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.

Tax Incentives as a Solution to the Uninsured: Evidence from the Self-Employed
Between 1996 and 2003, a series of amendments were made to the Tax Reform Act of 1986 that gradually increased the tax deduction for health insurance purchases by the self-employed (SE) from 25 to 100 percent. We study how these changes have influenced the likelihood that a SE person has health insurance coverage as the policyholder. The Current Population Survey is used to construct a data set corresponding to 1995–2005. Both the difference-in-differences and price elasticity of demand estimates suggest that the series of tax deductions did not provide sufficient incentives for the SE to obtain health insurance cove...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - November 1, 2013 Category: Health Management Authors: Gumus, G., Regan, T. L. Tags: Research Papers Source Type: research

The Power of Reinsurance in Health Insurance Exchanges to Improve the Fit of the Payment System and Reduce Incentives for Adverse Selection
This article assesses the power of reinsurance in the context of other plan payment features, including prospective and concurrent risk adjustment. Using data from the Medicare Expenditure Panel Survey (MEPS) to draw an "Exchange population," we simulate the contribution of reinsurance to improving the fit of the payment system to plan costs and to mitigating incentives for adverse selection for groups of enrollees with selected chronic illnesses. Modest reductions in attachment points equate the payment-system fit of retrospective to concurrent risk adjustment. Reinsurance is very powerful in fitting payments to costs and...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - November 1, 2013 Category: Health Management Authors: Zhu, J. M., Layton, T., Sinaiko, A. D., McGuire, T. G. Tags: Research Papers Source Type: research

Continuity and Change
(Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing)
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - November 1, 2013 Category: Health Management Authors: Monheit, A. C. Tags: Editorial Source Type: research

Impact of CPOE Usage on Medication Management Process Costs and Quality Outcomes
We assess the impact of computerized physician order entry (CPOE) systems usage on cost and process quality in the medication management process. Data are compiled from 1,014 U.S. acute-care hospitals that have already implemented CPOE. Data sources include the American Hospital Association, HIMSS Analytics, and the Centers for Medicare and Medicaid Services. We examine the association of CPOE usage with nursing and pharmacy salary costs, and evidence-based medication process compliance. Empirical findings controlling for endogeneity in usage show that benefits accrue even when 100 percent usage is not achieved. We demonst...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - August 1, 2013 Category: Health Management Authors: Spaulding, T. J., Raghu, T. S. Tags: Research Papers Source Type: research

Demand for Temporary Agency Nurses and Nursing Shortages
There is an ongoing debate about the reasons for the growth of temporary employment of registered nurses (RNs). Some argue that efficiency incentives to increase flexibility and reduce labor costs are the principal cause, while others point to shortages of RNs as the stronger determinant. Using hospital-level data from California’s Office of Statewide Health Planning and Development, we find a significant trend of increasing demand for agency nurses during the years of RN shortage. Demand rose with inpatient days, patient demand fluctuation, and the level of fringe benefits. Competition between hospitals and unioniza...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - August 1, 2013 Category: Health Management Authors: Seo, S., Spetz, J. Tags: Research Papers Source Type: research

Enrollment in Medicare Advantage Plans in Miami-Dade County: Evidence of Status Quo Bias?
Evidence from behavioral economics reveals that decision making in health care settings can be affected by circumstances and choice architecture. This paper conducts an analysis of choice of private Medicare plans (Medicare Advantage [MA] plans) in Miami-Dade County. We provide a detailed description of the choice of MA plans available in Miami over much of the program’s history. Our analysis suggests that first becoming eligible for Medicare is the key transition point for MA and that there is a significant status quo bias in the MA market. Policy that regulates the MA market should anticipate, monitor, and account ...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - August 1, 2013 Category: Health Management Authors: Sinaiko, A. D., Afendulis, C. C., Frank, R. G. Tags: Research Papers Source Type: research

Financial Burden of Medical Out-of-Pocket Spending by State and the Implications of the 2014 Medicaid Expansions
This study is the first to offer a detailed look at the burden of medical out-of-pocket spending, defined as total family medical out-of-pocket spending as a proportion of income, for each state. It further investigates which states have greater shares of individuals with high burden levels and no Medicaid coverage but would be Medicaid eligible under the 2014 rules of the Affordable Care Act should their state choose to participate in the expansion. This work suggests which states have the largest populations likely to benefit, in terms of lowering medical spending burden, from participating in the 2014 adult Medicaid exp...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - August 1, 2013 Category: Health Management Authors: Caswell, K. J., Waidmann, T., Blumberg, L. J. Tags: Research Papers Source Type: research

The Impact of the Massachusetts Health Care Reform on Unpaid Medical Bills
In this study, we use hospital financial information and a panel data difference-in-difference model to assess the impact of the Massachusetts health care reform on unpaid medical bills. We find that the reform reduced the financial burden for patients, reflected by a 26percent decrease in hospital bad debt. The effect was more pronounced among safety-net hospitals, indicating a larger benefit for the most vulnerable population. (Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing)
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - August 1, 2013 Category: Health Management Authors: Arrieta, A. Tags: Research Papers Source Type: research

Book Review: First, Do Less Harm: Confronting the Inconvenient Problems of Patient Safety by Ross Koppel and Suzanne Gordon
(Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing)
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2013 Category: Health Management Authors: Mitchell, P. H. Tags: Book Reviews Source Type: research

Book Review: The Battle over Health Care: What Obama's Reform Means for America's Future by Rosemary Gibson and Janardan Prasad Singh
(Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing)
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2013 Category: Health Management Authors: Short, P. F. Tags: Book Reviews Source Type: research

Do Workplace Wellness Programs Reduce Medical Costs? Evidence from a Fortune 500 Company
The recent passage of the Affordable Care Act has heightened the importance of workplace wellness programs. This paper used administrative data from 2002 to 2007 for PepsiCo’s self-insured plan members to evaluate the effect of its wellness program on medical costs and utilization. We used propensity score matching to identify a comparison group who were eligible for the program but did not participate. No significant changes were observed in inpatient admissions, emergency room visits, or per-member per-month (PMPM) costs. The discrepancy between our findings and those of prior studies may be due to the difference i...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2013 Category: Health Management Authors: Liu, H., Mattke, S., Harris, K. M., Weinberger, S., Serxner, S., Caloyeras, J. P., Exum, E. Tags: Research Papers Source Type: research

The Expansion of Medicaid Coverage under the ACA: Implications for Health Care Access, Use, and Spending for Vulnerable Low-income Adults
The expansion of Medicaid coverage under the Affordable Care Act offers the potential for significant increases in health care access, use, and spending for vulnerable nonelderly adults who are uninsured. Using pooled data from the Medical Expenditure Panel Survey, this study estimates the potential effects of Medicaid, controlling for individual and local community characteristics. Our findings project significant gains in health care access and use for uninsured adults who enroll in Medicaid coverage and have chronic health conditions and mental health conditions. With that increased use, annual per capita health care sp...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2013 Category: Health Management Authors: Clemans-Cope, L., Long, S. K., Coughlin, T. A., Yemane, A., Resnick, D. Tags: Research Papers Source Type: research

The Capacity of the Medical Expenditure Panel Survey to Inform the Affordable Care Act
The Affordable Care Act (ACA) was enacted with major provisions to expand health insurance coverage, control health care costs, and improve the health care delivery system. Essential data resources will be required for effective program planning, administration, and management, in addition to facilitating evaluations of program performance. The Medical Expenditure Panel Survey (MEPS) is one of the core data resources that has been used to inform several provisions of the ACA. This paper provides a summary of the capacity of the MEPS to inform program planning, implementation, and evaluations of program performance for seve...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2013 Category: Health Management Authors: Cohen, S. B., Cohen, J. W. Tags: Using Survey Data to Assess Health Reform Source Type: research

Preparing to Measure Health Coverage in Federal Surveys Post-Reform: Lessons from Massachusetts
In preparation for health reform in 2014, qualitative research was conducted with Massachusetts residents to explore how to adapt surveys to accommodate reporting information about health exchanges. Questions about exchange participation were effective when state-specific exchange program names were offered, but generic terms such as "marketplace" and "exchange" did not resonate with respondents. However, respondents were able to understand new questions about premiums and subsidies and to answer with a high degree of accuracy. These questions, taken in tandem with answers on plan type, were sufficient to distinguish among...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2013 Category: Health Management Authors: Pascale, J., Rodean, J., Leeman, J., Cosenza, C., Schoua-Glusberg, A. Tags: Using Survey Data to Assess Health Reform Source Type: research

Monitoring Health Reform Efforts: Which State-level Data to Use?
This study compares estimates of health insurance coverage from the American Community Survey (ACS) to those in twelve state-specific surveys. Uninsurance estimates for the nonelderly are consistently higher in the ACS than in state surveys, as are direct purchase insurance estimates. Estimates for employer-sponsored insurance are similar, but public coverage rates are lower in the ACS. The ACS meets some but not all of the states’ data needs; its large sample size and inclusion of all U.S. counties in the sample allow for comparison of insurance coverage within and across states. State-specific surveys provide the f...
Source: Inquiry: The Journal of Health Care Organization, Provision, and Financing - May 1, 2013 Category: Health Management Authors: Call, K. T., Blewett, L. A., Boudreaux, M. H., Turner, J. Tags: Using Survey Data to Assess Health Reform Source Type: research