2024
Medical Devices Applying for Outpatient Medicare Supplemental Payments
Moneer O, Johnston J, Rathi V, Ross J, Dhruva S. Medical Devices Applying for Outpatient Medicare Supplemental Payments. JAMA Health Forum 2024, 5: e244016. PMID: 39546305, PMCID: PMC11568453, DOI: 10.1001/jamahealthforum.2024.4016.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesMedicare beneficiariesUS Centers for Medicare & Medicaid ServicesCross-sectional studyCross-sectional analysisPatient demographic characteristicsClinical decision-makingMedicaid ServicesMain OutcomesHispanic patientsClinical evidence requirementsPremarket clinical studyOutpatient settingOutpatient paymentsTraditional pathwaysMedicareSupplemental paymentsFiscal yearTransitional pass-through paymentsReimbursementDemographic dataEffectiveness end pointPathway applicationClinical studiesAuthorization pathwaysFunding of evidence included within public comments submitted to inform Medicare national coverage determinations
Lu A, Ji R, Magee M, Ross J, Ramachandran R, Redberg R, Dhruva S. Funding of evidence included within public comments submitted to inform Medicare national coverage determinations. Health Affairs Scholar 2024, 2: qxae064. PMID: 38919964, PMCID: PMC11196998, DOI: 10.1093/haschl/qxae064.Peer-Reviewed Original ResearchCenters for Medicare & Medicaid ServicesScientific journal articlesNational Coverage DeterminationPublic commentsCoverage determinationCross-sectional studyMedicare national coverage determinationsJournal articlesMedicare coverage decisionsCoverage of itemsMedicaid ServicesMedicare beneficiariesCommentsMedicare coverageGreater fundingMedicareAuthor disclosuresArticleCoverage decisionsEvaluation of benefitsFunding statementsSupport research
2022
Assessment of Hypothetical Out-of-Pocket Costs of Guideline-Recommended Medications for the Treatment of Older Adults With Multiple Chronic Conditions, 2009 and 2019
Zhou T, Liu P, Dhruva SS, Shah ND, Ramachandran R, Berg KM, Ross JS. Assessment of Hypothetical Out-of-Pocket Costs of Guideline-Recommended Medications for the Treatment of Older Adults With Multiple Chronic Conditions, 2009 and 2019. JAMA Internal Medicine 2022, 182: 185-195. PMID: 34982097, PMCID: PMC8728660, DOI: 10.1001/jamainternmed.2021.7457.Peer-Reviewed Original ResearchMeSH KeywordsAgedAtrial FibrillationChronic DiseaseCross-Sectional StudiesDiabetes Mellitus, Type 2Drug CostsHealth ExpendituresHeart FailureHumansHypercholesterolemiaHypertensionMedicare Part CMedicare Part DMultiple Chronic ConditionsOsteoarthritisOsteoporosisPrescription DrugsPulmonary Disease, Chronic ObstructiveRetrospective StudiesUnited StatesConceptsCommon chronic diseasesGuideline-recommended medicationsGuideline-recommended managementPrescription drug plansCross-sectional studyChronic conditionsChronic diseasesPocket costsOlder adultsOutpatient medicationsMedicare prescription drug plansInitial treatmentMedicare Advantage plansRetrospective cross-sectional studyMultiple chronic conditionsMedicare Part D plansPart D plansSubstantial financial burdenAtrial fibrillationMAIN OUTCOMEExclusion criteriaMedicare beneficiariesAnnual outHypothetical patientsMedications
2021
Loneliness, sadness, and feelings of social disconnection in older adults during the COVID‐19 pandemic
Holaday LW, Oladele CR, Miller SM, Dueñas MI, Roy B, Ross JS. Loneliness, sadness, and feelings of social disconnection in older adults during the COVID‐19 pandemic. Journal Of The American Geriatrics Society 2021, 70: 329-340. PMID: 34850379, PMCID: PMC8896574, DOI: 10.1111/jgs.17599.Peer-Reviewed Original ResearchConceptsPrimary careMedicare beneficiariesMultivariable logistic regression modelCOVID-19 pandemicOlder adultsOlder Medicare beneficiariesFeelings of lonelinessHistory of depressionPublic health measuresCross-sectional analysisLogistic regression modelsRace/ethnicitySubsequent morbidityLower oddsBlack beneficiariesHealth measuresSocial disconnectionSociodemographic variablesClinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries
Wheelock KM, Ross JS, Murugiah K, Lin Z, Krumholz HM, Khera R. Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries. JAMA Network Open 2021, 4: e2137288. PMID: 34870678, PMCID: PMC8649845, DOI: 10.1001/jamanetworkopen.2021.37288.Peer-Reviewed Original ResearchConceptsDOAC useAnticoagulant prescriptionOral anticoagulantsUS cliniciansMedicare beneficiariesNational clinical practice guidelinesElevated bleeding riskOral anticoagulant prescriptionsRetrospective cohort studyDirect oral anticoagulantsClinical practice guidelinesUS Medicare beneficiariesInternal medicine physiciansNumber of cliniciansAnticoagulant prescribingDOAC prescriptionsUnique cliniciansBleeding riskCohort studyAnticoagulant strategiesPrescription claimsPractice guidelinesMAIN OUTCOMEMost indicationsMedicare populationThe Association Between History of Depression and Access to Care Among Medicare Beneficiaries During the COVID-19 Pandemic
Balasuriya L, Quinton JK, Canavan ME, Holland ML, Edelman EJ, Druss BG, Ross JS. The Association Between History of Depression and Access to Care Among Medicare Beneficiaries During the COVID-19 Pandemic. Journal Of General Internal Medicine 2021, 36: 3778-3785. PMID: 34405350, PMCID: PMC8370448, DOI: 10.1007/s11606-021-06990-4.Peer-Reviewed Original ResearchConceptsSelf-reported historyHistory of depressionMental health outcomesMedicare beneficiariesHealth outcomesCOVID-19Adverse health outcomesPARTICIPANTSCross-sectional studyMental health effectsUnmet social needsClinical characteristicsHigh riskKey ResultsParticipantsPublic Use FileMedical careGreater riskMental healthHealth effectsCareDepressionUse FileCOVID-19 pandemicOutcomesGreater inabilityMedicare
2020
Medicare beneficiaries' out-of-pocket costs for commonly used generic drugs, 2009-2017.
Liu P, Dhruva SS, Shah ND, Ross JS. Medicare beneficiaries' out-of-pocket costs for commonly used generic drugs, 2009-2017. The American Journal Of Managed Care 2020, 26: 112-117. PMID: 32181626, DOI: 10.37765/ajmc.2020.42635.Peer-Reviewed Original ResearchConceptsPrescription drug plansPocket costsMedicare prescription drug plansGeneric drugsDrug price transparencyCash pricesPrice transparencyPocket expenditureDiscount programDrug plansDrug discount programsMedicare beneficiariesGeneric drug discount programsBeneficiariesCostGeneric drug prescriptionPricesDrug listGeneric medications
2018
Trends in opioid use in commercially insured and Medicare Advantage populations in 2007-16: retrospective cohort study
Jeffery MM, Hooten WM, Henk HJ, Bellolio MF, Hess EP, Meara E, Ross JS, Shah ND. Trends in opioid use in commercially insured and Medicare Advantage populations in 2007-16: retrospective cohort study. The BMJ 2018, 362: k2833. PMID: 30068513, PMCID: PMC6066997, DOI: 10.1136/bmj.k2833.Peer-Reviewed Original ResearchConceptsMedicare Advantage beneficiariesAverage daily doseDisabled Medicare beneficiariesAged Medicare beneficiariesRetrospective cohort studyDaily doseOpioid useMedicare beneficiariesLong-term useCohort studyCommercial beneficiariesStudy periodUse prevalenceOpioid use prevalenceHigh rateMedicare Advantage populationTerm useAge 65 yearsOpioid use ratesAdministrative claims dataAverage daily dosesProportion of beneficiariesQuarterly prevalenceMorphine equivalentsOpioid prescriptions
2017
Quality of Care in the United States Territories, 1999–2012
Nuti SV, Wang Y, Masoudi FA, Nunez-Smith M, Normand ST, Murugiah K, Rodríguez-Vilá O, Ross JS, Krumholz HM. Quality of Care in the United States Territories, 1999–2012. Medical Care 2017, 55: 886-892. PMID: 28906314, PMCID: PMC6482857, DOI: 10.1097/mlr.0000000000000797.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureHospitalization ratesMedicare beneficiariesMortality rateService Medicare beneficiariesQuality of careRecent study periodPneumonia hospitalizationsMyocardial infarctionPatient outcomesMillions of AmericansMedicare feeHealth outcomesPneumoniaService beneficiariesHospital reimbursementUnique beneficiariesHealth equityStudy periodPatient paymentsInpatient paymentsHealth careMortalityCareAge Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling.
Dharmarajan K, McNamara RL, Wang Y, Masoudi FA, Ross JS, Spatz EE, Desai NR, de Lemos JA, Fonarow GC, Heidenreich PA, Bhatt DL, Bernheim SM, Slattery LE, Khan YM, Curtis JP. Age Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling. Annals Of Internal Medicine 2017, 167: 555-564. PMID: 28973634, PMCID: PMC9359429, DOI: 10.7326/m16-2871.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionOlder patientsYounger patientsMyocardial infarctionAge groupsHospital risk-standardized mortality ratesRetrospective cohort studyHospital mortality rankingsNational Quality ForumHospital mortalityMedian hospitalHospital outcomesCohort studyACTION RegistryAMI mortalityAmerican CollegeMedicare beneficiariesAMI hospitalizationPatientsMortality rateHospitalQuality ForumHospital ValueHospital profiling
2016
Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions
Desai NR, Ross JS, Kwon JY, Herrin J, Dharmarajan K, Bernheim SM, Krumholz HM, Horwitz LI. Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions. JAMA 2016, 316: 2647-2656. PMID: 28027367, PMCID: PMC5599851, DOI: 10.1001/jama.2016.18533.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionReadmission ratesReadmissions Reduction ProgramHeart failurePenalty statusNontarget conditionsMedicare feeMean readmission rateThirty-day riskRetrospective cohort studyUnplanned readmission rateReduction programsHRRP announcementHRRP implementationPenalized hospitalsCohort studyService patientsMyocardial infarctionMAIN OUTCOMEExcess readmissionsMedicare beneficiariesService beneficiariesHospitalPatientsImpact of Hospitalization for Acute Myocardial Infarction on Adherence to Statins Among Older Adults
Kronish IM, Ross JS, Zhao H, Muntner P. Impact of Hospitalization for Acute Myocardial Infarction on Adherence to Statins Among Older Adults. Circulation Cardiovascular Quality And Outcomes 2016, 9: 364-371. PMID: 27220368, PMCID: PMC4956547, DOI: 10.1161/circoutcomes.115.002418.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overDatabases, FactualDyslipidemiasFemaleHealth Knowledge, Attitudes, PracticeHospitalizationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMedicareMedication AdherenceMyocardial InfarctionRisk AssessmentRisk FactorsTherapeuticsTime FactorsUnited StatesConceptsAcute myocardial infarctionImpact of hospitalizationAMI hospitalizationMyocardial infarctionProportion of patientsPatients adherentStatin adherentNonadherent patientsAdherent patientsMedicare patientsHospitalizationAdministrative claimsStatinsMedicare beneficiariesPatientsPneumoniaSubsequent adherenceOlder adultsInfarctionRandom sampleAdherenceAdherentYearsProportionCohort
2015
Observation encounters and subsequent nursing facility stays.
Vashi AA, Cafardi SG, Powers CA, Ross JS, Shrank WH. Observation encounters and subsequent nursing facility stays. The American Journal Of Managed Care 2015, 21: e276-81. PMID: 26244791.Peer-Reviewed Original ResearchConceptsMedicare coverageCommunity-dwelling Medicare beneficiariesCommunity-dwelling beneficiariesRetrospective cohort studyHome health servicesSkilled nursing facility careNursing facility careCohort studyFacility stayInpatient stayMedicare beneficiariesFacility careObservation encountersHealth servicesStayLonger lengthPatientsAssociated costsSmall minorityOne-fourthBeneficiariesCare
2014
Evolution of Breast Cancer Screening in the Medicare Population: Clinical and Economic Implications
Killelea BK, Long JB, Chagpar AB, Ma X, Wang R, Ross JS, Gross CP. Evolution of Breast Cancer Screening in the Medicare Population: Clinical and Economic Implications. Journal Of The National Cancer Institute 2014, 106: dju159. PMID: 25031307, PMCID: PMC4155428, DOI: 10.1093/jnci/dju159.Peer-Reviewed Original ResearchConceptsEnd Results-MedicareBreast cancer stageCohort of womenEarly-stage tumorsBreast cancer screeningAdjunct imagingSignificant changesCancer screeningCancer stageIncidence rateBreast cancerAdjunct procedureOlder womenMedicare populationMedicare beneficiariesClinical practiceComputer-aided detectionPoisson regressionNational feeCohortBreast ultrasoundWomenEarlier cohortsLater cohortsMedicare spending
2013
For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery
Sen S, Soulos PR, Herrin J, Roberts KB, Yu JB, Lesnikoski BA, Ross JS, Krumholz HM, Gross CP. For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery. Surgery 2013, 155: 776-788. PMID: 24787104, PMCID: PMC4008843, DOI: 10.1016/j.surg.2013.12.009.Peer-Reviewed Original ResearchConceptsHospital ownership statusBreast-conserving operationsBreast-conserving surgeryUse of brachytherapyRadiation therapyOperative careBreast cancerMedicare beneficiariesOverall useReceipt of brachytherapyAdjuvant radiation therapyInvasive breast cancerFemale Medicare beneficiariesGreater overall useYears of ageShort life expectancyRetrospective studyRT modalityProfit hospitalsExpensive modalityOlder womenBrachytherapy useBreast brachytherapyHospitalBrachytherapyThe cost implications of prostate cancer screening in the Medicare population
Ma X, Wang R, Long JB, Ross JS, Soulos PR, Yu JB, Makarov DV, Gold HT, Gross CP. The cost implications of prostate cancer screening in the Medicare population. Cancer 2013, 120: 96-102. PMID: 24122801, PMCID: PMC3867600, DOI: 10.1002/cncr.28373.Peer-Reviewed Original ResearchConceptsProstate cancerScreening costsAnnual screening costsPopulation-based cohortProstate cancer screeningHospital referral region levelMale Medicare beneficiariesProstate-specific antigenCancer screeningLowest quartileHRR levelMedicare populationMedicare beneficiariesOlder menNational feeCancerService Medicare programCancer diagnosisMenQuartilePSACost implicationsAnnual expenditureMedicare programBiopsyTrends and clinical implications of preoperative breast MRI in Medicare beneficiaries with breast cancer
Killelea BK, Long JB, Chagpar AB, Ma X, Soulos PR, Ross JS, Gross CP. Trends and clinical implications of preoperative breast MRI in Medicare beneficiaries with breast cancer. Breast Cancer Research And Treatment 2013, 141: 155-163. PMID: 23942872, PMCID: PMC3893026, DOI: 10.1007/s10549-013-2656-1.Peer-Reviewed Original ResearchConceptsPreoperative breast magnetic resonance imagingBreast magnetic resonance imagingBreast-conserving surgeryMagnetic resonance imagingBreast cancerSurgical approachBilateral cancerMRI useOlder womenAssociation of MRIEnd Results-Medicare databasePreoperative MRI useContralateral prophylactic mastectomyType of surgeryCohort of womenBilateral mastectomyUnilateral mastectomyProphylactic mastectomyMastectomyMedicare beneficiariesSurgeryResonance imagingClinical implicationsCancerInvasive surgeryAge-based and Sex-based Disparities in Screening Colonoscopy Use Among Medicare Beneficiaries
Gancayco J, Soulos PR, Khiani V, Cramer LD, Ross JS, Genao I, Tinetti M, Gross CP. Age-based and Sex-based Disparities in Screening Colonoscopy Use Among Medicare Beneficiaries. Journal Of Clinical Gastroenterology 2013, 47: 630-636. PMID: 23619827, DOI: 10.1097/mcg.0b013e31828345c8.Peer-Reviewed Original ResearchConceptsColonoscopy useScreening colonoscopyColonoscopy ratesLife expectancyMedicare beneficiariesOlder personsColorectal cancer incidencePatient demographic characteristicsLow screening ratesSex-based disparitiesShort life expectancySex-based differencesLonger life expectancyPatients 68Older patientsPatients 75Screening ratesCancer incidenceLarge cohortMedicare claimsColonoscopyMedicare dataPatientsPoisson regressionLife table approach
2012
Impact of the 2008 US Preventive Services Task Force Recommendation to Discontinue Prostate Cancer Screening Among Male Medicare Beneficiaries
Ross JS, Wang R, Long JB, Gross CP, Ma X. Impact of the 2008 US Preventive Services Task Force Recommendation to Discontinue Prostate Cancer Screening Among Male Medicare Beneficiaries. JAMA Internal Medicine 2012, 172: 1601-1603. PMID: 22987029, PMCID: PMC3597450, DOI: 10.1001/archinternmed.2012.3726.Peer-Reviewed Original ResearchBased On Key Measures, Care Quality For Medicare Enrollees At Safety-Net And Non-Safety-Net Hospitals Was Almost Equal
Ross JS, Bernheim SM, Lin Z, Drye EE, Chen J, Normand SL, Krumholz HM. Based On Key Measures, Care Quality For Medicare Enrollees At Safety-Net And Non-Safety-Net Hospitals Was Almost Equal. Health Affairs 2012, 31: 1739-1748. PMID: 22869652, PMCID: PMC3527010, DOI: 10.1377/hlthaff.2011.1028.Peer-Reviewed Original ResearchConceptsSafety-net hospitalNet hospitalReadmission ratesUrban hospitalHeart failure mortalityRisk-standardized ratesAcute myocardial infarctionIndicators of careService Medicare beneficiariesHeart failureClinical outcomesMyocardial infarctionWorse outcomesMedicare beneficiariesHospitalMedicare enrolleesHospital qualityCare qualityVulnerable populationsGreater financial strainOutcomesMortalityFinancial strainCareMore affluent populations