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The Roger C. Lipitz Center for Integrated Health Care

Keyword: costs and spending

Are Transplant Centers That Meet Insurer Minimum Volume Requirements Better Quality?

A study by Lauren Hersch Nicholas and Sarah See Stith in Medical Care Research and Review tests whether private insurers’ use of volume requirements for kidney transplant centers improve patient outcomes. The researchers used an instrumental variables approach to show that minimum volume requirements in kidney transplantation do not reduce post-transplant mortality. Findings from this paper suggest that volume requirements are not a useful proxy measure for quality and that restricting the number of hospitals from which patients can receive care could reduce access to necessary health care services....Read More

Affording Genetic Therapies in the Medicaid Program

A study by Jeromie Ballreich, Ijeamaka Ezebilo, and Joshua Sharfstein in JAMA Pediatrics explores potential solutions to the challenge of the high cost of genetic therapies and other specialty drugs for diseases of childhood. Findings suggest a pooled subscription model negotiated across therapies and Medicaid programs may allow manufacturers to focus on the cooperation necessary for the administration of these complex therapies and help achieve the shared public and private goal of assuring access to care. 

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Older Americans' Preferences Between Lower Drug Prices and Prescription Drug Plan Choice, 2019

A study by Mariana Socal and Gerard Anderson in the American Journal of Public Health examines whether older adults would be willing to trade greater choice of drug prescription plans in exchange for lower drug prices. Study findings indicate that older adults prefer lower spending over prescription plan choice, and that this association is stronger among older adults in worse health, with lower education, and lower income. ...Read More

Association between treatment by Fraud and Abuse Perpetrators and Health Outcomes Among Medicare Beneficiaries

Study by Lauren Nicholas, Caroline Hanson, Jodi Segal, and Matthew Eisenberg examines the relationship between health outcomes of Medicare beneficiaries who are treated by healthcare providers with a record of fraud and abuse in their practice. Findings show higher likelihood of emergency hospitalization and mortality in adults who receive care from these perpetrators compared to other Medicare beneficiaries who receive care from healthcare providers without record of fraud and abuse. The worsened health outcomes among one group of Medicare beneficiaries in relationship to the standing of their healthcare provider has great implications on future work regarding both cost minimization and promoting healthier outcomes in the Medicare system. ...Read More

The Financial Hardship Faced by Older Americans Needing Long-Term Services and Supports.

Many older Americans in the Medicare program are at risk of incurring substantial costs from long-term services and supports (LTSS). An issue brief by Amber Willink, Karen Davis, John Mulcahy, Jennifer Wolff, and Judith Kasper using data from the National Health and Aging Trends Study (NHATS) analyzed medical and LTSS spending among older Medicare beneficiaries and the ways those costs are met. Findings suggest beneficiaries with high LTSS needs have higher Medicare and out-of-pocket spending, more medically-related credit card debt, and report trouble paying for food, rent, utilities, medical care, and prescription drugs....Read More

Are Older Americans Getting the Long-Term Services and Supports They Need?

With the recent passage of the Bipartisan Budget Act of 2018 (BBA), Medicare Advantage plans can now provide non-medical benefits such as long-term services and supports (LTSS). However, traditional Medicare does not cover LTSS, which individuals and their families typically pay for out-of-pocket. A study examines the LTSS usage patterns and characteristics of Medicare beneficiaries aged 65+ living in the community. Findings indicate two-thirds of older adults living in the community report using some degree of LTSS, suggesting they might benefit from broader coverage of LTSS in the Medicare program....Read More

Using Credit Scores to Understand Predictors and Consequences of Disease

Credit scores may serve as proxies for social and economic factors that are on the causal pathway between individual psychobehavioral characteristics and health. Study finds consumer credit may offer a promising measure for advancing public health research, but must be considered in the context of health equity to avoid reinforcing health disparities....Read More