What's Happening at Skilled Nursing Facilities on Day 20?
There’s something unusual happening on patients’ 20th day in skilled nursing facilities (SNFs).
Quantifying the Health Risks of Being a Family Caregiver
Penn Medicine's Amol Navathe Appointed to MedPAC
Meeting the Oral Health Needs of an Aging Population
An important, yet often overlooked aspect of comprehensive health care for a “graying” U.S. population is dental health. In a new commentary, Tim Wang, Mark Wolff, and Neeraj Panchal bring attention to the oral health needs of a growing geriatric population in the U.S., and suggest practical ways to prepare providers to meet the challenge of treating this unique group.
Five-Year Cost of Dementia: Medicare
[dropcap]A[/dropcap]bout 5.5 million older adults are living with dementia, a chronic, progressive disease characterized by severe cognitive decline. This number will likely grow significantly as the U.S. population ages, which has cost implications for the Medicare program. A full accounting of these additional expenses will help policymakers plan for them in their Medicare budgets. In this study, Norma Coe and colleagues examined survival and Medicare expenditures in older adults with and without dementia to estimate dementia’s incremental costs to Medicare in the five years after diagnosis.
Payment and Care Innovation at the VA
At first glance, it appears that the new Veterans Affairs (VA) Center for Innovation for Care and Payment shares much in common with the Center for Medicare and Medicaid Innovation (CMMI). Both are charged with implementing payment and care models that address rising costs, while maintaining or improving quality of care.
Medicaid and Nursing Home Choice: Why Do Duals End Up in Low-Quality Facilities?
Hari Sharma, Marcelo Coca Perraillon, Rachel M. Werner, David C. Grabowski, R. Tamara Konetzka
ABSTRACT [FROM JOURNAL]
We provide empirical evidence on the relative importance of specific observable factors that can explain why individuals enrolled in both Medicare and Medicaid (duals) are concentrated in lower quality nursing homes, relative to those not on Medicaid. Descriptive results show that duals are 9.7 percentage points more likely than nonduals to be admitted to a low-quality (1-2 stars) nursing home. Using the Blinder–Oaxaca decomposition approach in a multivariate framework, we find that 35.4% of the difference in admission to low-quality nursing homes can be...
Two Penn Med Students Win LDI William Kissick Policy Research Award
Tracking a Trend: Nursing Home Specialists
The world of health care is divided into many areas of specialization. At one point or another, we may have seen a podiatrist for a foot problem or a dermatologist for skin issues. Not all of us realize that – in addition to specializing in, say, the lungs – clinicians can devote their practice to providing general care to patients in a specific setting. For example, some physicians, called ‘hospitalists,’ see all or most of their patients in a hospital environment.
Assessing First Visits By Physicians To Medicare Patients Discharged To Skilled Nursing Facilities
In this study of postacute care, more than 10% of Medicare skilled nursing facility (SNF) stays included no visit from
a physician or advanced practitioner. Of stays with visits, about half of initial assessments occurred within a day of
admission, and nearly 80% occurred within four days. Patients who did not receive a visit from a physician or advanced
practitioner were nearly twice as likely to be readmitted to a hospital (28%) or to die (14%) within 30 days of SNF
admission than patients who had an initial visit.
Patient Outcomes After Hospital Discharge to Home with Home Health Care vs to a Skilled Nursing Facility
In this study of more than 17 million Medicare hospitalizations between 2010 and 2016, patients discharged to home
health care had a 5.6 percent higher 30-day readmission rate than similar patients discharged to a skilled nursing facility
(SNF). There was no difference in mortality or functional outcomes between the two groups, but home health care was
associated with an average savings of $4,514 in total Medicare payments in the 60 days after the first hospital admission.
Medicare for all? How about Medicare for me?
Supporting Medicare's Value-Based Transformation
The Centers for Medicare and Medicaid Services (CMS) recently released results from year 1 of Medicare’s largest pay-for-performance program, the Merit-based Incentive Payment System (MIPS).
Does Accountable Care Worsen Health Disparities?
Health system reforms, such as value-based payment, can worsen or improve existing health care disparities, even if policy changes do not target the disparities themselves.
Did the Hospital Readmissions Reduction Program Increase or Decrease Mortality?
