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https://www.readbyqxmd.com/read/29355927/early-impact-of-the-affordable-care-act-coverage-expansion-on-safety-net-hospital-inpatient-payer-mix-and-market-shares
#1
Vivian Y Wu, Kathryn R Fingar, H Joanna Jiang, Raynard Washington, Andrew W Mulcahy, Eli Cutler, Gary Pickens
OBJECTIVE: To examine the impact of the Affordable Care Act's coverage expansion on safety-net hospitals (SNHs). STUDY SETTING: Nine Medicaid expansion states. STUDY DESIGN: Differences-in-differences (DID) models compare payer-specific pre-post changes in inpatient stays of adults aged 19-64 years at SNHs and non-SNHs. DATA COLLECTION METHODS: 2013-2014 Healthcare Cost and Utilization Project State Inpatient Databases...
January 21, 2018: Health Services Research
https://www.readbyqxmd.com/read/29353559/what-should-health-insurance-cover-a-comparison-of-israeli-and-us-approaches-to-benefit-design-under-national-health-reform
#2
Rachel Nissanholtz Gannot, David P Chinitz, Sara Rosenbaum
What health insurance should cover and pay for represents one of the most complex questions in national health policy. Israel shares with the US reliance on a regulated insurance market and we compare the approaches of the two countries regarding determining health benefits. Based on review and analysis of literature, laws and policy in the United States and Israel. The Israeli experience consists of selection of a starting point for defining coverage; calculating the expected cost of covered benefits; and creating a mechanism for updating covered benefits within a defined budget...
January 22, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29351776/readmission-rates-in-not-for-profit-vs-proprietary-hospitals-before-and-after-the-hospital-readmission-reduction-program-implementation
#3
Lauren E Birmingham, Willie H Oglesby
BACKGROUND: The Patient Protection and Affordable Care Act established the Hospital Readmission Reduction Program (HRRP) to penalize hospitals with excessive 30-day hospital readmissions of Medicare enrollees for specific conditions. This policy was aimed at increasing the quality of care delivered to patients and decreasing the amount of money paid for potentially preventable hospital readmissions. While it has been established that the number of 30-day hospital readmissions decreased after program implementation, it is unknown whether this effect occurred equally between not-for-profit and proprietary hospitals...
January 19, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29350076/health-care-public-sector-share-and-the-u-s-life-expectancy-lag-a-country-level-longitudinal-study
#4
Megan M Reynolds
Growing research on the political economy of health has begun to emphasize sociopolitical influences on cross-national differences in population health above and beyond economic growth. While this research investigates the impact of overall public health spending as a share of GDP ("health care effort"), it has for the most part overlooked the distribution of health care spending across the public and private spheres ("public sector share"). I evaluate the relative contributions of health care effort, public sector share, and GDP to the large and growing disadvantage in U...
January 1, 2018: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/29347831/racial-ethnic-disparities-in-human-papillomavirus-vaccination-initiation-and-completion-among-u-s-women-in-the-post-affordable-care-act-era
#5
Madina Agénor, Ashley Pérez, Sarah M Peitzmeier, Sonya Borrero
OBJECTIVE: To ascertain the magnitude and potential mechanisms of racial/ethnic disparities in initiating and completing the 3-dose human papillomavirus (HPV) vaccine among U.S. women in the post-Affordable Care Act era. DESIGN: Using 2015 National Health Interview Survey data, we used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between race/ethnicity and HPV vaccination initiation and completion among black, Latina, Asian, and white U...
January 18, 2018: Ethnicity & Health
https://www.readbyqxmd.com/read/29346003/medicaid-expansion-and-infant-mortality-in-the-united-states
#6
Chintan B Bhatt, Consuelo M Beck-Sagué
OBJECTIVES: To explore the effect of Medicaid expansion on US infant mortality rate. METHODS: We examined data from 2010 to 2016 and 2014 to 2016 to compare infant mortality rates in states and Washington, DC, that accepted the Affordable Care Act Medicaid expansion (Medicaid expansion states) and states that did not (non-Medicaid expansion states), stratifying data by race/ethnicity. RESULTS: Mean infant mortality rate in non-Medicaid expansion states rose (6...
January 18, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29345995/the-effects-of-household-medical-expenditures-on-income-inequality-in-the-united-states
#7
Andrea S Christopher, David U Himmelstein, Steffie Woolhandler, Danny McCormick
OBJECTIVES: To assess the effect of households' outlays for medical expenditures on income inequality and changes since the implementation of the Affordable Care Act (ACA). METHODS: We analyzed data from the US Current Population Surveys for calendar years 2010 through 2014. We calculated the Gini index of income inequality before and after subtracting households' medical outlays (including insurance premiums and out-of-pocket costs) from income, the financial burden of medical outlays for each income decile, and the number of individuals pushed below poverty by medical outlays...
January 18, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29342379/elimination-of-cost-sharing-for-screening-mammography-in-medicare-advantage-plans
#8
Amal N Trivedi, Bryan Leyva, Yoojin Lee, Orestis A Panagiotou, Issa J Dahabreh
BACKGROUND: The Affordable Care Act (ACA) required most insurers and the Medicare program to eliminate cost sharing for screening mammography. METHODS: We conducted a difference-in-differences study of biennial screening mammography among 15,085 women 65 to 74 years of age in 24 Medicare Advantage plans that eliminated cost sharing to provide full coverage for screening mammography, as compared with 52,035 women in 48 matched control plans that had and maintained full coverage...
January 18, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29341413/effects-of-health-insurance-coverage-on-risky-behaviors
#9
Jungtaek Lee
Prior to implementation of the Patient Protection and Affordable Care Act, dependent health insurance coverage was typically available only for young adults under the age of 19. As of September 2010, the Affordable Care Act extended dependent health insurance coverage to include young adults up to the age of 26. I use the National Health Interview Survey for the sample period from 2011 to 2013 to analyze the causal relationship between the expansion of dependent coverage and risky behaviors including smoking and drinking as well as preventive care...
January 17, 2018: Health Economics
https://www.readbyqxmd.com/read/29336222/implementing-a-health-home-michigan-s-experience
#10
Jackie Prokop, Marie LaPres, Brad Barron, Jon Villasurda
As the number of individuals in the United States with chronic conditions and the associated costs in caring for these individuals continues to rise, there is a need to transform how health care services are delivered. Under Section 2703 of the Affordable Care Act of 2010, the federal government provides state Medicaid programs the opportunity to improve care coordination for people with chronic conditions in a person-centered approach through the establishment of health homes. Given the complexity of care for Medicaid beneficiaries with chronic conditions, addressing the social determinants of health and providing integrated care are central to effectively improving health outcomes and generating cost-savings...
January 1, 2018: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/29320288/policy-evaluation-with-incomplete-data-assessing-the-affordable-care-act-breastfeeding-provision
#11
Summer Sherburne Hawkins, Alice Noble, Christopher F Baum
No abstract text is available yet for this article.
February 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29309224/community-benefit-spending-by-tax-exempt-hospitals-changed-little-after-aca
#12
Gary J Young, Stephen Flaherty, E David Zepeda, Simone Rauscher Singh, Geri Rosen Cramer
Provisions of the Affordable Care Act (ACA) encouraged tax-exempt hospitals to invest broadly in community health benefits. Four years after the ACA's enactment, hospitals had increased their average spending for all community benefits by 0.5 percentage point, from 7.6 percent of their operating expenses in 2010 to 8.1 percent in 2014.
January 2018: Health Affairs
https://www.readbyqxmd.com/read/29309219/understanding-the-relationship-between-medicaid-expansions-and-hospital-closures
#13
Richard C Lindrooth, Marcelo C Perraillon, Rose Y Hardy, Gregory J Tung
Decisions by states about whether to expand Medicaid under the Affordable Care Act (ACA) have implications for hospitals' financial health. We hypothesized that Medicaid expansion of eligibility for childless adults prevents hospital closures because increased Medicaid coverage for previously uninsured people reduces uncompensated care expenditures and strengthens hospitals' financial position. We tested this hypothesis using data for the period 2008-16 on hospital closures and financial performance. We found that the ACA's Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of uninsured adults before Medicaid expansion...
January 2018: Health Affairs
https://www.readbyqxmd.com/read/29307258/choosing-the-best-and-scrambling-for-the-rest-hospital-nursing-home-relationships-and-admissions-to-post-acute-care
#14
Renée Shield, Ulrika Winblad, John McHugh, Emily Gadbois, Denise Tyler
OBJECTIVE: We explored post-Affordable Care Act hospital and skilled nursing facility (SNF) perspectives in discharge and admission practices. METHOD: Interviews were conducted with 138 administrative personnel in 16 hospitals and 25 SNFs in eight U.S. markets and qualitatively analyzed. RESULTS: Hospitals may use prior referral rates and patients' geographic proximity to SNFs to guide discharges. SNFs with higher hospital referral rates often use licensed nurses to screen patients to admit more preferred patients...
January 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29306992/health-and-welfare-of-women-and-child-survival-a-key-to-nation-building
#15
Meharban Singh
Health of women has a profound effect on the health and welfare of communities, countries and the world at large. A large number of social, economic, educational, political and religious dimensions impact the lives of girls and women with repercussions on their health and status in society and welfare of their children. It is a sad reality that a large number of children, adolescents and women worldwide have limited or no access to essential health care services, nutrition and education. Gender inequity and discrimination against girls cannot be bridged unless there are equal opportunities for healthcare and education for boys and girls...
January 6, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29306342/the-effects-of-competition-on-premiums-using-united-healthcare-s-2015-entry-into-affordable-care-act-s-marketplaces-as-an-instrumental-variable
#16
Cagdas Agirdas, Robert J Krebs, Masato Yano
One goal of the Affordable Care Act is to increase insurance coverage by improving competition and lowering premiums. To facilitate this goal, the federal government enacted online marketplaces in the 395 rating areas spanning 34 states that chose not to establish their own state-run marketplaces. Few multivariate regression studies analyzing the effects of competition on premiums suffer from endogeneity, due to simultaneity and omitted variable biases. However, United Healthcare's decision to enter these marketplaces in 2015 provides the researcher with an opportunity to address this endogeneity problem...
January 8, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29303825/the-relationship-of-hospital-ceo-characteristics-to-patient-experience-scores
#17
Christina Galstian, Larry Hearld, Stephen J O'Connor, Nancy Borkowski
Efforts by hospitals to improve patient experience continue as changes in policy such as the Affordable Care Act of 2010 have made patient experience a cornerstone of promoting greater value in the United States. Hospital CEOs play an important role in promoting positive patient experiences as they set the organizational vision and strategic goals and can execute change to support positive experiences.This study assessed whether three CEO characteristics-education, tenure with the organization, and gender-were associated with patient experience scores of California hospitals in 2013 and 2014...
January 2018: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29302881/could-pay-for-performance-worsen-health-disparities
#18
Mubeen Shakir, Katrina Armstrong, Jason H Wasfy
Pay-for-performance (P4P) has become a prominent component of health care funding in the Affordable Care Act (ACA) era. Although the ACA's future remains unclear, these programs receive bipartisan support and will likely continue to be a part of payment policies. At the same time, racial and class disparities remain among the most pressing of the many challenges facing the US health system. We review evidence of the effects of P4P on disparities at the population and individual levels. Providers caring for predominantly minority patients or those with lower socioeconomic status are known to have poorer quality metrics...
January 4, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29299473/economic-evaluation-of-different-suture-closure-methods-barbed-versus-traditional-interrupted-sutures
#19
REVIEW
Randa K Elmallah, Anton Khlopas, Mhamad Faour, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Martin Roche, Steven F Harwin, Michael A Mont
Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298175/trends-in-preventable-inpatient-and-emergency-department-utilization-in-california-between-2012-and-2015-the-role-of-health-insurance-coverage-and-primary-care-supply
#20
Peter Cunningham, Yaou Sheng
BACKGROUND: Expansions of health insurance coverage tend to increase hospital emergency department (ED) utilization and inpatient admissions. However, provisions in the Affordable Care Act that expanded primary care supply were intended in part to offset the potential for increased hospital utilization. OBJECTIVES: To examine the association between health insurance coverage, primary care supply, and ED and inpatient utilization, and to assess how both factors contributed to trends in utilization in California between 2012 and 2015...
January 2, 2018: Medical Care
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