Medicare

Perspectives of Physicians in Small Rural Practices on the Medicare Quality Payment Program

The objectives of this research effort were to collect feedback through interviews with physicians in small rural practices on the initial implementation of Medicare’s Quality Payment Program in 2017, a new value-based purchasing program for Medicare physicians. RAND's findings suggest that small rural practices are struggling to participate in

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Analysis of the Joint Distribution of Disproportionate Share Hospital Payments. Appendix E. Federal Support for Uncompensated Care Costs Incurred by Ambulatory Care Providers

Overview

Analysis of the Joint Distribution of Disproportionate Share Hospital Payments. Appendix D. Simulation Results from Three State Analysis

Analysis of the Joint Distribution of Disproportionate Share Hospital Payments. Appendix C. Summary of Financial Indicators by Hospital Class

Analysis of the Joint Distribution of Disproportionate Share Hospital Payments. Appendix B. Additional Tables on the Current Distribution of DSH Payments

Analysis of the Joint Distribution of Disproportionate Share Hospital Payments. Appendix A. Technical Documentation for Estimating DSH Payments

Data Sources Used to Estimate Medicare Payments

Analysis of the Joint Distribution of Disproportionate Share Hospital Payments. Appendices

Are Homeless Families Connected to the Social Safety Net?

New analysis of data from HUD's Family Options Study of families' experiences in shelter and 20 months later shows that families experiencing homelessness are generally connected to public benefits at similar rates to other families in deep poverty. This non-experimental analysis finds that homeless families receive TANF, publicly funded health i

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Health Care Spending Growth and Federal Policy

In this Issue Brief, we examine spending growth through 2014, the first year the Affordable Care Act’s coverage provisions were in effect, and 2015, where possible. We provide detailed cost growth trends for Medicare and the private insurance market. We also estimate the effect of recently introduced specialty drugs on current and future spendin

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Medicare Part B Drugs: Pricing and Incentives

Medicare Part B covers infusible and injectable drugs and biologics administered in physician offices and hospital outpatient departments; as well as certain other drugs required by law provided by suppliers such as pharmacies The Part B payment method provides weak incentives for physicians to consider value – that is choose the lowest cost the

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Examining Post Acute Care Relationships in an Integrated Hospital System. Footnotes

1 Medicare Benefit Policy Manual, Chapter 3 Duration of Covered Inpatient Services. 2 Medicare Benefit Policy Manual, Chapter 7 Home Health Services. 3 An index hospitalization is an acute hospitalization with a prior 60-day clean period. In the prior 60 days, no acute or post-acute (IRF, LTCH, SNF, HHA, outpatient therapy) services were

Examining Post Acute Care Relationships in an Integrated Hospital System. Appendix B

Table B-1. Utilization 1 and Payment, by Claim Type, by DRG and APR-DRG Severity Index 2 , for Live Discharges, 2005 APR-DRG Severity of Illness Level DRG N % with Claim Mean Use Mean Payment N

Examining Post Acute Care Relationships in an Integrated Hospital System. Appendix A

HHC Label HCC1 HIV/AIDS HCC2 Septicemia/Shock HCC5 Opportunistic Infections HCC7 Metastatic Cancer and Acute Leukemia HCC8 Lung, Upper Digestive Tract, and Other Severe Cancers

Examining Post Acute Care Relationships in an Integrated Hospital System. 5. References

Berenson, R. 2004. The Medicare Chronic Improvement Program. Retrieved August 2008 from http://www.urban.org/publications/900714.html Buntin MB, AD Garten, S Paddock, D Saliba, M Totten, and JJ Escarce. 2005. How much is postacute care use affected by its availability? Health Serv. Res., 40(2): 413-34. CDC (Centers for Disease Control and P

Examining Post Acute Care Relationships in an Integrated Hospital System. 4.2 Next Steps

The results of the current work will feed directly in to work we will be completing as part of a contract modification. The additional work will include use of the CCW data to identify the presence of chronic conditions in beneficiaries in our 2006 episode file. Similar to some of the analyses presented in this report, we will look at the patterns

Examining Post Acute Care Relationships in an Integrated Hospital System. 4.1 Implications of the Findings

These analyses provide important information for understanding who uses PAC services, how their likelihood of using them differs by certain characteristics, and which factors are most important in predicting hospital length of stay, probability of PAC use, relative probability of PAC site of care choices, hospital readmission rates, and average ep

Examining Post Acute Care Relationships in an Integrated Hospital System. 4. Discussion

Examining Post Acute Care Relationships in an Integrated Hospital System. 3.9.5 Ordinary Least Squares Regression Predicting Post-Acute Care Episode Payment

In the regression predicting PAC episode payments, increasing severity is associated with increases in episode payments. For example, in the model using MS-DRG severity measures and HCCs (Set 3, Table 3-27 ), beneficiaries with MS-DRG w/MCC have $6,313 higher episode payments compared to beneficiaries in the lowest severity level.

Examining Post Acute Care Relationships in an Integrated Hospital System. 3.9.4 Binomial Logit Regression Predicting Readmission During Post-Acute Care Episodes

As in the other models, severity is an important predictor of acute hospital readmission during PAC episodes. The odds of readmission increase with increasing severity. In the binomial logit model using both the MS-DRG severity measures and the HCCs (Set 3, Table 3-27 ), the odds of readmission for beneficiaries with MS-DRG w/MCC are 1.4 times t

Examining Post Acute Care Relationships in an Integrated Hospital System. 3.9.3 Multinomial Logit Predicting First Site of Post-Acute Care

The effect of severity on first site of PAC demonstrates that the odds of discharge to IRFs, LTCHs, and SNFs are much higher compared to the odds of discharge to hospital outpatient therapy or home health for beneficiaries of higher severity. For example, in the multinomial model run using the APR-DRG severity measures (Set 1, Table 3-24 ), the

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