Editorial Material
Medicine, General & Internal
Eric T. Roberts, Kenton J. Johnston, Jose F. Figueroa
Summary: This Viewpoint emphasizes the expensive inefficiencies in providing care to patients who are eligible for both Medicare and Medicaid, and suggests more effective care models.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Health Care Sciences & Services
Eric T. Roberts, Jennifer M. Mellor
Summary: Policy makers are exploring strategies to integrate Medicare and Medicaid coverage for dual eligibles, with Dual Eligible Special Needs Plans (D-SNPs) serving as Medicare Advantage plans exclusively for this population. This study found that, compared to traditional Medicare, dual eligibles generally reported better access to care, higher use of preventive services, and greater satisfaction with care in D-SNPs. However, there were fewer differences in these outcomes between dual eligibles in D-SNPs and those in other Medicare Advantage plans. Additionally, dual eligibles of color were less likely to report receiving better care in D-SNPs compared to other forms of Medicare coverage.
Article
Health Care Sciences & Services
Andrew J. Potter, John R. Bowblis
Summary: The study found that the implementation of MLTSS did not have a significant impact on nursing home quality, occupancy, or the percentage of low-care residents in NHs.
HEALTH SERVICES RESEARCH
(2021)
Article
Health Care Sciences & Services
Chanee D. Fabius, Portia Y. Cornell, Wenhan Zhang, Kali S. Thomas
Summary: The analysis of 2014 Medicare data reveals significant variability among states in the share of dual-eligible assisted living residents, with this variation strongly correlated with Medicaid support for assisted living care. States with Medicaid coverage options for services in assisted living had a higher percentage of dual-eligible residents compared to states without such options. This finding sheds light on the role of Medicaid financing in access to assisted living for dual-eligible individuals.
MEDICAL CARE RESEARCH AND REVIEW
(2022)
Article
Multidisciplinary Sciences
Aaron Jones, Fabrice Mowbray, Lindsey Falk, Nathan M. Stall, Kevin A. Brown, Kamil Malikov, Sarah L. Malecki, Sharan Lail, Hae Young Jung, Andrew P. Costa, Amol A. Verma, Fahad Razak
Summary: This study examines the impact of the COVID-19 pandemic on the demographic and clinical characteristics, in-hospital care, and outcomes of long-term care residents admitted to general medicine wards for non-COVID-19 reasons. The study found a significant decrease in hospital admissions during the pandemic period, and residents admitted during this period were more likely to be diagnosed with delirium and less likely to be admitted for pneumonia. They were also more likely to be prescribed antipsychotics and had a higher in-hospital mortality rate.
Article
Environmental Sciences
Jochem O. Klompmaker, Francine Laden, Peter James, M. Benjamin Sabath, Xiao Wu, Francesca Dominici, Antonella Zanobetti, Jaime E. Hart
Summary: The study found that long-term exposure to higher summer specific humidity and humidity variability was positively associated with cardiovascular disease hospitalization risk, especially among beneficiaries eligible for Medicaid and beneficiaries with an unknown or other race.
ENVIRONMENT INTERNATIONAL
(2023)
Article
Health Care Sciences & Services
Jennifer M. Mellor, Melissa McInerney, Lindsay M. Sabik
Summary: The study found that there is a measurement error in self-reports of Medicaid participation among low-income Medicare beneficiaries, with a significant false negative rate. Additionally, the likelihood of false negative reports is systematically associated with respondent traits. The researchers also warn about biased coefficient estimates when interpreting survey reports as pertaining to full Medicaid coverage only.
MEDICAL CARE RESEARCH AND REVIEW
(2021)
Article
Health Care Sciences & Services
David E. Velasquez, E. John Orav, Jose F. Figueroa
Summary: Integrated care programs (ICPs) have increased the proportion of dual-eligible beneficiaries from 2.0 percent in 2013 to 9.4 percent in 2020. However, non-integrated or partially integrated coordination-only MA plans have experienced the largest growth in enrollment. Beneficiaries in ICPs were more likely to be Black and Hispanic, and less likely to be rural, younger, or disabled compared to non-ICP fee-for-service Medicare. Policymakers should monitor the growth of ICPs and less integrated dual-eligible plans and evaluate their impact on equity, spending, and quality of care.
Article
Health Care Sciences & Services
Renee Garrow, Jennifer M. Mellor, Melissa McInerney, Lindsay M. Sabik
Summary: This study examines the financial and health changes that occur when individuals newly enroll in Medicaid. The results show that new Medicaid participants often experience an increase in out-of-pocket medical expenses, a decrease in assets, and an increase in activities of daily living limitations. The study also observes financial changes among those continuously enrolled in Medicaid.
MEDICAL CARE RESEARCH AND REVIEW
(2023)
Article
Geriatrics & Gerontology
Andrew J. Potter, Brad Wright, Jill Akiyama, Grace G. Stehlin, Amal N. Trivedi, Fredric D. Wolinsky
Summary: This study found that Medicare-Medicaid dual-eligibles with Alzheimer's disease and related dementias primarily received primary care in nursing facilities or physician offices. However, there has been a shift in recent years towards receiving care in Federally Qualified Health Centers and other settings.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Health Care Sciences & Services
Eric T. Roberts, Sunita M. Desai
Summary: The study assessed changes in physicians' provision of care to duals in response to a policy that required Medicaid to fully pay Medicare's cost sharing for office visits with these patients. The results showed that physicians' provision of care to low-income Medicare beneficiaries may not be responsive to short-run payment changes.
HEALTH SERVICES RESEARCH
(2021)
Article
Hematology
Boshen Jiao, Kate M. Johnson, Scott D. Ramsey, M. A. Bender, Beth Devine, Anirban Basu
Summary: We present the first population-based period life table for patients with sickle cell disease (SCD) in the United States, showing disparities in survival by insurance types. A retrospective cohort of SCD patients receiving common care was constructed based on Medicare and Medicaid claim data. The study highlights the persistent life expectancy shortfall and survival disparities among SCD patients based on insurance status.
Article
Cardiac & Cardiovascular Systems
Sarah Crook, Kacie Dragan, Joyce L. Woo, Matthew Neidell, Pengfei Jiang, Stephen Cook, Edward L. Hannan, Jane W. Newburger, Marshall L. Jacobs, Emile A. Bacha, Christopher J. Petit, Robert Vincent, Kathleen Walsh-Spoonhower, Ralph Mosca, T. K. Susheel Kumar, Neil Devejian, Steven A. Kamenir, George M. Alfieris, Michael F. Swartz, David Meyer, Erin A. Paul, John Billings, Brett R. Anderson
Summary: This study describes and identifies predictors of health care expenditures and utilization for Medicaid-insured pediatric cardiac surgical patients in New York State. The health care expenditures and utilization for cardiac surgical patients were significantly higher compared to non-cardiac surgical patients. Hispanic children had higher emergency department visits, inpatient admissions, and subspecialist visits, but fewer primary care visits and higher 5-year mortality.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Peripheral Vascular Disease
C. Barrett Bowling, Richard Sloane, Carl Pieper, Alison Luciano, Barry R. Davis, Lara M. Simpson, Paula T. Einhorn, Suzanne Oparil, Paul Muntner
Summary: Analysis of data from ALLHAT showed that sustained SBP control is associated with a lower risk of long-term nursing home admission, with participants maintaining 100% SBP control having the lowest risk of nursing home admission.
JOURNAL OF HYPERTENSION
(2021)
Article
Pediatrics
Sarah A. Sobotka, David E. Hall, Cary Thurm, James Gay, Jay G. Berry
Summary: This study assessed the characteristics, providers, and payments of pediatric home health care (HHC) recipients. The results showed that children using HHC are a diverse population who receive care from a variety of providers.