2024
Evaluation of a collaborative model between managed care and affordable housing on acute care costs.
Tsai J, Rajan S, Truong C, Schick V, Ganduglia Cazaban C. Evaluation of a collaborative model between managed care and affordable housing on acute care costs. The American Journal Of Managed Care 2024, 30: 133-138. PMID: 38457821, DOI: 10.37765/ajmc.2024.89514.Peer-Reviewed Original ResearchMeSH KeywordsCephalosporinsCosts and Cost AnalysisHousingHumansManaged Care ProgramsMedicaidUnited StatesConceptsEmergency department/urgent care visitsHealth care outcomesCollaborative modelAcute care costsHealth care coverageCommunity serviceCare outcomesHousing communitiesCare visitsCare coverageCollaborative service modelCare costsPrescription costsMedical claimsMedicaid MCOsProsperaService modelHousingResearch designMCOParticipantsCommunityEconomic valueServicesHealthplan
2023
State-Level Variation in Supplemental Maternity Kick Payments in Medicaid Managed Care
Auty S, Daw J, Wallace J. State-Level Variation in Supplemental Maternity Kick Payments in Medicaid Managed Care. JAMA Internal Medicine 2023, 183: 80-82. PMID: 36374489, PMCID: PMC9664368, DOI: 10.1001/jamainternmed.2022.5146.Peer-Reviewed Original Research
2022
Factors Associated With Contracting Between Area Agencies on Aging and Health Care Entities
Brewster AL, Wilson TL, Kunkel SR, Curry LA, Rubeo C. Factors Associated With Contracting Between Area Agencies on Aging and Health Care Entities. Journal Of Applied Gerontology 2022, 41: 1878-1886. PMID: 35505592, DOI: 10.1177/07334648221096137.Peer-Reviewed Original ResearchIn Medicaid Managed Care Networks, Care Is Highly Concentrated Among A Small Percentage Of Physicians
Ludomirsky AB, Schpero WL, Wallace J, Lollo A, Bernheim S, Ross JS, Ndumele CD. In Medicaid Managed Care Networks, Care Is Highly Concentrated Among A Small Percentage Of Physicians. Health Affairs 2022, 41: 760-768. PMID: 35500192, DOI: 10.1377/hlthaff.2021.01747.Peer-Reviewed Original ResearchConceptsCare plansPercent of specialistsOutpatient primary carePrimary care physiciansManaged Care NetworkCare physiciansPrimary careMedicaid patientsMedicaid beneficiariesPhysicians' willingnessSpecialist physiciansPhysiciansCare networkMedicaid ServicesCareMedicaid participationOne-thirdNetwork adequacy standardsSmall percentagePercentBeneficiary preferencesPatients
2021
Effects of forced disruption in Medicaid managed care on children with asthma
Piwnica‐Worms K, Staiger B, Ross JS, Rosenthal MS, Ndumele CD. Effects of forced disruption in Medicaid managed care on children with asthma. Health Services Research 2021, 56: 668-676. PMID: 33624290, PMCID: PMC8313960, DOI: 10.1111/1475-6773.13643.Peer-Reviewed Original ResearchConceptsPrimary care providersPersistent asthmaCare plansOutpatient visitsCare utilizationCare administrative claims dataEmergency department utilizationHealth care utilizationAdministrative claims dataIndicators of asthmaProportion of childrenPatients outpatientHealth utilizationAdministrative claimsAsthmaCare providersClaims dataNumber of childrenConsistent associationMedicaidVisitsChildrenOutpatientsPercentage point decreaseEnrollment data
2018
Network Optimization And The Continuity Of Physicians In Medicaid Managed Care
Ndumele CD, Staiger B, Ross JS, Schlesinger MJ. Network Optimization And The Continuity Of Physicians In Medicaid Managed Care. Health Affairs 2018, 37: 929-935. PMID: 29863934, DOI: 10.1377/hlthaff.2017.1410.Peer-Reviewed Original ResearchMeSH KeywordsChronic DiseaseContinuity of Patient CareCost ControlDatabases, FactualDelivery of Health CareFemaleHealth ExpendituresHealth Maintenance OrganizationsHealth Services AccessibilityHumansMaleManaged Care ProgramsMedicaidPhysiciansPractice Patterns, Physicians'Retrospective StudiesUnited States
2017
Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees
Ndumele CD, Cohen MS, Cleary PD. Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees. JAMA Internal Medicine 2017, 177: 1445-1451. PMID: 28806455, PMCID: PMC5710214, DOI: 10.1001/jamainternmed.2017.3766.Peer-Reviewed Original Research
2016
Medicare Prescription Drug Plan Enrollees Report Less Positive Experiences Than Their Medicare Advantage Counterparts
Elliott MN, Landon BE, Zaslavsky AM, Edwards C, Orr N, Beckett MK, Mallett J, Cleary PD. Medicare Prescription Drug Plan Enrollees Report Less Positive Experiences Than Their Medicare Advantage Counterparts. Health Affairs 2016, 35: 456-463. PMID: 26953300, DOI: 10.1377/hlthaff.2015.0816.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overDatabases, FactualDrug PrescriptionsFemaleHealth ExpendituresHumansInsurance CoverageInsurance, Pharmaceutical ServicesMaleManaged Care ProgramsMedicare Part CMedicare Part DPatient SatisfactionRetrospective StudiesSex FactorsSurveys and QuestionnairesUnited StatesConceptsPrescription drug plansPrescription drug coverageDrug plansMedicare beneficiariesDrug coverageCommunity-dwelling Medicare beneficiariesOverall health care costsMedicare Advantage health plansMA plansHealth care costsPercent of beneficiariesAffordable Care ActQuality bonus paymentsPlan enrolleesMedicare prescription drug coverageCare costsHealth plansCare ActPositive experiencesAge sixtyBeneficiary assessmentMedicationsMA counterpartsBeneficiariesEnrollees
2013
Evaluation of a Care Coordination Measure for the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Medicare Survey
Hays RD, Martino S, Brown JA, Cui M, Cleary P, Gaillot S, Elliott M. Evaluation of a Care Coordination Measure for the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Medicare Survey. Medical Care Research And Review 2013, 71: 192-202. PMID: 24227813, PMCID: PMC3959996, DOI: 10.1177/1077558713508205.Peer-Reviewed Original ResearchConceptsCare coordinationHealthcare providersConsumer AssessmentCAHPS global ratingCare coordination measuresBetter care coordinationMedicare surveyOverall care qualityMedical recordsPersonal doctorPatient reportsStrong unique associationCare qualityGlobal ratingHealth careFive-item measureComposite scoreCarePlan performanceCoordination measuresUnique associationPatientsProvidersCare Experiences of Managed Care Medicare Enrollees Near the End of Life
Elliott MN, Haviland AM, Cleary PD, Zaslavsky AM, Farley DO, Klein DJ, Edwards CA, Beckett MK, Orr N, Saliba D. Care Experiences of Managed Care Medicare Enrollees Near the End of Life. Journal Of The American Geriatrics Society 2013, 61: 407-412. PMID: 23379270, DOI: 10.1111/jgs.12121.Peer-Reviewed Original ResearchConceptsCare experiencesSocial Security Administration death recordsParticipants' experiencesIndividual experiencesBad experiencesExperienceRepresentative sampleFuture researchEnd of lifeIndividual deathSurvey completionSurveyHealthcare providersGood experienceRaceEthnicityPrescription drug coverageEducationRetrospective reportsGeographic regions
2011
Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in traditional Medicare.
Mittler JN, Landon BE, Zaslavsky AM, Cleary PD. Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in traditional Medicare. Medicare & Medicaid Research Review 2011, 1: e1-19. PMID: 22340776, PMCID: PMC4010617, DOI: 10.5600/mmrr.001.03.a03.Peer-Reviewed Original ResearchConceptsMarket characteristicsBeneficiaries' awarenessTraditional MedicareMedicare risk plansCoverage choicesChoice setsMedicare riskMedicare Current Beneficiary Survey dataCare penetrationSurvey dataBeneficiary knowledgeRisk plansBeneficiariesElderly beneficiariesMore plansTraditional Medicare beneficiariesMedicareCross-sectional analysisRegression modelsChoiceMore accurate knowledgeMedicare beneficiariesMore successConsumersCare optionsHow Do the Experiences of Medicare Beneficiary Subgroups Differ between Managed Care and Original Medicare?
Elliott MN, Haviland AM, Orr N, Hambarsoomian K, Cleary PD. How Do the Experiences of Medicare Beneficiary Subgroups Differ between Managed Care and Original Medicare? Health Services Research 2011, 46: 1039-1058. PMID: 21306370, PMCID: PMC3165177, DOI: 10.1111/j.1475-6773.2011.01245.x.Peer-Reviewed Original ResearchConceptsFair self-rated healthHealth care providersSubgroup characteristicsSelf-rated healthHealth care experiencesLow-income subsidyMedicare Consumer AssessmentUniform careCare scoresAge 85Care providersMedicare beneficiariesService MedicareCare experiencesCAHPS measuresConsumer AssessmentHigh school degreeCareSystem surveyParticular subgroupManaged CareAssessed differencesTraditional feeLow incomeSignificant positive interaction
2010
Market Variations in Intensity of Medicare Service Use and Beneficiary Experiences with Care
Mittler JN, Landon BE, Fisher ES, Cleary PD, Zaslavsky AM. Market Variations in Intensity of Medicare Service Use and Beneficiary Experiences with Care. Health Services Research 2010, 45: 647-669. PMID: 20403055, PMCID: PMC2875753, DOI: 10.1111/j.1475-6773.2010.01108.x.Peer-Reviewed Original ResearchAgedAged, 80 and overClinical CompetenceCommunicationFee-for-Service PlansFemaleHealth Care SurveysHealth Services AccessibilityHumansLinear ModelsMaleManaged Care ProgramsMarketing of Health ServicesMedicarePatient SatisfactionProfessional-Patient RelationsQuality of Health CareReferral and ConsultationRisk AdjustmentSmall-Area AnalysisTerminal CareTime FactorsUnited StatesVaccination
2009
Quality Assessments by Sick and Healthy Beneficiaries in Traditional Medicare and Medicare Managed Care
Keenan PS, Elliott MN, Cleary PD, Zaslavsky AM, Landon BE. Quality Assessments by Sick and Healthy Beneficiaries in Traditional Medicare and Medicare Managed Care. Medical Care 2009, 47: 882-888. PMID: 19543123, DOI: 10.1097/mlr.0b013e3181a39415.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overFemaleHealth StatusHumansMaleManaged Care ProgramsMedicaidMedicareQuality Assurance, Health CareSocioeconomic FactorsUnited StatesConceptsPreventive services measuresCare experiencesPreventive servicesMedicaid ServicesPreventive services receiptRates of immunizationCAHPS scoresExperience measuresOffice wait timeQuality of careTraditional MedicareSick groupPhysician ratingsCare plansMedicare Managed CareHealthcare providersService MedicareCAHPS measuresHealth plansService receiptConsumer AssessmentSystem surveyHealthier beneficiariesManaged CareMedicareMarket and Beneficiary Characteristics Associated With Enrollment in Medicare Managed Care Plans and Fee-for-Service
Shimada SL, Zaslavsky AM, Zaborski LB, O'Malley AJ, Heller A, Cleary PD. Market and Beneficiary Characteristics Associated With Enrollment in Medicare Managed Care Plans and Fee-for-Service. Medical Care 2009, 47: 517-523. PMID: 19365291, DOI: 10.1097/mlr.0b013e318195f86e.Peer-Reviewed Original Research
2005
Does the Impact of Managed Care on Substance Abuse Treatment Services Vary by Provider Profit Status?
Olmstead TA, Sindelar JL. Does the Impact of Managed Care on Substance Abuse Treatment Services Vary by Provider Profit Status? Health Services Research 2005, 40: 1862-1882. PMID: 16336553, PMCID: PMC1361225, DOI: 10.1111/j.1475-6773.2005.00431.x.Peer-Reviewed Original ResearchMeSH KeywordsHealth Facilities, ProprietaryHumansManaged Care ProgramsOwnershipSubstance Abuse Treatment CentersConceptsSubstance abuse treatment servicesTreatment servicesSAT facilitiesImpact of MCQuality of careFacility ownership typeFacility ownershipArea Resource FileFP clinicsTherapy/counselingRange of servicesSAT servicesMC activityManaged CareResource FileCareNational surveyTransitional servicesMedical testingSpecific mechanismsProfit statusInvolvementFurther researchImpact of Managed Care on Cancer Trial Enrollment
Gross CP, Krumholz HM. Impact of Managed Care on Cancer Trial Enrollment. Journal Of Clinical Oncology 2005, 23: 3811-3818. PMID: 15923575, DOI: 10.1200/jco.2005.00.430.Peer-Reviewed Original ResearchConceptsTrial enrollment ratesCancer trial enrollmentTrial enrollmentCare penetrationCooperative group trialsLow enrollment ratesNational Cancer InstituteCounty characteristicsFourth quartileTrial participationLowest quartileProstate cancerCare competitionGroup trialsCancer InstituteStrong inverse correlationBivariate analysisCare activitiesMultivariate modelParticipant dataInverse correlationEnrollment ratesManaged CareZip codesQuartile
2004
Plan, Geographical, and Temporal Variation of Consumer Assessments of Ambulatory Health Care
Zaslavsky AM, Zaborski LB, Cleary PD. Plan, Geographical, and Temporal Variation of Consumer Assessments of Ambulatory Health Care. Health Services Research 2004, 39: 1467-1486. PMID: 15333118, PMCID: PMC1361079, DOI: 10.1111/j.1475-6773.2004.00299.x.Peer-Reviewed Original ResearchConceptsHealth plansConsumer AssessmentCare plansHealth Plans Study (CAHPS) surveyGlobal ratingRatings of careHealth plan qualityAspects of careQuality of careAmbulatory health careQuality improvement measuresPrescription drug benefitPrescription accessStudy periodDrug benefitCareHealth carePlan qualityMedicareBenefit designMeaningful changeRepresentative sampleDoctorsYearsUtilization of nonsteroidal anti-inflammatory drugs and antisecretory agents: a managed care claims analysis
Ofman JJ, Badamgarav E, Henning JM, Knight K, Laine L. Utilization of nonsteroidal anti-inflammatory drugs and antisecretory agents: a managed care claims analysis. The American Journal Of Medicine 2004, 116: 835-842. PMID: 15178499, DOI: 10.1016/j.amjmed.2004.02.028.Peer-Reviewed Original ResearchConceptsCOX-2 inhibitorsCardiac eventsHealth care costsGastrointestinal bleedingTraditional NSAIDsHigh riskGreater total health care costsNonsteroidal anti-inflammatory drug therapyCare costsAnti-inflammatory drug therapyCOX-2 inhibitor therapyTotal health care costsCyclooxygenase-2 selective inhibitorNonsteroidal anti-inflammatory drugsCardiac risk profileProton pump inhibitorsAnti-inflammatory drugsLogistic regression analysisNSAID therapyNSAID usersGastrointestinal riskInhibitor useNonselective NSAIDsInhibitor therapyCardiac riskComparison of Performance of Traditional Medicare vs Medicare Managed Care
Landon BE, Zaslavsky AM, Bernard SL, Cioffi MJ, Cleary PD. Comparison of Performance of Traditional Medicare vs Medicare Managed Care. JAMA 2004, 291: 1744-1752. PMID: 15082702, DOI: 10.1001/jama.291.14.1744.Peer-Reviewed Original ResearchConceptsPreventive servicesHealth Plans Study (CAHPS) surveyRatings of careAspects of careModel of careBeneficiaries' experiencesFFS Medicare beneficiariesReports of receiptTraditional MedicareCare enrolleesFFS plansMedicare populationMedicare beneficiariesMedicare Managed CareCAHPS surveyCase mixMMC plansService MedicareMMC enrollmentSample of beneficiariesMedicaid ServicesConsumer AssessmentCareHealth careManaged Care
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