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The Roger C. Lipitz Center for Integrated Health Care

Keyword: medicare

Unmet family caregiver training needs associated with acute care utilization during home health care

In a new Journal of the American Geriatrics Society study supported by the T32 Training Program in Health Service and Outcomes Research for Aging Populations grant, first author Julia Burgdorf found that unmet training needs among family caregivers are associated with greater likelihood of acute care utilization among Medicare beneficiaries receiving home health care. Rates of unmet need for training varied by activity, from 8.2% of family caregivers assisting with household chores to 16.0% assisting with self-care tasks. Investigators suggest that identifying and addressing family caregivers' training needs may reduce older adults' risk of acute care utilization during home health care. 

Family Caregiver Training Needs and Medicare Home Health Visit Utilization

A study led by Julia Burgdorf, and co-authors Elizabeth Stuart, Alicia Arbaje, and Jennifer Wolff in Medical Care found that family caregivers' activity-specific training needs may affect home health visit utilization. The researchers analyzed data from participants receiving Medicare-funded home health between 2011 and 2016 using linked National Health and Aging Trends Study (NHATS), Outcomes and Assessment Information Set (OASIS), and Medicare claims data. Key findings included that receipt of nursing visits was more likely when family caregivers had an identified need for training related to medication management or household chores and receipt of therapy visits was more likely when caregivers had an identified need for training related to self-care tasks. 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

Older Adult Factors Associated With Identified Need for Family Caregiver Assistance During Home Health Care

A study led by doctoral student Julia Burgdorf with Alicia Arbaje and Jennifer Wolff in Home Health Care Management & Practice analyzes the role of family caregivers during Medicare home health visits. The Centers for Medicare and Medicaid Services (CMS) recently enacted a policy that requires home health providers to assess family caregivers’ abilities and offer training and education. The study finds nearly 9 in 10 Medicare beneficiaries receiving home health care require family caregiver assistance in addition to care from home health care: the majority require assistance with 5 or more health care activities. Study findings support calls to develop training interventions and strengthen the partnership between home health providers and family caregivers. ...Read More

Measuring Nonprofit Hospitals' Provision of Charity Care Using IRS and CMS Data

We explore whether nonprofit hospitals report similar amounts of charity care to the Internal Revenue Service (IRS) and Centers for Medicare & Medicaid Services (CMS). We use nonprofit hospitals’ financial reports to the IRS and the CMS Medicare costs report for 2011 and 2012. In 2012, hospitals reported spending 7.6% more in charity care to the IRS than to CMS: 2.54% of revenues ($5.74 million per hospital) to the IRS versus 2.36% ($5.16 million) to CMS. While the averages are close, there are wide discrepancies for individual hospitals. For example, despite efforts for standardization, 80% of hospitals reported charity care to the CMS that was 40% greater in absolute value than what they reported to the IRS, and only 10% of hospitals reported charity care to CMS that was within 20% of what they reported to the IRS. Our findings suggest that individual hospitals routinely report different amounts of charity care to the IRS and CMS, yet we find relatively few hospital or market characteristics that may explain these differences....Read More

Concentration of Physician Services Across Insurers and Effects on Quality: Early Evidence From Medicare Advantage.

The percentage of Medicare enrollees covered by private insurers through Medicare Advantage (MA) has grown from 17% in 2000 to 33% in 2017. Over this period, research has shown that MA plans tend to provide lower-cost care compared with traditional Medicare (TM), due to both lower utilization and lower prices....Read More

Financial Eligibility Criteria and Medication Coverage for Independent Charity Patient Assistance Programs.

Independent charity patient assistance programs have grown rapidly since the enactment of the Medicare Modernization Act of 2003, which became effective in 2006. Between 2007 and 2016, the total amount of patient assistance granted by the 5 largest independent charities increased by 588%. Independent charity patient assistance programs must observe legal constraints on their program design and distribution of funds, and remain independent regardless of the source of their revenue....Read More

Air Ambulances With Sky-High Charges.

Health care providers have full discretion to determine the amount they charge, and high charges have the potential to impose financial burdens on uninsured and out-of-network patients. High charges are common for emergency services, where patients have few options to choose providers and thus are likely to be treated by out-of-network providers and billed the full charge amount....Read More

Redesigning Medicare to Work for Everyone

Medicare is a pillar of the U.S. health insurance system. But with no ceiling on out-of-pocket costs for covered benefits, a high deductible for hospital episodes, and exclusion of needed costly benefits such as dental, vision, and hearing care as well as personal care aides for the disabled, Medicare leaves its enrollees exposed to burdensome health costs unless they buy expensive supplemental coverage....Read More