Current Awareness in Aging Research (CAAR) Report #147--August 8, 2002

CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:


I. Data:


A. "1995 AHEAD (Wave 2) Core Final V2.0: Additional variable for Section M," (University of Michigan Institute for Social Research, Asset and Health Dynamics among the Oldest Old Study, July 25, 2002). Note: The original release of Version 2 did not include data for variable 'D5634 RANDOM 2'. This data is now available as a separate data file, which can be download from the Public File Download Area (registration is required prior to accessing data)."

B. "AHEAD 1995 Imputation Release (Version 2.0)," (University of Michigan Institute for Social Research, Asset and Health Dynamics among the Oldest Old Study, August 7, 2002).

2. NCHS ICD-10-CM PRE RELEASE DRAFT: The US National Center for Health Statistics has made available a pre release draft (.pdf format) of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) (May 2002). "Although this draft of ICD-10-CM is available for public viewing, it should be noted that the codes in ICD-10-CM are not currently valid for any purpose or uses. Furthermore, there is not yet an anticipated implementation date for the ICD-10-CM. Updates to this draft are anticipated prior to implementation of ICD-10-CM."

II. Reports and articles:

3. CONGRESSIONAL BUDGET OFFICE POLICY BRIEF: "Social Security and the Federal Budget: The Necessity of Maintaining a Comprehensive Long-Range Perspective," (Congressional Budget Office, August 2002, .pdf and WordPerfect format, 4p.).

To access the .pdf format go to:

Follow the link to No3August.pdf.

To access the WordPerfect format go to:

Follow the link to No3August.wpd.


A. "Validation of Long-Term and Post-Acute Care Quality Indicators," by Abt Associates Inc. (US Department of Health and Human Services, Centers for Medicare and Medicaid Services, August 2002, .pdf format, 85p.).

To view the executive summary, go to:

To view the full report go to:

B. "Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment Systems and Fiscal-Year 2003 Rates," (US Department of Health and Human Services, Centers for Medicare and Medicaid Services, CMS-1206-P, August 2002, .pdf and Word format, 286p.). Note: This proposed change will appear in the August 9, 2002 Federal Register.

Follow the link to .zip format (Word document) to download, or .pdf format to view the document.

5. GAO REPORT: "Medicaid and SCHIP: Recent HHS Approvals of Demonstration Waiver Projects Raise Concerns," (US General Accounting Office, GAO-02-817, July 2002, 71p.).

Note: This address is temporary. GAO correspondence may or may not be archived at:

Search on title or report number.


A. "Review of Managed Care Payments for Dual Eligible Beneficiaries with Institutional Status," (US Department of Health and Human Services, Office of Inspector General, A-05-00-00015, July 2002, .pdf format, 22p.).

Report Summary:

This final report points out that for some managed care organizations (MCOs) there was a disparity between the Medicare payment and the cost of the medical care provided to beneficiaries with institutional status. Some MCOs were significantly overpaid while others were significantly underpaid. For example, one MCO had an annual average shortfall of almost $4,500 per beneficiary during 1998, and a second MCO had an annual average overage exceeding $4,000 for each beneficiary during the same period. This disparity in payments may have hurt the Centers for Medicare and Medicaid Services (CMS) ability to provide managed care options to beneficiaries. Underpayments could reduce the number of MCOs willing or able to remain in the Medicare program. If they remain in the program, these MCOs might be forced to target only healthier beneficiaries for enrollment, limiting the health care choices of those individuals who are sicker. To help correct for this the CMS is implementing a risk adjustment methodology based on the beneficiarys health status, but it is planned to be phased in over the 8-year period 2000 through 2007. We believe that delaying the risk-adjusted payment structure perpetuates the payment problems of the existing system. We recommended that CMS consider the results of our work as it proceeds with the implementation of the risk adjustment factors and seek legislation to accelerate the phase-in of the risk adjustment payment system.

B. "Audit of Medicare Adjusted Community Rate Proposals Submitted by 55 Medicare+Choice Organizations for Contract Year 2000," (US Department of Health and Human Services, Office of Inspector General, A-09-01-00051, July 2002, .pdf format, 28p.).

Report Summary:

This final report summarizes the results of our reviews, made at the request of the Centers for Medicare & Medicaid Services (CMS), of 186 adjusted community rate proposals (ACRPs) submitted by 55 Medicare+Choice (M+C) organizations for Contract Year 2000. In general, we found that: 49 percent of the ACRPs were not prepared in accordance with CMS instructions; 66 percent contained errors that affected at least one of the three components of the adjusted community rate (direct medical care, administration, or additional revenues); and 36 percent overstated the beneficiary premium/cost sharing amounts and/or did not provide additional benefits. We were unable to determine an overall dollar effect of the miscalculated ACRPs, however, there could have been a significant impact on (1) payments made by the M+C organizations to their providers, (2) out-of-pocket expenses of the beneficiaries, and (3) amount of profit earned by the M+C organizations. Among other things, we recommended that CMS (1) reiterate to M+C organizations the importance of following CMS instructions in preparing the ACRPs, (2) work with the M+C organizations to have them develop corrective actions to address the deficiencies noted in our audits to ensure that future ACRP submissions are correct, and (3) perform follow-up evaluations of such actions. The CMS generally concurred with our recommendations.

C. "Medicare Inpatient Hospital Prospective Payment System Discharges Improperly Reported and Paid After Hospital Consolidations," (US Department of Health and Human Services, Office of Inspector General, A-06-00-00044, July 2002, .pdf format, 14p.).

Report Summary:

Under Medicare rules, a consolidation of hospitals is considered a change of ownership. After a consolidation, only the surviving hospital would be entitled to Medicare payments because it was the legal owner on the date patients were discharged. This final report points out that 15 hospitals, that technically ceased to exist after consolidation with another hospital, were paid for 1,118 discharges that should not have been billed to Medicare. Issues that arise include potential duplicate payments and inflated cost reports. We have identified claims overpayments of more than $4.5 million for 6 of the 15 hospitals and will make appropriate referrals to fiscal intermediaries for recovery. Fiscal intermediaries have recovered nearly $300,000 related to 2 consolidations and have begun recovery actions related to 2 additional consolidations. Further, the Department of Justice has reached settlements totaling nearly $3.2 million related to 5 consolidations. Among other things, we recommended that the Centers for Medicare & Medicaid Services (CMS) review current claim, cost report, audit, and change of ownership instructions to determine whether revisions or additions are necessary to clearly address proper claim fining and cost treatment when a change of ownership or consolidation occurs. The CMS concurred with our recommendations.

7. NSF REPORT: "Older Doctoral Scientists and Engineers: Selected Labor Force Characteristics," (National Science Foundation, July 2002, .pdf and HTML format, 19p.).


A. "Ibritumomab Tiuxetan (Zevalin) for Non-Hodgkin's Lymphoma," (Centers for Medicare and Medicaid Services, August 2002). Note: "Posted New tracking sheet announcing national coverage determination review."

B. "Neuromuscular Electrical Stimulation (NMES) for Spinal Cord Injury," (Centers for Medicare and Medicaid Services, August 2002). Note: "Posted NMES Case Series Studies for Use of Non-ParastepI Systems with Decision Memorandum."

C. "Report to Congress--National Coverage Determinations," (Centers for Medicare and Medicaid Services, August 2002).

D. "MCAC Medical and Surgical Procedures Panel," (Centers for Medicare and Medicaid Services, August 2002). Note: "Posted Minutes from June 12, 2002 meeting on Deep Brain Stimulation for Parkinson's Disease (DBS)."

9. _NEJM_ ARTICLE ABSTRACT: "Intramuscular Injection of Botulinum Toxin for the Treatment of Wrist and Finger Spasticity after a Stroke," by Allison Brashear, Mark F. Gordon, Elie Elovic, V. Daniel Kassicieh, Christina Marciniak, Mai Do, Chia-Ho Lee, Stephen Jenkins, Catherine Turkel, for the Botox Post-Stroke Spasticity Study Group (_New England Journal of Medicine_, Vol. 347, No. 6, August 8, 2002, .pdf and HTML format, p. 395-400).


A. "Continuous combined hormone replacement therapy and endometrial hyperplasia," by David F. Archer (_British Medical Journal_, Vol. 325, No. 7358, August 3, 2002, .pdf and HTML format, p. 231-232).

B. "Effect on endometrium of long term treatment with continuous combined oestrogen-progestogen replacement therapy: follow up study," by Michael Wells, David W. Sturdee, David H. Barlow, Lian G. Ulrich, Karen O'Brien, Michael J. Campbell, Martin P. Vessey, and Anthony J. Bragg (_British Medical Journal_, Vol. 325, No. 7358, August 3, 2002, .pdf and HTML format, p. 239-243).

11. _JAMA_ RESEARCH LETTER: "Trends in Drug Prescriptions Among Elderly Residents of Ontario in the Weeks After September 11, 2001," by Peter C. Austin, Muhammad M. Mamdani, Liisa Jaakkimainen, and Janet E. Hux (_Journal of the American Medical Journal_, Vol. 288, No. 5, August 7, 2002, .pdf and HTML format, p. 575-577).

12. _NATURE MEDICINE_ ARTICLE ABSTRACT: "Visualization of advanced human prostate cancer lesions in living mice by a targeted gene transfer vector and optical imaging," by Jason Y. Adams, Mai Johnson, Makoto Sato, Frank Berger, Sanjiv S. Gambhir, Michael Carey, M. Luisa Iruela-Arispe, and Lily Wu (Nature Medicine, Vol. 8, No. 8, August 2002, .pdf and HTML format, p. 891-897).

13. _SCIENCE_ BREVIA: "Biomarkers of Caloric Restriction May Predict Longevity in Humans," by George S. Roth, Mark A. Lane, Donald K. Ingram, Julie A. Mattison, Dariush Elahi, Jordan D. Tobin, Denis Muller, and E. Jeffrey Metter (_Science_, Vol. 297, No. 5582, August 2, 2002, p. 811).

A NIH press release concerning this article, "Three Physiological Measures Linked To Longevity in Men" (US National Institutes of Health, Aug. 1, 2002), can be found at:


A. "The threshold for polyglutamine-expansion protein aggregation and cellular toxicity is dynamic and influenced by aging in Caenorhabditis elegans," by James F. Morley, Heather R. Brignull, Jill J. Weyers, and Richard I. Morimoto (_Proceedings of the National Academy of Sciences_, Vol. 99, No. 16, August 6, 2002, .pdf and HTML format, p. 10417-10422).

B. "Effects of aging on central and peripheral mammalian clocks," by Shin Yamazaki, Marty Straume, Hajime Tei, Yoshiyuki Sakaki, Michael Menaker, and Gene D. Block (_Proceedings of the National Academy of Sciences_, Vol. 99, No. 16, August 6, 2002, .pdf and HTML format, p. 10801-10806).

C. "alpha -Synucleinopathy and selective dopaminergic neuron loss in a rat lentiviral-based model of Parkinson's disease," by C. Lo Bianco, J-L. Ridet, B. L. Schneider, N. Deglon, and P. Aebischer (_Proceedings of the National Academy of Sciences_, Vol. 99, No. 16, August 6, 2002, .pdf and HTML format, p. 10813-10818).

D. "Prominent neurodegeneration and increased plaque formation in complement-inhibited Alzheimer's mice," by Tony Wyss-Coray, Fengrong Yan, Amy Hsiu-Ti Lin, John D. Lambris, Jessy J. Alexander, Richard J. Quigg, and Eliezer Masliah (_Proceedings of the National Academy of Sciences_, Vol. 99, No. 16, August 6, 2002, .pdf and HTML format, p. 10837-10842).

E. "Clusterin promotes amyloid plaque formation and is critical for neuritic toxicity in a mouse model of Alzheimer's disease," by Ronald B. DeMattos, Mark A. O'dell, Maia Parsadanian, Jennie W. Taylor, Judith A. K. Harmony, Kelly R. Bales, Steven M. Paul, Bruce J. Aronow, and David M. Holtzman (_Proceedings of the National Academy of Sciences_, Vol. 99, No. 16, August 6, 2002, .pdf and HTML format, p. 10843-10848).

15. _MEDSCAPE_ ARTICLE: Note: Medscape requires free registration before providing articles.

A. "Study: Seniors With Late Life Depression May Not Recover" (_Mental Health Weekly_, No. Vol. 12, No. 28, 2002, p. 3-4, via Medscape).

B. "Hormone Replacement Therapy: Guidance From the National Association of Nurse Practitioners in Women's Health" (_Topics in Advanced Practice Nursing eJournal, Vol. 2, No. 3, 2002).

C. "Hormonal Therapy for Prostate Cancer: Controversies and Advances," (_Medscape_, July 2002, HTML and Flash format). Note: Continuing Medical Education credits may be available.

16. _TIME_: "How to Surf the Age Wave," by Daniel Kadlec (_Time_, Vol. 160 No. 7, August 12, 2002).,9171,1101020812-333872,00.html

17. AARP PRIME TIME RADIO: The following AARP _Prime Time Radio_ shows (covering Jun. 25 through Jul. 31, 2002, are now available (RealPlayer plug-in or helper application required, audio transcripts run between about 24 and 30 minutes).

Jul. 31, 2002. Traveling - Without Reservations

Scroll to show title.

18. AARP PERIODICAL: Selected articles from the September-October 2002 issue of _Modern Maturity_ have been released at the AARP website.

19. AARP PERIODICAL: Selected articles from the September-October 2002 edition of _My Generation_ are available from the AARP website.

III. Working Papers:

20. NBER:

A. "Annuities for an Ageing World," by Olivia S. Mitchell and David McCarthy (National Bureau of Economic Research w9092, August 2002, .pdf format, 48p.).


Substantial research attention has been devoted to the pension accumulation process, whereby employees and those advising them work to accumulate funds for retirement. Until recently, less analysis has been devoted to the pension decumulation process -- the process by which retirees finance their consumption during retirement. This gap has recently begun to be filled by an active group of researchers examining key aspects of the pension payout market. One of the areas of most interesting investigation has been in the area of annuities, which are financial products intended to cover the risk of retirees outliving their assets. This paper reviews and extends recent research examining the role of annuities in helping finance retirement consumption. We also examine key market and regulatory factors.

Click on "PDF" or submit your email address at the bottom of the page for full text.

B. "An Assessment of the Proposals of the President's Commission to Strengthen Social Security," by Peter A. Diamond and Peter R. Orszag (National Bureau of Economic Research w9097, August 2002, .pdf format, 76p.).


The President's Commission to Strengthen Social Security proposed three reform plans. Two, analyzed here, restore actuarial balance in the absence of individual accounts. One achieves this balance solely through benefit reductions. The other uses new dedicated revenue to cover one-third of the actuarial deficit, reducing benefits to close the rest. Both plans cut disability and young survivor benefits in step with retirement benefits, while bolstering benefits for long-career low earners and surviving spouses with low benefits. The plans both include voluntary individual accounts that replace part of the scaled-back Social Security system. Payroll taxes are diverted to the accounts and one of the plans also requires a (subsidized) add-on contribution for those choosing accounts. Under both models, any payroll tax deposited in an individual account is also recorded in a 'liability account' for the worker. The liability account tracks the diverted payroll revenue (with interest) and is paid off by reducing traditional benefits. The individual accounts are subsidized through a sub-market interest rate on the liability accounts. This subsidy worsens the financial position of the Trust Fund. The accounts also create a cash-flow problem. Consequently, by themselves, the individual accounts make Social Security's solvency problems worse both in the short run and over the long run. To offset the adverse impact of the accounts, the plans call for large transfers of general revenues (despite substantial projected budget deficits). If all (two-thirds of) eligible workers opted for the accounts, the new revenues required over the next 75 years would amount to between 1.2 and 1.5 (0.8 and 1.1) percent of payroll. Holding the disabled harmless from the benefit reductions would raise the required transfers to between 1.5 and 1.7 (1.1 and 1.3) percent of payroll (compared to a projected actuarial deficit of 1.9 percent of payroll under current law). Despite requiring this much general revenue relative to paying scheduled benefits, the plans would produce significant reductions in expected combined benefits. At the end of 75 years, however, assets in the accounts would amount to between 53 and 66 (35 and 44) percent of GDP, and the value to Social Security of the accumulated liabilities that reduce later benefits would amount to more than 20 (15) percent of GDP.

Click on "PDF" or submit your email address at the bottom of the page for full text.

21. CENTER FOR RETIREMENT RESEARCH AT BOSTON COLLEGE: "The Role and Impact of Gifts and Estates," a conference held October 21-23, 2001. The Center for Retirement Research at Boston College is making available the papers and discussant comments from the conference (.pdf format). "The conference addressed how individuals dispose of their assets in retirement and the social and economic impact of their choices."

Papers published from the conference include:

"Bequests: A Historical Perspective," by J. Bradford DeLong
"How Do People Leave Bequests: Accidents or Purpose?" by Michael D. Hurd
"How Do People Leave Bequests: Family or Philanthropic Organizations?" by John J. Havens and Paul G. Schervish
"How Do People Make Transfers in the Family?: Mothers, Fathers, Sons and Daughters," by Donald Cox
"The Impact of the Growth of Defined Contribution Plans on Bequests," by Alicia H. Munnell, Annika Sundn, Mauricio Soto, and Catherine Taylor
"The Impact of Bequests on Aggregate Saving and Capital Accumulation," by William G. Gale and Samara Potter
"The Role of Gift and Estate Transfers in the United States and in Europe," by Pierre Pestieau
"Tax Impacts on Wealth Accumulation and Transfers of the Rich," by Wojciech Kopczuk and Joel B. Slemrod
"Impact of Bequests on the Distribution of Wealth," by Edward N. Wolff

22. WHARTON SCHOOL [UNIVERSITY OF PENNSYLVANIA] PENSION RESEARCH COUNCIL: "The Role of Economic Policy in Social Security Reform: Perspectives from the President's Commission," by John F. Cogan and Olivia S. Mitchell (WP 2002-13, August 2002, .pdf format, 35p.).


Recently we were asked to serve on the President's Commission to Strengthen Social Security (CSSS) along with 14 other members drawn equally from both major political parties. The Commission's charge was to provide recommendations to modernize the Social Security system, restore its fiscal soundness, and develop a workable system of Personal Retirement Accounts. This paper explains how the Commission arrived at some of its recommendations and the role that economics played in contributing to these recommendations. We describe the key institutional constraints confronting efforts to reform Social Security and how these constraints influenced Commission decisions. We also illustrate how economics research influenced the Commission's analysis of how to structure personal accounts, ways to enhance traditional Social Security program finances, and means of measuring the extent of financial progress achieved through reform.

IV. Journal Tables of Contents (check your library for availability):

23. AMEDEO MEDICAL LITERATURE: Note: "AMEDEO has been created to serve the needs of healthcare professionals, including physicians, nurses, pharmacists, administrators, other members of the health professions, and patients and their friends. They can easily access timely, relevant information within their respective fields... All AMEDEO services are free of charge. This policy was made possible thanks to generous unrestricted educational grants provided by AMGEN, Berlex, Eisai, Glaxo Wellcome, Novartis, Pfizer, Roche, and Schering AG."

A. Osteoporosis: Literature for the week of August, 2002:

B. Alzheimer's Disease: Literature for the week of August 6, 2002:

C. Parkinson's Disease: Literature for the week of August 6, 2002:

AMADEO Literature Guide:


V. Funding Opportunities:

24. NCHS/ACADEMY FOR HEALTH SERVICES RESEARCH AND HEALTH POLICY: "Health Policy Research 2003". "The Department of Health and Human Services (DHHS), Centers for Disease Control and Preventions (CDC) National Center for Health Statistics (NCHS), and the Academy for Health Services Research and Health Policy seek applications for the second cycle of the NCHS/ Academy Health Policy Fellowship. This program brings visiting scholars in health services research-related disciplines to NCHS to collaborate on studies of interest to policymakers and the health services research community using NCHS data systems." The deadline for application is January 10, 2003. For more information about the program, including application material, go to:

25. NIH: "Tools for Genetic Studies in Zebrafish," (National Institutes of Health, National Institute on Aging in conjunction with other agencies, PAR-02-142, August 2, 2002).

VI. Legislation Information Updates:

26. US HOUSE COMMITTEE ON THE BUDGET HEARING PUBLICATION: "Medicare and the Federal Budget," a hearing held May 8, 2002 (US House Publication Serial No. 107-30, ASCII text and .pdf format, 40p.).

Scroll down to or "find in page" "107-30" (without the quotes).

27. US HOUSE COMMITTEE ON ENERGY AND COMMERCE SUBCOMMITTEE ON HEALTH HEARING PUBLICATION: "The 2003 Budget: A Review of the HHS Health Care Priorities," a hearing held March 13, 2002 (US House Publication Serial No. 107-100, ASCII and .pdf format, 65p.).

Scroll down to or "find in page" "107-100" (without the quotes).

28. US HOUSE COMMITTEE ON WAYS AND MEANS SUBCOMMITTEE ON HEALTH HEARING PUBLICATION: "Physician Payments," a hearing held February 28, 2002 (US House Publication Serial No. 107-70, .pdf format, 90p.).

Scroll down to or "find in page" "107-70" (without the quotes).




Charlie Fiss
Information Manager
Center for Demography and Ecology and
Center for Demography of Health and Aging
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