Inquiry: The Journal of Health Care Organization, Provision, and Financing This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Medicaid Family Planning Waivers in 3 States: Did They Reduce Unwanted Births?
Effects of Medicaid family planning waivers on unintended births and contraceptive use postpartum were examined in Illinois, New York, and Oregon using the Pregnancy Risk Assessment Monitoring System. Estimates for women who would be Medicaid eligible "if" pregnant in the waiver states and states without expansions were derived using a difference-in-differences approach. Waivers in New York and Illinois were associated with almost a 5.0 percentage point reduction in unwanted births among adults and with a 7 to 8.0 percentage point reduction, among youth less than 21 years of age. Oregon’s waiver was associated with a...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - June 4, 2015 Category: Health Management Authors: Adams, E. K., Galactionova, K., Kenney, G. M. Tags: Article Source Type: research

The 2014 Governors Races and Health Care: A Campaign Web Site Analysis
The November 2014 midterm election was the first election since key coverage provisions of the Affordable Care Act (ACA) were implemented, including the Medicaid expansion and creation of the health insurance exchanges. The pre-election variability in the states’ implementation of these provisions coupled with the large number of states selecting their next governor made the election important at the state level. To better understand the role of health care in the recent gubernatorial elections, we analyzed health policy content presented by 71 candidates for governor on their campaign Web sites. Nearly 80% of all ca...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 5, 2015 Category: Health Management Authors: Scott, K. W., Blendon, R. J., Sommers, B. D. Tags: Research Letter Source Type: research

The 2014 Governors' Races and Health Care: A Campaign Web Site Analysis
The November 2014 midterm election was the first election since key coverage provisions of the Affordable Care Act (ACA) were implemented, including the Medicaid expansion and creation of the health insurance exchanges. The pre-election variability in the states’ implementation of these provisions coupled with the large number of states selecting their next governor made the election important at the state level. To better understand the role of health care in the recent gubernatorial elections, we analyzed health policy content presented by 71 candidates for governor on their campaign Web sites. Nearly 80% of all ca...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 5, 2015 Category: Health Management Authors: Scott, K. W., Blendon, R. J., Sommers, B. D. Tags: Article Source Type: research

The Opportunity Cost of Capital: Development of New Pharmaceuticals
The opportunity cost of the capital invested in pharmaceutical research and development (R&D) to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this "hidden" cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost o...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2015 Category: Health Management Authors: Chit, A., Chit, A., Papadimitropoulos, M., Krahn, M., Parker, J., Grootendorst, P. Tags: Article Source Type: research

Mispricing in the Medicare Advantage Risk Adjustment Model
The Centers for Medicare and Medicaid Services (CMS) implemented hierarchical condition category (HCC) models in 2004 to adjust payments to Medicare Advantage (MA) plans to reflect enrollees’ expected health care costs. We use Verisk Health’s diagnostic cost group (DxCG) Medicare models, refined "descendants" of the same HCC framework with 189 comprehensive clinical categories available to CMS in 2004, to reveal 2 mispricing errors resulting from CMS’ implementation. One comes from ignoring all diagnostic information for "new enrollees" (those with less than 12 months of prior claims). Another comes from ...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2015 Category: Health Management Authors: Chen, J., Ellis, R. P., Toro, K. H., Ash, A. S. Tags: Article Source Type: research

Development and Psychometric Assessment of the Healthcare Provider Cultural Competence Instrument
This study presents the measurement properties of 5 scales used in the Healthcare Provider Cultural Competence Instrument (HPCCI). The HPCCI measures a health care provider’s cultural competence along 5 primary dimensions: (1) awareness/sensitivity, (2) behaviors, (3) patient-centered communication, (4) practice orientation, and (5) self-assessment. Exploratory factor analysis demonstrated that the 5 scales were distinct, and within each scale items loaded as expected. Reliability statistics indicated a high level of internal consistency within each scale. The results indicate that the HPCCI effectively measures the ...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - April 24, 2015 Category: Health Management Authors: Schwarz, J. L., Witte, R., Sellers, S. L., Luzadis, R. A., Weiner, J. L., Domingo-Snyder, E., Page, J. E. Tags: Article Source Type: research

The Expanding Role of Managed Care in the Medicaid Program: Implications for Health Care Access, Use, and Expenditures for Nonelderly Adults
States increasingly use managed care for Medicaid enrollees, yet evidence of its impact on health care outcomes is mixed. This research studies county-level Medicaid managed care (MMC) penetration and health care outcomes among nonelderly disabled and nondisabled enrollees. Results for nondisabled adults show that increased penetration is associated with increased probability of an emergency department visit, difficulty seeing a specialist, and unmet need for prescription drugs, and is not associated with reduced expenditures. We find no association between penetration and health care outcomes for disabled adults. This sug...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - April 16, 2015 Category: Health Management Authors: Caswell, K. J., Long, S. K. Tags: Article Source Type: research

Outpatient Provider Concentration and Commercial Colonoscopy Prices
The objective was to evaluate the magnitude of various contributors to outpatient commercial colonoscopy prices, including market- and provider-level factors, especially market share. We used adjudicated fee-for-service facility claims from a large commercial insurer for colonoscopies occurring in hospital outpatient department or ambulatory surgery center from October 2005 to December 2012. Claims were matched to provider- and market-level data. Linear fixed effects regressions of negotiated colonoscopy price were run on provider, system, and market characteristics. Markets were defined as counties. There were 178 433 cla...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - April 13, 2015 Category: Health Management Authors: Pozen, A. Tags: Article Source Type: research

Price-Transparency and Cost Accounting: Challenges for Health Care Organizations in the Consumer-Driven Era
This article discusses use of activity-based costing (ABC) to better measure the cost of health care. It describes examples of ABC in health care organizations and discusses impediments to adoption in the United States including cultural and institutional barriers. (Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing)
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - April 10, 2015 Category: Health Management Authors: Hilsenrath, P., Eakin, C., Fischer, K. Tags: Article Source Type: research

A Cost Analysis of Kidney Replacement Therapy Options in Palestine
This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16 277 for the first year; the estimated cost of HD per patient av...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - March 11, 2015 Category: Health Management Authors: Younis, M., Jabr, S., Al-Khatib, A., Forgione, D., Hartmann, M., Kisa, A. Tags: Article Source Type: research

Use of Statins by Medicare Beneficiaries Post Myocardial Infarction: Poor Physician Quality or Patient-Centered Care?
Even though guidelines strongly recommend that patients receive a statin for secondary prevention after an acute myocardial infarction (MI), many elderly patients do not fill a statin prescription within 30 days of discharge. This paper assesses whether patterns of statin use by Medicare beneficiaries post-discharge may be due to a mix of high-quality and low-quality physicians. Our data come from the Centers for Medicare & Medicaid Services (CMS) Chronic Condition Data Warehouse (CCW) and include 100% of Medicare beneficiaries hospitalized for an acute myocardial infarction in 2008 or 2009. Our study sample included p...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - February 27, 2015 Category: Health Management Authors: Schroeder, M. C., Robinson, J. G., Chapman, C. G., Brooks, J. M. Tags: Article Source Type: research

Factors Influencing the Opinion of Patients Concerning the Functioning of the Polish Hospital Before and After Ownership Transformation
Studies of satisfaction among patients are a popular and frequently obligatory tool used in improving the quality of medical services worldwide. Becoming familiar with the opinion of the patients enables to adjust the venue to their expectations, thus contributing to the increase in its competitiveness. We aimed to study patients’ satisfaction understood as a tool used in increasing the quality of medical services; in addition, we assessed factors that affect a worse review patients gave about the functioning of this Polish hospital before and after its transformation into a commercial company. The study of satisfact...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - February 25, 2015 Category: Health Management Authors: Krakowiak, J., Kuzdak, M., Rzeznicki, A., Stelmach, I., Kowalska, A., Stelmach, W. Tags: Article Source Type: research

The Volume-Quality Relationship in Antibiotic Prescribing: When More Isnt Better
For many surgeries and high-risk medical conditions, higher volume providers provide higher quality care. The impact of volume on more common medical conditions such as acute respiratory infections (ARIs) has not been examined. Using electronic health record data for adult ambulatory ARI visits, we divided primary care physicians into ARI volume quintiles. We fitted a linear regression model of antibiotic prescribing rates across quintiles to assess for a significant difference in trend. Higher ARI volume physicians had lower quality across a number of domains, including higher antibiotic prescribing rates, higher broad-sp...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - February 10, 2015 Category: Health Management Authors: Gidengil, C. A., Linder, J. A., Hunter, G., Setodji, C., Mehrotra, A. Tags: Research Letter Source Type: research

The Volume-Quality Relationship in Antibiotic Prescribing: When More Isn't Better
For many surgeries and high-risk medical conditions, higher volume providers provide higher quality care. The impact of volume on more common medical conditions such as acute respiratory infections (ARIs) has not been examined. Using electronic health record data for adult ambulatory ARI visits, we divided primary care physicians into ARI volume quintiles. We fitted a linear regression model of antibiotic prescribing rates across quintiles to assess for a significant difference in trend. Higher ARI volume physicians had lower quality across a number of domains, including higher antibiotic prescribing rates, higher broad-sp...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - February 10, 2015 Category: Health Management Authors: Gidengil, C. A., Linder, J. A., Hunter, G., Setodji, C., Mehrotra, A. Tags: Article Source Type: research

Open-Access Journals: Bane or Boon?
(Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing)
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - October 27, 2014 Category: Health Management Authors: Rohrer, J. E. Tags: Editorial Source Type: research