Medicare

The federal program that covers medical care for people age 65 or older, younger people with disabilities, and people with End-Stage Renal Disease. Medicare covers about 13% of the US population and makes up a fifth of national health expenditures.

Psoriasis in the US Medicare Population: Prevalence, Treatment, and Factors Associated with Biologic Use

Jan. 29, 2016

Junko Takeshita, Joel Gelfand, Penxiang Li, Lionel Pinto, Xinyan Yu, Preethi Rao, Hema Viswanathan, Jalpa Doshi

In the Journal of Investigative Dermatology, Junko Takeshita and colleagues, including Preethi Rao and Jalpa Doshi, look at factors associated with the use of biologics and other treatments for psoriasis. They  analyzed claims from a nationally representative sample of Medicare beneficiaries with Part D drug coverage. The researchers find that Medicare Part D beneficiaries without a low-income subsidy (LIS) had 70% lower odds of having received biologics than those with LIS. Similarly, the odds of having received biologics were 69% lower among black patients compared with white...

Internalizing Behavioral Externalities: Benefit Integration in Health Insurance

Dec. 18, 2015

Amanda Starc, Robert Town

In an NBER working paper, Amanda Starc and Robert Town demonstrate the benefits of integrating medical and drug benefits in the Medicare Part D setting. They compare stand-alone prescription drug plans (PDPs, which cover only drugs) and Medicare Advantage-prescription drug (MA-PD) plans (which cover total medical expenditures).  They document that plans that cover all medical expenses spend more on drugs than plans that are only responsible for prescription drug spending, consistent with drug spending offsetting some medical costs. The effect is driven by drug categories that are likely to...

Cost Differences After Initial CT Colonography Versus Optical Colonoscopy in the Elderly

Nov. 19, 2015

Hanna Zafar, Jianing Yang, Katrina Armstrong, Peter Groeneveld

In Academic Radiology, Hanna Zafar and colleagues, including Peter Groeneveld, compare differences in total Medicare costs among asymptomatic elderly patients in the year after initial computed tomographic colonography (CTC) or initial optical colonoscopy (OC). In 2009, the Centers for Medicare and Medicaid Services stopped covering CTC screening among asymptomatic individuals based on the scarcity of data regarding differences in outcomes and costs between patients who received CTC and OC. Zafar and colleagues performed a retrospective cohort study of asymptomatic Medicare...

How Nursing Affects Medicare’s Outcome-based Hospital Payments

Data Brief
Nov. 12, 2015

Improving value is one of the central aims of recent and ongoing health care reform. In our last LDI/INQRI Brief, we reviewed the evidence of the role of nurses in increasing the value of health care. In this companion brief, we dig deeper into the three reimbursement strategies that Medicare uses to align hospital financial incentives with quality of care, and we calculate the potential effects of nursing-sensitive quality indicators on hospital payments.

How Nurses Affect Medicare's Hospital Incentive Payments

Nov. 12, 2015

In our last LDI/INQRI Brief, we looked at the evidence of nursing's role in increasing the value of health care, and we pointed out where "value" and "business case" may differ for hospitals. In our latest Brief, we analyze the three Medicare programs designed to align hospital incentives with value, and how nursing-sensitive quality indicators relate to those programs. 

Elimination of cost-sharing and receipt of screening for colorectal and breast cancer

Sep. 17, 2015

Stacey A. Fedewa, Michael Goodman, W. Dana Flanders, Xuesong Han, Robert A. Smith, Elizabeth M. Ward, Chyke A. Doubeni, Ann Goding Sauer, Ahmedin Jemal

In Cancer, Stacey Fedewa and colleagues, including Chyke Doubeni, investigate whether the cost-sharing provision of the Affordable Care Act (ACA), which aimed to reduce financial barriers for preventive services, affected the prevalence of screening for certain cancers. The research looks specifically at the rates of screening for colorectal cancer and breast cancer among the privately insured and Medicare-enrolled adults of varying socioeconomic status (SES). It uses data from the National Health Interview Survey from 2008 and 2013. The authors find that the rate of screening for...

Who Has The Most To Lose From Health Insurance Mergers?

Jul. 31, 2015

cross-posted with the Field Clinic

In recent weeks, two sets of already huge health insurers—Aetna and Humana, Cigna and Anthem—have announced plans to combine. And more mergers may be in the works.  Should the rest of us fear being trampled when these behemoths connect? The answer to that question, as with almost all questions in health economics, is “it all depends.”

Medicare, Medicaid and the Leonard Davis Institute - Intertwined Legacies

Jul. 24, 2015

Fifty years ago, on July 30, 1965, President Lyndon Johnson signed Medicare and Medicaid into law. Over the next two years, more than 29 million people gained health coverage through these programs. By 1967, as Alice Rivlin recalls, economists were sounding an alarm about rising Medicare costs and reporting to the President that projected growth would be unsustainable.

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