Article
Health Care Sciences & Services
Jennifer Reckrey, Katherine Ornstein, Karen McKendrick, Emma Tsui, R. Sean Morrison, Melissa Aldridge
Summary: Hospice aide visits are a common component of hospice care, but visit frequency does not increase as death approaches. Receipt of hospice aide visits was primarily associated with community and hospice agency (rather than patient) characteristics.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2022)
Article
Medicine, General & Internal
Fiona Bhondoekhan, Brandon D. L. Marshall, Theresa I. Shireman, Amal N. Trivedi, Jessica S. Merlin, Patience Moyo
Summary: Nonpharmacologic treatments are important for managing chronic pain among persons with opioid use disorder (OUD). This retrospective cohort study analyzes the differences in receipt of physical therapy (PT) or chiropractic care for chronic low back pain (CLBP) among persons with comorbid OUD across racial and ethnic groups. The findings indicate low overall utilization of PT and chiropractic care, particularly among racial and ethnic minority groups.
Article
Health Care Sciences & Services
Jennifer Miles, Peter Treitler, James Lloyd, Hillary Samples, Anais Mahone, Richard Hermida, Sumedha Gupta, Alexandra Duncan, Vanessa Baaklini, Kosali I. Simon, Stephen Crystal
Summary: This study analyzed Medicare Part D claims from 2015-19 to identify racial and ethnic disparities in buprenorphine receipt among Medicare disability beneficiaries with opioid use disorder or overdose. The findings showed persistent high disparities, especially for Black beneficiaries, suggesting the need for targeted interventions and policies.
Article
Health Care Sciences & Services
Lacey Loomer, Cyrus M. Kosar, David J. Meyers, Kali S. Thomas
Summary: Analysis of Medicare beneficiary data shows that MA enrollees are less likely to receive prescribed post-acute HH compared to TM enrollees. In MA plans, those with cost sharing, referrals, and pre-authorization are less likely to receive prescribed HH.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2021)
Editorial Material
Medicine, General & Internal
Douglas Jacobs, Purva Rawal, Liz Fowler, Meena Seshamani
Summary: By better aligning its initiatives and policies related to accountable care organizations, CMS aims to create pathways for payers and providers to advance high-quality, accountable care.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Clinical Neurology
Aakash Bipin Gandhi, Eberechukwu Onukwugha, Husam Albarmawi, Abree Johnson, Daniela E. Myers, David Gray, Jose Alvir, Lauren Hynicka, Lisa M. Shulman
Summary: This study compared health care resource utilization between Medicare beneficiaries with and without Parkinson's disease over a 10-year period, finding that beneficiaries with PD had higher rates of inpatient admissions, emergency department visits, skilled nursing facility admissions, healthcare provider encounters, neurologist visits, rehabilitation service visits, and non-PD medication fills compared to those without PD. The results provide evidence for the allocation of healthcare resources for PD management.
Article
Geriatrics & Gerontology
Berna Demiralp, Jessica S. Speelman, Christine M. Cook, Danielle Pierotti, Marie Steele-Adjognon, Norbert Hudak, Michael P. Neuman, Ian Juliano, Sharon Harder, Lane Koenig
Summary: This study investigated the prevalence of incomplete home health referrals after acute care hospitalization and found that complete referrals were associated with lower mortality and readmission rates as well as higher spending. As policymakers implement alternative policies and payment models, they should consider the tradeoff between quality and cost in increasing home health care utilization.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Article
Substance Abuse
Jennifer Miles, Peter Treitler, Richard Hermida, Amesika N. Nyaku, Kosali Simon, Sumedha Gupta, Stephen Crystal, Hillary Samples
Summary: The study revealed racial disparities in timely access to medication for opioid use disorder among Medicare disability beneficiaries, highlighting the need to improve healthcare services for underserved minority groups and increase the accessibility of office-based buprenorphine prescribing.
DRUG AND ALCOHOL DEPENDENCE
(2023)
Article
Geriatrics & Gerontology
Samir K. Shah, Adoma Manful, Amanda J. Reich, Robert S. Semco, Jennifer Tjia, Keren Ladin, Joel S. Weissman
Summary: The study found low utilization of ACP billing codes among Medicare patients with ADRD undergoing surgery, with a reactive pattern of ACP occurring most commonly after surgery and in association with postoperative mortality and complications. Further research is needed to understand barriers to the use of ACP.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Letter
Medicine, General & Internal
Suhas Gondi, Yong Li, Dana Drzayich Antol, Emily Boudreau, William H. Shrank, Brian W. Powers
Summary: This cohort study examines the relationship between value-based payment and acute care in a national population of Medicare Advantage beneficiaries.
Article
Neurosciences
Caroline Pearson, Alex Hartzman, Dianne Munevar, Megan Feeney, Rachel Dolhun, Veronica Todaro, Sheera Rosenfeld, Allison Willis, James C. Beck
Summary: It is important to understand how people with Parkinson's disease (PD) in the US utilize the healthcare system. A study analyzed the healthcare utilization patterns of PD patients enrolled in Medicare in 2019 and found significant disparities in care. Many patients did not see a neurologist or receive recommended therapy services, indicating the need for further research on barriers to accessing PD-related health care.
NPJ PARKINSONS DISEASE
(2023)
Article
Multidisciplinary Sciences
Linh Tran, Jeah Jung, Roger Feldman, Thomas Riley
Summary: Disparities in the quality of care for chronic hepatitis C virus infection exist, with lower probabilities of testing and screening among racial/ethnic minorities and rural residents.
Article
Medicine, General & Internal
Monica Farid, Yusuke Tsugawa, Anupam B. Jena
Summary: This study investigated the association between inpatient handoffs of hospitalist physicians and patient mortality among hospitalized Medicare beneficiaries. It found that, overall, physician handoff was not associated with increased mortality, but among patients with high illness severity, there was a higher mortality rate in those with a high likelihood of physician handoff compared to those with a low likelihood.
Article
Orthopedics
Hyunkyu Ko, Darrel S. S. Brodke, Megan E. E. Vanneman, Andrew J. J. Schoenfeld, Brook I. I. Martin
Summary: Spine surgery and its costs have increased in recent years and vary across geographic regions. A study found that the variation in spending is mainly due to discretionary care rather than pricing, age, or illness severity. However, increased discretionary care does not improve patient safety.
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
(2022)
Article
Oncology
Yaw A. Nyame, Sarah K. Holt, Ruth D. Etzioni, John L. Gore
Summary: Black men in the US have a higher mortality rate from prostate cancer due to lower quality care. The study found that black patients were more likely to receive care from surgeons and facilities with lower surgical volumes, which could impact surgical quality and outcomes. Access to high-quality prostate cancer care can help reduce racial disparities in disease outcomes.
Article
Geriatrics & Gerontology
Halima Amjad, John Mulcahy, Judith D. Kasper, Julia Burgdorf, David L. Roth, Ken Covinsky, Jennifer L. Wolff
Summary: Although older adults with dementia have similar hospitalization rates compared to those without, caregiving factors have a similar impact on hospitalization risk for both groups.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Article
Clinical Neurology
Julia G. Burgdorf, Halima Amjad, Kathryn H. Bowles
Summary: Patients with cognitive impairment in Medicare-funded home health care are more likely to receive multiple successive HHC episodes and additional visits during the initial HHC episode, suggesting that recent reimbursement changes do not consider the more intensive care needs of these patients.
ALZHEIMERS & DEMENTIA
(2022)
Article
Health Care Sciences & Services
Julia G. Burgdorf, Aditi P. Sen, Jennifer L. Wolff
Summary: This study shows that home health agencies experience significantly higher costs when providing care for patients with cognitive impairment. Policies and models should consider patient cognitive function in order to incentivize agencies to provide care for those with cognitive impairment. Monitoring of home health access among Medicare beneficiaries with cognitive impairment is recommended.
HEALTH SERVICES RESEARCH
(2022)
Article
Geriatrics & Gerontology
Julia G. Burgdorf, Alicia Arbaje, Jo-Ana Chase, Jennifer L. Wolff
Summary: This study found that caregiver training is crucial in home health care and influences clinicians' decisions and practices. However, clinicians face a lack of structured assessment instruments or training materials, highlighting the need for efforts to facilitate their training.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2022)
Article
Health Policy & Services
Julia G. Burgdorf, Halima Amjad
Summary: Research on home health utilization for patients with cognitive impairment is gaining interest, but there is a lack of standardization in measuring cognitive impairment, leading to varying prevalence estimates. Regardless of the measure used, a significant percentage of home health patients have cognitive impairment, highlighting the need for ongoing research in this area.
HOME HEALTH CARE SERVICES QUARTERLY
(2022)
Article
Geriatrics & Gerontology
Julia G. Burgdorf, Jennifer L. Wolff, Jo-Ana Chase, Alicia Arbaje
Summary: During Medicare home health care, family caregiver training is often unmet, leading to potential risks. HHC clinicians identified various barriers and facilitators in delivering family caregiver training.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2022)
Article
Geriatrics & Gerontology
Chanee D. Fabius, Safiyyah M. Okoye, John Mulcahy, Julia G. Burgdorf, Jennifer L. Wolff
Summary: This study examines the relationship between care experiences of community-living dual-enrollees and receiving paid help as well as the state and neighborhood environment. The findings suggest that dual-enrollees with dementia are more likely to receive paid help, and neighborhood disadvantage and state Medicaid HCBS generosity are associated with the use of paid help. Dual-enrollees with dementia who receive paid help are more likely to experience adverse consequences. However, there is no significant association between paid help, LTSS environment, and care experiences for dual-enrollees without dementia.
JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES
(2022)
Article
Gerontology
Julia G. Burgdorf, Jo-Ana D. Chase, Christina Whitehouse, Kathryn H. Bowles
Summary: This study examines the prevalence and underlying causes of unmet caregiving needs for sepsis survivors receiving Medicare home health care (HHC). The findings show that the most common unmet needs are assistance with daily activities and medication administration, and caregivers' need for training contributes to the majority of these unmet needs. Additionally, sepsis survivors with declined or no improvement in cognitive function are more likely to have unmet caregiving needs. These findings emphasize the importance of expanding family caregiver training to improve outcomes for sepsis survivors receiving HHC.
JOURNAL OF APPLIED GERONTOLOGY
(2022)
Article
Gerontology
Julia G. Burgdorf, Jennifer Reckrey, David Russell
Summary: This study investigates the perspectives of caregivers of Alzheimer's Disease and Related Dementias (ADRD) patients on communication and support from the home health (HH) care team. The findings reveal four major support needs identified by caregivers: assistance with insurance and service coverage, training on nursing tasks, referral to respite care, and information on ADRD disease progression. However, caregivers face barriers such as not being directly asked about their needs and information discontinuity within the HH care team. Based on the results, a new model of assessment and support is proposed to address these gaps.
Article
Geriatrics & Gerontology
Julia G. G. Burgdorf, Chanee D. D. Fabius, Jennifer L. L. Wolff
Summary: This study examined the use of patient portals among older adults and their caregivers, and found differences between individual and joint use. Although some older adults and caregivers used patient portals, there were still disparities in access and further efforts are needed to address this issue.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Geriatrics & Gerontology
Julia G. Burgdorf, Halima Amjad
Summary: This study explores the impact of a recognized formal diagnosis of Alzheimer's disease and related dementias (ADRD) on family caregivers. The results show that caregivers assisting individuals with a formal diagnosis are more likely to experience emotional difficulty and family disagreement, but they are also more likely to assist with communication during doctor's visits and receive caregiving-related training.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Clinical Neurology
Julia G. Burgdorf, Tracy M. Mroz, Jennifer M. Reckrey, Yolanda Barron, Miriam Ryvicker
Summary: Home health (HH) is an important source of care for early-stage/undiagnosed Alzheimer's Disease and Related Dementias (ADRD) patients. This study aims to investigate the prevalence and predictors of incident ADRD diagnosis following HH. The results show that 10% of HH patients without diagnosed ADRD received an incident diagnosis within 1 year. Furthermore, HH patients with impaired overall cognition and community-referred patients were more likely to receive an incident ADRD diagnosis.
ALZHEIMERS & DEMENTIA
(2023)
Article
Public, Environmental & Occupational Health
David Russell, Julia G. Burgdorf, Karla T. Washington, Jennifer Schmitz, Kathryn H. Bowles
Summary: This study explored how the COVID-19 pandemic affected family caregivers of older adults who were hospitalized with the virus and then received post-acute home health care services. The findings revealed that family caregivers faced barriers in assisting older adults during post-acute care transitions due to hospital visitation restrictions and difficulties accessing community-based resources and medical equipment. Despite these challenges, many caregivers identified post-acute home health care, whether in-person or via telehealth, as crucial for addressing care gaps for older adults and their own needs for training and support during the pandemic.
PATIENT EDUCATION AND COUNSELING
(2023)
Article
Computer Science, Information Systems
Maryam Zolnoori, Yolanda Barron, Jiyoun Song, James Noble, Julia Burgdorf, Miriam Ryvicker, Maxim Topaz
Summary: This study developed HomeADScreen, a risk screening model for Alzheimer's disease and related dementia (ADRD) based on structured data from home healthcare (HHC) patients and information extracted from HHC clinical notes. By combining natural language processing with Outcome and Assessment Information Set (OASIS) data, the model achieved good performance in predicting ADRD risk and showed improvement in overall performance across different time windows. Risk factors such as hearing impairment and impaired patient ability in using telephone were associated with increased risk of ADRD.
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
(2023)
Article
Geriatrics & Gerontology
Jennifer L. Wolff, Vadim Dukhanin, Julia G. Burgdorf, Catherine M. DesRoches
Summary: As the reliance on patient portals as a mainstream mode of health system interactions grows, it is important to prioritize digital health equity and support for all individuals. This article discusses the challenges and opportunities of systematically engaging care partners through shared access to patient portals, particularly for older adults with vulnerabilities.