OBJECTIVE We aim to examine the relationships between substance use disorders and preventable hospitalizations for Ambulatory Care Sensitive Conditions among adult Medicaid beneficiaries. METHODS Cross-sectional analysis using de-identified Medicaid claims data in 2012 from 177,568 beneficiaries in Missouri was conducted. Logistic regression models were estimated for the associations of subst...

The US Centers for Medicaid and Medicare Services reimburses ambulatory blood pressure monitoring (ABPM) for suspected white coat hypertension. We estimated ABPM use between 2007 and 2010 among a 5% random sample of Medicare beneficiaries (≥65 years). In 2007, 2008, 2009, and 2010, the percentage of beneficiaries with ABPM claims was 0.10%, 0.11%, 0.10%, and 0.09%, respectively. A prior diagnos...

This study analyzes administrative data from the Medicare program to compare differences by race in the use of 17 major procedures performed in the hospital. In both 1986 and 1992, black beneficiaries were less likely than white beneficiaries to have received these procedures while hospitalized. The largest differences were seen for "referral-sensitive surgeries" such as percutaneous translumin...

We use linked administrative data from program and earnings records to summarize the 2007 employment rates of Social Security disability program beneficiaries at the national and state levels, as well as changes in employment since 1996. The findings provide new information on the employment activities of beneficiaries that should be useful in assessing current agency policies and providing ben...

beneficiaries was $6832, but expenditures were significantly less for overweight and obese beneficiaries ($5473 [P .001] and $5790 [P=.02], respectively). Expenditures increased over time for all groups but appeared to increase more quickly in obese beneficiaries. In regression analysis adjusting for demographic and economic covariates, expenditures increased by a mean of $122 per year (P .001)...

The Medicare Advantage (MA) program offers beneficiaries a choice of private health plans as alternatives to the traditional fee-for-service Medicare program. MA plans potentially provide additional value, but as plan choices have proliferated, consumers contemplating their options have had difficulty understanding how they differ. Through "standardization" more consistent types of information ...

Success of the Medicare prescription drug benefit depends on private organizations offering beneficiaries appropriate access to medications while controlling costs. There is limited guidance, however, as to what constitutes best practice in benefit and formulary design. This issue brief examines Medicare stand-alone prescription drug plans in the four most populous Medicare states-California, F...

IMPORTANCE The Pioneer Accountable Care Organization (ACO) Model aims to drive health care organizations to reduce expenditures while improving quality for fee-for-service (FFS) Medicare beneficiaries. OBJECTIVE To determine whether FFS beneficiaries aligned with Pioneer ACOs had smaller increases in spending and utilization than other FFS beneficiaries while retaining similar levels of care ...

BACKGROUND National guidelines recommend use of high-intensity statins after hospitalization for coronary heart disease (CHD) events. OBJECTIVES This study sought to estimate the proportion of Medicare beneficiaries filling prescriptions for high-intensity statins after hospital discharge for a CHD event and to analyze whether statin intensity before hospitalization is associated with statin ...

background: wound infections are associated with increased morbidity and mortality. etiologic agents of wound infections vary with geographical locations. this study was conducted to assess the prevalence of wound infections, the effect of age and gender on the prevalence as well as the etiologic agents and their susceptibility to antibacterial agents. methods: wound swabs collected from 2061 p...