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Full-Text Articles in Health Policy

Searching For The Fulcrum: Can Accountable Care Organizations Lower Spending By Balancing Specialists-To-Primary Care Providers?, Vishal Shetty Oct 2018

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 Jun 2018

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 …


Spillover Theory: Unintended Consequences Of Provisions In The Affordable Care Act, Robert T. Braun Jan 2018

Spillover Theory: Unintended Consequences Of Provisions In The Affordable Care Act, Robert T. Braun

Theses and Dissertations

Objective: To examine spillovers from a federal policy, managed care market, and community perspective.

Data Sources/Study Setting: We studied spillovers from a federal policy and managed care market perspective using the Health Care Utilization Project’s (HCUP) State Inpatient Database (SID). American Hospital Association (AHA) data, Interstudy Commercial Managed Care, and Area Health Resource File (AHRF). Medicare Advantage county-level payment schedules originate from CMS. We examined community uninsurance spillovers using 2011-2015 Medical Expenditure Panel Survey (MEPS), the Area Health Resource File (AHRF), and the Small Area Health Insurance Estimator (SAHIE).

Study Design: Ordinary Least Squares (OLS) and difference-in-difference regression analyses were …


Analyzing Charges And Payments Received For Discharged Patients At Teaching Hospitals In Relation To Patient Satisfaction And Overall Medicare Charges, Rob Sutter Jan 2015

Analyzing Charges And Payments Received For Discharged Patients At Teaching Hospitals In Relation To Patient Satisfaction And Overall Medicare Charges, Rob Sutter

MPA/MPP/MPFM Capstone Projects

The affordability of healthcare is a major, recurring topic in the media. One of President Obama’s cornerstone policies has been the attempt to make health care affordable. Part of the concern lies in cost differences for similar procedures. The cost for a standardized procedure such as abnormal cardiac dysrhythmia without complication varies greatly between hospitals. The cost difference of a patient getting treated for such an event can be an average of $30,000 depending on which hospital you go to. There is no immediately apparent reason for such a large difference. Another noticeable item is that all the hospitals receive …