2023
Financial Conflicts of Interest in Public Comments on Medicare National Coverage Determinations of Medical Devices
Lu A, Ji R, Ge A, Ross J, Ramachandran R, Redberg R, Dhruva S. Financial Conflicts of Interest in Public Comments on Medicare National Coverage Determinations of Medical Devices. JAMA 2023, 330: 1094-1096. PMID: 37589985, PMCID: PMC10436180, DOI: 10.1001/jama.2023.14414.Peer-Reviewed Original Research
2022
Medicare’s National Coverage Determination for Aducanumab — A One-Off or a Pragmatic Path Forward?
Dhruva SS, Ramachandran R, Ross JS. Medicare’s National Coverage Determination for Aducanumab — A One-Off or a Pragmatic Path Forward? New England Journal Of Medicine 2022, 387: 1539-1541. PMID: 36301560, DOI: 10.1056/nejmp2210198.Commentaries, Editorials and Letters
2021
Medicare’s New Device-Coverage Pathway — Breakthrough or Breakdown?
Rathi VK, Johnston JL, Ross JS, Dhruva SS. Medicare’s New Device-Coverage Pathway — Breakthrough or Breakdown? New England Journal Of Medicine 2021, 384: e43. PMID: 33691059, DOI: 10.1056/nejmp2101874.Commentaries, Editorials and Letters
2020
Medicare Prescription Drug Plan Coverage of Hormone Therapies Used by Transgender Individuals
Solotke MT, Liu P, Dhruva SS, Gulanski B, Shah ND, Ross JS. Medicare Prescription Drug Plan Coverage of Hormone Therapies Used by Transgender Individuals. LGBT Health 2020, 7: 137-145. PMID: 32267818, DOI: 10.1089/lgbt.2019.0306.Peer-Reviewed Original Research
2019
Evolution of Medicare Formulary Coverage Changes for Antithrombotic Therapies After Guideline Updates
Dayoub EJ, Ross JS, Shah ND, Dhruva SS. Evolution of Medicare Formulary Coverage Changes for Antithrombotic Therapies After Guideline Updates. Circulation 2019, 140: 1227-1230. PMID: 31567008, DOI: 10.1161/circulationaha.119.040580.Peer-Reviewed Original ResearchMedicare Spending on Drugs and Biologics Not Recommended for Coverage by International Health Technology Assessment Agencies
Egilman AC, Wallach JD, Dhruva SS, Gonsalves GS, Ross JS. Medicare Spending on Drugs and Biologics Not Recommended for Coverage by International Health Technology Assessment Agencies. Journal Of General Internal Medicine 2019, 34: 2319-2321. PMID: 31313117, PMCID: PMC6848610, DOI: 10.1007/s11606-019-05149-6.Peer-Reviewed Original ResearchAssociation Between Insurance Status and Access to Hospital Care in Emergency Department Disposition
Venkatesh AK, Chou SC, Li SX, Choi J, Ross JS, D’Onofrio G, Krumholz HM, Dharmarajan K. Association Between Insurance Status and Access to Hospital Care in Emergency Department Disposition. JAMA Internal Medicine 2019, 179: 686-693. PMID: 30933243, PMCID: PMC6503571, DOI: 10.1001/jamainternmed.2019.0037.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAsthmaCritical CareCross-Sectional StudiesDatabases, FactualEmergency Service, HospitalFemaleHealth Services AccessibilityHospitalizationHumansInsurance CoverageInsurance, HealthLung DiseasesMaleMedicaidMedically UninsuredMiddle AgedPatient DischargePatient TransferPneumoniaPulmonary Disease, Chronic ObstructiveUnited StatesConceptsNational Emergency Department SampleEmergency Department SampleCommon medical conditionsUninsured patientsCritical care capabilitiesED dischargeED visitsED transfersPulmonary diseaseCare capabilitiesInsurance statusHigher oddsMedicaid beneficiariesMedical conditionsChronic obstructive pulmonary diseaseAcute pulmonary diseaseEmergency department transfersAdult ED visitsHospital admission ratesObstructive pulmonary diseaseEmergency department dispositionPatient insurance statusPatient case mixHospital ownership statusIntensive care capabilitiesMedicare Formulary Coverage and Restrictions for Opioid Potentiators from 2013 to 2017
Vijay A, Ross JS, Shah ND, Jeffery MM, Dhruva SS. Medicare Formulary Coverage and Restrictions for Opioid Potentiators from 2013 to 2017. Journal Of General Internal Medicine 2019, 34: 518-520. PMID: 30623386, PMCID: PMC6445908, DOI: 10.1007/s11606-018-4752-8.Peer-Reviewed Original Research
2018
Coverage of Novel Therapeutic Agents by Medicare Prescription Drug Plans Following FDA Approval
Shaw DL, Dhruva SS, Ross JS. Coverage of Novel Therapeutic Agents by Medicare Prescription Drug Plans Following FDA Approval. Journal Of Managed Care & Specialty Pharmacy 2018, 24: 10.18553/jmcp.2018.24.12.1230. PMID: 30479199, PMCID: PMC10397592, DOI: 10.18553/jmcp.2018.24.12.1230.Peer-Reviewed Original ResearchConceptsNovel therapeutic agentsPrescription drug plansOrphan drug statusFDA approvalYear of approvalTherapeutic agentsNovel therapeuticsPrior authorizationNovel therapiesPriority reviewStep therapyMedicare prescription drug plansDrug plansDrug coverageNational InstituteDrug statusPart D prescription drug benefitMedicaid ServicesDrug characteristicsTherapeutic areasCross-sectional studyDrug benefit coverageHealth insurance payerBlue Cross Blue Shield AssociationPrescription drug benefitEvidence supporting FDA approval and CMS national coverage determinations for novel medical products, 2005 through 2016
Roginiel AC, Dhruva SS, Ross JS. Evidence supporting FDA approval and CMS national coverage determinations for novel medical products, 2005 through 2016. Medicine 2018, 97: e12715. PMID: 30290675, PMCID: PMC6200488, DOI: 10.1097/md.0000000000012715.Peer-Reviewed Original ResearchConceptsOriginal clinical trialsCMS national coverage determinationsNational Coverage DeterminationClinical trialsFDA approvalControl armFDA approval documentsQuality of trialsCross-sectional studySignificant differencesCoverage determinationMedian ageMedian timePivotal trialsQuantity of evidenceInclusion criteriaTrial participantsMedicare populationCMS coverageDrug AdministrationStudy sizeNovel therapeuticsMedicaid ServicesMarketing approvalTrials
2017
Health and Health Care Use Among Individuals at Risk to Lose Health Insurance With Repeal of the Affordable Care Act
Karaca-Mandic P, Jena AB, Ross JS. Health and Health Care Use Among Individuals at Risk to Lose Health Insurance With Repeal of the Affordable Care Act. JAMA Internal Medicine 2017, 177: 590-593. PMID: 28114528, PMCID: PMC5470386, DOI: 10.1001/jamainternmed.2016.9541.Peer-Reviewed Original ResearchMeSH KeywordsHumansInsurance CoverageInsurance, HealthPatient Protection and Affordable Care ActUnited States
2016
Accounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates
Bernheim SM, Parzynski CS, Horwitz L, Lin Z, Araas MJ, Ross JS, Drye EE, Suter LG, Normand SL, Krumholz HM. Accounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates. Health Affairs 2016, 35: 1461-1470. PMID: 27503972, PMCID: PMC7664840, DOI: 10.1377/hlthaff.2015.0394.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramPatients' socioeconomic statusMedicare's Hospital Readmissions Reduction ProgramLow socioeconomic statusReadmission ratesSocioeconomic statusRisk-standardized readmission ratesHospital readmission ratesReadmissions Reduction ProgramMedicaid Services methodologyReadmission measuresHospital resultsPatientsHospitalSuch hospitalsPayment penaltiesReduction programsStatusCurrent CentersLower proportionLarge proportionPercentAdjustmentProportion
2013
Hospital Discharge and the Transition Home for Poor Patients: “I Knew I Couldn’t Do What They Were Asking Me”
Bernheim SM, Ross JS. Hospital Discharge and the Transition Home for Poor Patients: “I Knew I Couldn’t Do What They Were Asking Me”. Journal Of General Internal Medicine 2013, 29: 269-270. PMID: 24327310, PMCID: PMC3912274, DOI: 10.1007/s11606-013-2698-4.Commentaries, Editorials and LettersMeSH KeywordsContinuity of Patient CareFemaleHealth BehaviorHumansInsurance CoverageMaleMedicaidMedically UninsuredPatient DischargeTrends 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 surgery
2012
Impact of State Laws That Extend Eligibility for Parents’ Health Insurance Coverage to Young Adults
Blum AB, Kleinman LC, Starfield B, Ross JS. Impact of State Laws That Extend Eligibility for Parents’ Health Insurance Coverage to Young Adults. Pediatrics 2012, 129: 426-432. PMID: 22331339, PMCID: PMC3356137, DOI: 10.1542/peds.2011-1505.Peer-Reviewed Original ResearchConceptsHealth insurance coverageParents' insurancePhysical examYoung adultsBehavior Risk Factor Surveillance SystemRisk Factor Surveillance SystemRecent physical examInsurance coveragePhysicians/cliniciansForgone careAffordable Care ActClinician identificationHealth insurance companiesSelf-reported health insurance coverageAge 26Parents' policiesHealth insuranceCare ActCareDifferential improvementEligibilityAdultsSurveillance systemOutcomesPast year
2010
Beyond insurance coverage: Usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003-2006 National Health and Nutrition Examination Survey
Spatz ES, Ross JS, Desai MM, Canavan ME, Krumholz HM. Beyond insurance coverage: Usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003-2006 National Health and Nutrition Examination Survey. American Heart Journal 2010, 160: 115-121. PMID: 20598981, PMCID: PMC3025407, DOI: 10.1016/j.ahj.2010.04.013.Peer-Reviewed Original ResearchConceptsTreatment of hypertensionNutrition Examination SurveyInsurance statusMedication treatmentExamination SurveyNational HealthUsual sourceAdult Treatment Panel III recommendationsJoint National Committee 7Multivariable logistic regression modelingInsurance coverageSeparate multivariable modelsChronic disease managementLogistic regression modelingHigh-quality careRace/ethnicityCardiovascular diseaseMultivariable modelStratified analysisHypertensionHypercholesterolemiaRegular sourceCareDisease managementIndependent effectsHealth Care Insurance, Financial Concerns in Accessing Care, and Delays to Hospital Presentation in Acute Myocardial Infarction
Smolderen KG, Spertus JA, Nallamothu BK, Krumholz HM, Tang F, Ross JS, Ting HH, Alexander KP, Rathore SS, Chan PS. Health Care Insurance, Financial Concerns in Accessing Care, and Delays to Hospital Presentation in Acute Myocardial Infarction. JAMA 2010, 303: 1392-1400. PMID: 20388895, PMCID: PMC3020978, DOI: 10.1001/jama.2010.409.Peer-Reviewed Original Research
2009
Mis-SHAPEing Public Health Policy
Spatz ES, Ross JS. Mis-SHAPEing Public Health Policy. Circulation Cardiovascular Quality And Outcomes 2009, 2: 681-683. PMID: 20031909, PMCID: PMC2835162, DOI: 10.1161/circoutcomes.109.890715.Commentaries, Editorials and Letters
2007
Insurance coverage and care of patients with non ST-segment elevation acute coronary syndromes.
Ross JS. Insurance coverage and care of patients with non ST-segment elevation acute coronary syndromes. Annals Of Internal Medicine 2007, 147: 212; author reply 212. PMID: 17679711, DOI: 10.7326/0003-4819-147-3-200708070-00014.Commentaries, Editorials and Letters