-2016 using publicly available data provided by the Centers for Medicare and Medicaid Services at the ACO level. We examined the association between the proportion of primary care services delivered by specialists versus other types of care providers and ACO …
Healthcare Utilization & Health Behaviors Among Older Adults: The Role Of Insurance, Jennifer Rose Geiger
Healthcare Utilization & Health Behaviors Among Older Adults: The Role Of Insurance, Jennifer Rose Geiger
LSU Doctoral Dissertations
As the population of older adults in the U.S. continues its exponential growth, so too will the need for high-quality health and preventive services. Despite the widely acknowledged need for proactive solutions to the coming public health challenges for this rapidly expanding age cohort, healthcare providers and social work practitioners continue to lack the proper education training to serve the needs of older adults. Furthermore, these allied health professionals also frequently engage in ageist behaviors across care settings that also often employ institutionally ageist policies and procedures. As a result, older adults may be particularly at risk of negative health …
Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah T. Croll Mph, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd
Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah T. Croll Mph, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd
Long Term Services and Supports
The aging of the baby boom generation is projected to dramatically increase the population aged 65 and older in the coming decades. In particular, those aged 85 and older (the ‘oldest old’) are expanding at a faster rate than any other age group and by 2050 are expected to make up 4.5 percent of the population, compared to 1.9 percent in 2012. Faster growth in the percentage of older people (65+) in rural than in urban areas is likely to challenge the healthcare and long term services and supports (LTSS) capacity in many rural communities.
This study used Medicare Current …
Rural Disabled Medicare Beneficiaries Spend More Out-Of-Pocket Than Their Urban Counterparts, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Rural Disabled Medicare Beneficiaries Spend More Out-Of-Pocket Than Their Urban Counterparts, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Access / Insurance
The majority of Medicare beneficiaries experience gaps between the care they need and costs covered by Medicare and seek supplemental coverage to meet this gap, including private plans offered by former employers or purchased individually, or public coverage through Medicaid. Since rural beneficiaries are more likely to purchase supplemental indemnity coverage individually, to participate in Medicaid, or to go without supplemental coverage altogether, it is likely that their out-of-pocket spending differs from that of urban residents, although the magnitude and direction of these differences may vary for individual beneficiaries. This study used data from the 2006-2010 Medical Expenditure Panel Survey …
Policy Issues Affecting Maine’S Hospitals, John A. Gale Ms, Jennifer D. Lenardson Mhs
Policy Issues Affecting Maine’S Hospitals, John A. Gale Ms, Jennifer D. Lenardson Mhs
Rural Hospitals (Flex Program)
Legislators and other policymakers will be continually challenged to balance the needs of hospitals for appropriate reimbursement and oversight with supporting their provision of important services to local communities.