Variation in Health Care Spending: Target Decision Making, Not Geography, edited by Joseph P. Newhouse, Alan M. Garber, Robin P. Graham, Margaret A. McCoy, Michelle Mancher, and Ashna Kibria (2013, 978-0-309-28869-9, OpenBook and .pdf format, 206p.). Ordering information for a print copy is available at the site. Note: NAP requires free registration before providing a .pdf copy.
October 1, 2013
September 30, 2013
CAAR – US Centers for Medicare and Medicaid Services Decision Memorandum – September 30, 2013
“Decision Memo for Beta Amyloid Positron Emission Tomography in Dementia and Neurodegenerative Disease (CAG-00431N),” (Sept. 27, 2013).
www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=265
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CAAR – Tables of Contents – September 30, 2013
Medical Care Research and Review (Vol. 70, No. 5, October 2013).
mcr.sagepub.com/content/70/5.toc
Rotman International Journal of Pension Management (Vol. 42, No. 2, Fall 2013).
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September 26, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Reports – September 26, 2013
A. “Utilization of Medicare Ambulance Transports, 2002-2011,” (OEI-09-12-00350, September 2013, .pdf format, 26p.).
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.).
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CAAR – US Centers for Medicare and Medicaid Services Decision Memorandum – September 26, 2013
“Decision Memo for Bariatric Surgery for the Treatment of Morbid Obesity – Facility Certification Requirement,” (CAG-00250R3),” (Sept. 24, 2013).
www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=266
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September 20, 2013
CAAR – New England Journal of Medicine Article Abstract – September 20, 2013
“Variation in Surgical-Readmission Rates and Quality of Hospital Care,” by Thomas C. Tsai, Karen E. Joynt, E. John Orav, Atul A. Gawande, and Ashish K. Jha (Vol. 369, No. 12, September 19, 2013, p. 1134-1142).
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CAAR – Kaiser Family Foundation Report – September 20, 2013
“Wide Disparities in the Income and Assets of People on Medicare by Race and Ethnicity: Now and in the Future,” by Gretchen Jacobson, Jennifer Huang, Patricia Neuman and Karen Smith (September 2013, HTML format).
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September 18, 2013
September 16, 2013
CAAR – Moment of Truth Project/National Coalition on Health Care Report – September 16, 2013
“Achieving Real Savings through Better Care: Policy Options for Improving Care and Slowing Cost Growth through Bipartisan Delivery System and Payment Reform,” (September 2013, .pdf format, 40p.).
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September 11, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – September 11, 2013
“Medicare Could Collect Billions If Pharmaceutical Manufacturers Were Required to Pay Rebates for Part B Drugs,” (OEI-12-12-00260, September 2013, .pdf format, 26p.).
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CAAR – US Centers for Medicare and Medicaid Services Article – September 11, 2013
“Standardizing Medicare Payment Information to Support Examining Geographic Variation in Costs,” by Brian E. O’Donnell, Kathleen M. Schneider, John M. Brooks, Gregory Lessman, June Wilwert, Elizabeth Cook, Glenda Martens, Kara Wright, and Elizabeth A. Chrischilles (Medicare & Medicaid Research Review, Vol. 3, No. 3, August 2013, .pdf format, 21p.).
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September 6, 2013
CAAR – Commonwealth Fund Issue Brief – September 6, 2013
“Hospital Readmissions: Measuring for Improvement, Accountability, and Patients,” by Clifford Marks, Saranya Loehrer, and Douglas McCarthy (September 2013, .pdf format, 8p.).
www.commonwealthfund.org/Publications/Issue-Briefs/2013/Sep/Measuring-Readmissions.aspx
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September 4, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – September 4, 2013
“Medicare Recovery Audit Contractors and CMS’s Actions to Address Improper Payments, Referrals of Potential Fraud, and Performance,” (OEI-04-11-00680, September 2013, .pdf format, 27p.).
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September 3, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Reports – September 3, 2013
A. “Frequency of Medicare Recertification Surveys for Hospices Is Unimproved,” (OEI-06-13-00130, August 2013, .pdf format, 8p.).
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.).
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CAAR – Medicare Payment Advisory Commission Rule Comment Letters – September 3, 2013
A. “CMS’s physician fee schedule, clinical laboratory fee schedule, and other Part B proposed rule,” (August 30, 2013, .pdf format, 21p.).
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.).
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August 23, 2013
August 22, 2013
CAAR – US Congressional Budget Office Working Paper – August 22, 2013
“Why Has Growth in Spending for Fee-for-Service Medicare Slowed?” by Michael Levine and Melinda Buntin (Working Paper 2013-06, August 2013, .pdf format, 56p.). Note: Links to the abstract and full-text can be found at:
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CAAR – US Government Accountability Office Report – August 22, 2013
“Medicare Program Integrity: Increasing Consistency of Contractor Requirements May Improve Administrative Efficiency,” (GAO-13-522, July 2013, .pdf format, 47p.).
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CAAR – US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE) Issue Brief – August 22, 2013
“Access to Physicians’ Services for Medicare Beneficiaries,” by Adele Shartzer, Rachael Zuckerman, Audrey McDowell, and Richard Kronick (August 2013, .pdf and HTML format, 7p.).
aspe.hhs.gov/health/reports/2013/PhysicianMedicare/ib_PhysicianMedicare.cfm
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CAAR – US Centers for Medicare and Medicaid Services Article – August 22, 2013
“Effect of Long-term Care Use on Medicare and Medicaid Expenditures for Dual Eligible and Non-dual Eligible Elderly Beneficiaries,” by Robert L. Kane, Andrea Wysocki, Shriram Parashuram, Tetyana Shippee, and Terry Lum (Medicare & Medicaid Research Review, Vol. 3, No. 3, August 2013, .pdf format, 22p.).
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August 20, 2013
CAAR – Heritage Foundation Issue Brief – August 20, 2013
“Obamacare’s Impact on Seniors: An Update,” by Alyene Senger (Issue Brief No. 4019, August 2013, HTML format).
www.heritage.org/research/reports/2013/08/obamacares-impact-on-seniors-an-update
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August 15, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – August 15, 2013
“Most Critical Access Hospitals Would Not Meet the Location Requirements If Required To Re-enroll in Medicare,” (OEI-05-12-00080, August 2013, .pdf format, 34p.).
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CAAR – Table of Contents – August 15, 2013
Medical Care (Vol. 51, No. 9, September 2013).
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August 13, 2013
CAAR – US Center for Medicare and Medicaid Services Decision Memorandum – August 13, 2013
“National Coverage Analysis (NCA) for Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3),” (Aug. 13, 2013).
www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=267
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August 6, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – August 6, 2013
“Medicare Could Save Millions by Strengthening Billing Requirements for Canceled Elective Surgeries,” (A-01-12-00509, August 2013, .pdf format, 18p.).
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CAAR – US Centers for Medicare and Medicaid Services Article – August 6, 2013
“Bundling Post-Acute Care Services into MS-DRG Payments,” by James C. Vertrees, Richard F. Averill, Jon Eisenhandler, Anthony Quain, and James Switalski (Medicare & Medicaid Research Review, Vol. 3, No. 3, August 2013, .pdf format, 19p.).
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August 1, 2013
CAAR – Medicare Payment Advisory Commission [MEDPAC] Report – August 1, 2013
“A Data Book: Health Care Spending and the Medicare Program,” (June 2013, .pdf format, 208p.).
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CAAR – US Government Accountability Office Report – August 1, 2013
“Medicare: Higher Use of Costly Prostate Cancer Treatment by Providers Who Self-Refer Warrants Scrutiny,” (GAO-13-525, July 2013, .pdf format, 50p.).
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July 30, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – July 30, 2013
“Hospitals’ Use of Observation Stays and Short Inpatient Stays for Medicare Beneficiaries,” (OEI-02-12-00040, July 2013, .pdf format, 20p.).
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CAAR – US Government Accountability Office Correspondence – July 30, 2013
“Medicare: Ownership Status of Inpatient Prospective Payment System Hospitals That Qualify for Payment Adjustments,” (GAO-13-667R, June 2013, .pdf format, 8p.).
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CAAR – National Bureau of Economic Research Working Papers – July 30, 2013
A. “Evidence for Significant Compression of Morbidity In the Elderly U.S. Population,” by David M. Cutler, Kaushik Ghosh, and Mary Beth Landrum (w19268, July 2013, .pdf format, 51p.).
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.
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.
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July 25, 2013
CAAR – Kaiser Family Foundation Brief – July 25, 2013
“Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders,” by Jeffrey S. Crowley, MaryBeth Musumeci and Erica L. Reaves (July 2013, .pdf format, 21p.).
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July 23, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – July 23, 2013
“Performance Data for the Senior Medicare Patrol Projects: July 2013 Performance Report,” (OEI-02-13-00170, July 2013, .pdf format, 91p.).
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July 17, 2013
CAAR – Kaiser Family Foundation Issue Brief – July 17, 2013
“Faces of Dually Eligible Beneficiaries: Profiles of People with Medicare and Medicaid Coverage,” by Erica L. Reaves, MaryBeth Musumeci, Gretchen Jacobson, Michael Perry, Naomi Mulligan Kolb and Loren Saulsberry (July 2013, .pdf format, 26p.).
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July 16, 2013
CAAR – Kaiser Family Foundation Issue Brief – July 16, 2013
“Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS,” by MaryBeth Musumeci (July 2013, .pdf format, 18p.).
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July 15, 2013
CAAR – US Government Accountability Office Report – July 15, 2013
“Medicare: Action Needed to Address Higher Use of Anatomic Pathology Services by Providers Who Self-Refer,” (GAO-13-445, June 2013, .pdf format, 61p.).
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July 12, 2013
CAAR – US Senate Committee on Finance Hearing Testimony – July 12, 2013
“Repealing the SGR and the Path Forward: A View from CMS,” a hearing held July 10, 2013 (witness statements available in .pdf format, full hearing can be viewed in Flash format, running time 1 hour 35 minutes). Note: The hearing starts at the 46:15 mark.
www.finance.senate.gov/hearings/hearing/?id=79be36be-5056-a032-52cc-5d4afbff2db7
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July 10, 2013
CAAR – US Government Accountability Office Reports – July 10, 2013
A. “Elder Justice: More Federal Coordination and Public Awareness Needed,” (GAO-13-498, July 2013, .pdf format, 60p.).
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.).
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July 9, 2013
CAAR – Table of Contents – July 9, 2013
Health Affairs (Vol. 32, No. 7, July/August 2013).
content.healthaffairs.org/content/vol32/issue7/index.dtl?etoc
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July 2, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Reports – July 2, 2013
A. “Medicare’s Currently Not Collectible Overpayments,” (OEI-03-11-00670, June 2013, .pdf format, 22p.).
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
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July 1, 2013
CAAR – Medicare Payment Advisory Commission [MEDPAC] Report – July 1, 2013
“Report to the Congress: Medicare and the Health Care Delivery System,” (June 2013, .pdf format, 281p.).
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CAAR – National Bureau of Economic Research Working Papers – July 1, 2013
A. “Decision Complexity as a Barrier to Annuitization,” by Jeffrey R. Brown, Arie Kapteyn, Erzo F.P. Luttmer, and Olivia S. Mitchell (w19168, June 2013, .pdf format, 37p.).
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.
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.
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CAAR – Tables of Contents – July 1, 2013
American Journal of Alzheimer’s Disease and Other Dementias (Vol. 28, No. 4, June 2013).
aja.sagepub.com/content/28/4.toc
Medical Care (Vol. 51, No. 7, July 2013).
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June 28, 2013
CAAR – US House Committee on Energy and Commerce, Subcommittee on Health Hearing Testimony – June 28, 2013
“Examining Reforms to Improve the Medicare Part B Drug Program for Seniors,” a hearing held June 28, 2013 (witness statements available in .pdf format, full hearing can be viewed in Flash format, running time 1 hour 41 minutes).
energycommerce.house.gov/hearing/examining-reforms-improve-medicare-part-b-drug-program-seniors
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CAAR – US House of Representatives Energy and Commerce Committee, Health Subcommittee Hearing Transcript – June 28, 2013
“Examining Reforms to Improve the Medicare Part B Drug Program for Seniors,” a hearing held Jun. 28, 2013 (.pdf format). In addition to print testimony transcripts, a video hearing transcript (running time: 1 hour, 41 minutes, 44 seconds) is available at the site.
energycommerce.house.gov/hearing/examining-reforms-improve-medicare-part-b-drug-program-seniors
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June 26, 2013
CAAR – US House Committee on Energy and Commerce, Subcommittee on Health Hearing Testimony – June 26, 2013
“A 21st Century Medicare: Bipartisan Proposals to Redesign the Program’s Outdated Benefit Structure,” a hearing held June 26, 2013 (witness statements available in .pdf format, full hearing can be viewed in Flash format, running time 1 hour 46 minutes).
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CAAR – US Centers for Medicare and Medicaid Service Decision Memorandum – June 26, 2013
“National Coverage Analysis (NCA) for Positron Emission Tomography (FDG) for Solid Tumors (CAG-00181R4),” (June 2013, HTML format).
www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=263
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June 25, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – June 25, 2013
“Replacement Schedules for Medicare Continuous Positive Airway Pressure Supplies,” (OEI-07-12-00250, June 2013, .pdf format, 19p.).
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