www.nap.edu/catalog.php?record_id=18393

www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=265

mcr.sagepub.com/content/70/5.toc

Rotman International Journal of Pension Management (Vol. 42, No. 2, Fall 2013).

www.rijpm.com/journal/journal

oig.hhs.gov/oei/reports/oei-09-12-00350.asp

B. “Medicare Incorrectly Paid Hospitals for Beneficiaries Who Had Not Received 96 or More Hours of Mechanical Ventilation,” (A-09-12-02066, September 2013, .pdf format, 9p.).

oig.hhs.gov/oas/reports/region9/91202066.asp

www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=266

www.nejm.org/doi/full/10.1056/NEJMsa1303118#t=abstract

kff.org/medicare/report/wide-disparities-in-the-income-and-assets-of-people-on-medicare-by-race-and-ethnicity-now-and-in-the-future/

www.cbo.gov/publication/44521

www.momentoftruthproject.org/publications/achieving-real-savings-through-better-care-policy-options-improving-care-and-slowing-co

oig.hhs.gov/oei/reports/OEI-12-12-00260.asp

www.cms.gov/mmrr/Articles/A2013/MMRR2013_003_03_a06.html

www.commonwealthfund.org/Publications/Issue-Briefs/2013/Sep/Measuring-Readmissions.aspx

oig.hhs.gov/oei/reports/oei-04-11-00680.asp

oig.hhs.gov/oei/reports/oei-06-13-00130.asp

B. “Medicaid Drug Pricing in State Maximum Allowable Cost Programs,” (OEI-03-11-00640, August 2013, .pdf format, 41p.).

oig.hhs.gov/oei/reports/oei-03-11-00640.asp

www.medpac.gov/documents/083013_MedPAC_PartB_COMMENT.pdf

B. “CMS’s end-stage renal disease proposed rule,” (August 30, 2013, .pdf format, 10p.).

www.medpac.gov/documents/08302013_MedPAC_ESRD_COMMENT.pdf

C. “CMS’s hospital outpatient and ambulatory surgical center proposed rule,” (August 30, 2013, .pdf format, 14p.).

www.medpac.gov/documents/08302013_MedPAC_OPPS_ASC_COMMENT.pdf

D. “CMS’s home health proposed rule,” (August 26, 2013, .pdf format, 6p.).

www.medpac.gov/documents/08262013_MedPAC_HHA_COMMENT.pdf

Abstract:

Social Security retirement benefits can be claimed at any age between 62 and 70, with delayed claiming resulting in larger monthly payments. In Shoven and Slavov (2013), we show that claiming later increases the present value of lifetime benefits for most individuals. However, this has not always been the case. During the late 1990s and early 2000s, a number of policy changes increased the gains from delay, particularly for couples. In addition, mortality improved and real interest rates fell substantially over this period, further increasing the attractiveness of delay. We perform simulations to examine the role of these factors in changing the gains from delay. We find that the gains from delay increased substantially after 2000, with changes in the interest rate playing the largest role in driving the increase. Using data from the Health and Retirement study, we show that individuals who turned 62 after 2000 are indeed more likely to delay than those who turned 62 before 2000. However, even in the younger cohort, most individuals still claim benefits soon after turning 62. Moreover, we find no evidence of a relationship between the probability of delay and the individual characteristics (e.g., gender, race, or health status) that affect the gains from delay.

www.nber.org/papers/w19370

B. “The Response of Drug Expenditures to Non-Linear Contract Design: Evidence from Medicare Part D,” by Liran Einav, Amy Finkelstein, and Paul Schrimpf (w19393, August 2013, .pdf format, 75p.).

Abstract:

We study the demand response to non-linear price schedules using data on insurance contracts and prescription drug purchases in Medicare Part D. Consistent with a static response of drug use to price, we document bunching of annual drug spending as individuals enter the famous “donut hole,” where insurance becomes discontinuously much less generous on the margin. Consistent with a dynamic response to price, we document a response of drug use to the future out-of-pocket price by using variation in beneficiary birth month which generates variation in contract duration during the first year of eligibility. Motivated by these two facts, we develop and estimate a dynamic model of drug use during the coverage year that allows us to quantify and explore the effects of alternative contract designs on drug expenditures. For example, our estimates suggest that “filling” the donut hole, as required under the Affordable Care Act, will increase annual drug spending by $180 per beneficiary, or about 10%. Moreover, almost half of this increase is “anticipatory,” coming from beneficiaries whose spending prior to the policy change would leave them short of reaching the donut hole. We also describe the nature of the utilization response and its heterogeneity across individuals and types of drugs.

www.nber.org/papers/w19393

crfb.org/document/report-social-security-reform-and-cost-delay

B. “Modernizing the Medicare Benefit,” by Marc Goldwein, Ed Lorenzen, and Jessica Stone (June 2013, .pdf format, 21p.).

crfb.org/document/mot-report-modernizing-medicare-benefit

www.cbo.gov/publication/44513

www.gao.gov/products/GAO-13-522

aspe.hhs.gov/health/reports/2013/PhysicianMedicare/ib_PhysicianMedicare.cfm

www.cms.gov/mmrr/Articles/A2013/MMRR2013_003_03_a05.html

www.heritage.org/research/reports/2013/08/obamacares-impact-on-seniors-an-update

oig.hhs.gov/oei/reports/oei-05-12-00080.asp

journals.lww.com/lww-medicalcare/pages/currenttoc.aspx

www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=267

www.aarp.org/work/social-security/info-10-2011/Social-Security-Medicare-Importance-State-Profiles.html

oig.hhs.gov/oas/reports/region1/11200509.asp

www.cms.gov/mmrr/Articles/A2013/MMRR2013_003_03_a03.html

www.medpac.gov/documents/Jun13DataBookEntireReport.pdf

www.gao.gov/products/GAO-13-525

oig.hhs.gov/oei/reports/oei-02-12-00040.asp

www.gao.gov/products/GAO-13-667R

Abstract:

The question of whether morbidity is being compressed into the period just before death has been at the center of health debates in the United States for some time. Compression of morbidity would lead to longer life but less rapid medical spending increases than if life extension were accompanied by expanding morbidity. Using nearly 20 years of data from the Medicare Current Beneficiary Survey, we examine how health is changing by time period until death. We show that functional measures of health are improving, and more so the farther away from death the person is surveyed. Disease rates are relatively constant at all times until death. On net, there is strong evidence for compression of morbidity based on measured disability, but less clear evidence based on disease-free survival.

www.nber.org/papers/w19268

B. “Physician Agency and Competition: Evidence from a Major Change to Medicare Chemotherapy Reimbursement Policy,” by Mireille Jacobson, Tom Y. Chang, Joseph P. Newhouse, and Craig C. Earle, M.D. (w19247, July 2013, .pdf format, 71p.).

Abstract:

We investigate the role of physician agency and competition in determining health care supply and patient outcomes. A 2005 change to Medicare fees had a large, negative impact on physician profit margins for providing chemotherapy treatment. In response to these cuts, physicians increased their provision of chemotherapy and changed the mix of chemotherapy drugs they administered. The increase in treatment improved patient survival. These changes were larger in states that experienced larger decreases in physician profit margins. Finally while physician response was larger in more competitive markets, survival improvements were larger in less competitive markets.

www.nber.org/papers/w19247

kff.org/medicaid/issue-brief/development-of-the-financial-alignment-demonstrations-for-dual-eligible-beneficiaries-perspectives-from-national-and-state-disability-stakeholders/

oig.hhs.gov/oei/reports/oei-02-13-00170.asp

kff.org/medicaid/issue-brief/faces-of-dually-eligible-beneficiaries-profiles-of-people-with-medicare-and-medicaid-coverage/

kff.org/medicaid/issue-brief/financial-alignment-demonstrations-for-dual-eligible-beneficiaries-compared/

www.gao.gov/products/GAO-13-445

www.finance.senate.gov/hearings/hearing/?id=79be36be-5056-a032-52cc-5d4afbff2db7

www.gao.gov/products/GAO-13-498

B. “Medicare Outpatient Therapy: Implementation of the 2012 Manual Medical Review Process,” (GAO-13-613, July 2013, .pdf format, 31p.).

www.gao.gov/products/GAO-13-613

content.healthaffairs.org/content/vol32/issue7/index.dtl?etoc

oig.hhs.gov/oei/reports/oei-03-11-00670.asp

B. “Some States Improperly Restrict Eligibility for Medicaid Mandatory Home Health Services” (OEI-07-13-00060, July 2013, .pdf format, 5p.).

oig.hhs.gov/oei/reports/oei-07-13-00060.asp

www.medpac.gov/documents/Jun13_EntireReport.pdf

Abstract:

We show that people have difficulty valuing annuities, and this, instead of a preference for lumpsums, helps explain observed low annuity demand. Although the median price at which people are willing to sell an annuity stream is close to the actuarial value, many responses diverge greatly from optimizing behavior. Moreover, people will pay substantially less to buy than to sell annuities. We conclude that boundedly rational consumers adopt “buy low, sell high” heuristics when confronting a complex trade-off. This suggests that many consumers do not make optimizing decisions, underscoring the difficulty of explaining cross-sectional annuity valuation differences using standard models.

www.nber.org/papers/w19168

B. “Evolving Choice Inconsistencies in Choice of Prescription Drug Insurance,” by Jason Abaluck and Jonathan Gruber (w19163, June 2013, .pdf format, 47p.).

Abstract:

We explore choice inconsistency over time within the Medicare Part D Prescription Drug Program. Using the full universe of Part D claims data, we revisit our earlier work on partial data to replicate our results showing large “foregone savings” among Part D enrollees. We also document that this foregone savings increases over time during the first four years of the Part D program. We then develop a rich dynamic structural framework that allows us to mathematically decompose the “foregone welfare” from inconsistent plan choices into components due to demand side factors, supply side factors, and changes in preferences over time. We find that the welfare cost of choice inconsistencies increases over time. Most importantly, we find that there is little improvement in the ability of consumers to choose plans over time; we identify and estimate little learning at either the individual or cohort level over the years of our analysis. Inertia does reduce welfare, but even in a world with no inertia we estimate that substantial welfare losses would remain. We conclude that the increased choice inconsistencies over time are driven by changes on the supply side that are not offset both because of inertia and because non-inertial consumers still make inconsistent choices.

www.nber.org/papers/w19163

aja.sagepub.com/content/28/4.toc

Medical Care (Vol. 51, No. 7, July 2013).

journals.lww.com/lww-medicalcare/pages/currenttoc.aspx

energycommerce.house.gov/hearing/examining-reforms-improve-medicare-part-b-drug-program-seniors

energycommerce.house.gov/hearing/examining-reforms-improve-medicare-part-b-drug-program-seniors

energycommerce.house.gov/hearing/21st-century-medicare-bipartisan-proposals-redesign-programs-outdated-benefit-structure

www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=263

oig.hhs.gov/oei/reports/oei-07-12-00250.asp