Current Awareness in Aging Research (CAAR) Report #250--August 19, 2004


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. Reports and articles:

1. GAO REPORT: "Medicare: Call Centers Need to Improve Responses to Policy-Oriented Questions from Providers," (US Government Accountability Office, GAO-04-669, July 2004, .pdf format, 30p.).

Note: This is a temporary address. GAO reports are always available at:


A. "Long Term Care Hospitals-Within-Hospitals," (US Department of Health and Human Services, Office of Inspector General, OEI-01-02-00630, July 2004, .pdf format, 28p.).

Executive summary:

This report found that 19 of 87 hospitals-within-hospitals exceeded the annual 5 percent threshold for readmissions from their host hospitals at least once during their fiscal years ending in September 2000 through December 2002. Currently, CMS lacks a system to detect readmissions over the 5 percent threshold. Many of these readmissions involved high cost diagnosis-related groups (DRGs). As Medicare's prospective payment system for long-term care hospitals is fully implemented, paying hospitals-within-hospitals that are over the 5 percent readmission level could result in increased costs to the Medicare program. In addition, CMS has no ongoing mechanism to determine whether hospitals-within-hospitals are financially and organizationally separate from their host hospitals. OIG recommends that CMS develop a system to monitor hospitals-within-hospitals' compliance with the 5 percent readmission rule, and require hospitals-within-hospitals to demonstrate their organizational and financial independence on a continuing basis.

B. "Audit of Medicaid Payments for Oxygen-Related Durable Medical Equipment and Supplies," (US Department of Health and Human Services, Office of Inspector General, A-05-03-00018, August 2004, .pdf format, 16p.).

Executive summary:

The report provides summary results of audits completed in 9 States and additional analyses in 41 other States of paid claims for oxygen related durable medical equipment (DME) and supplies. The audits were made to determine whether State Medicaid programs reimbursed providers in excess of Medicare payment limits for DME and supplies used to provide oxygen. We found that Medicaid paid providers in 6 of the 9 States approximately $12.7 million (Federal share $7.3 million) more than Medicare would have paid. Further, our analyses in the other 41 States demonstrated that significant additional savings are possible. We recommended that the Centers for Medicare & Medicaid Services instruct those State agencies that limit Medicaid rates to Medicare reimbursement levels to apply Medicaid payment limits for oxygen-related DME and supplies correctly and in a timely manner, and alert the remaining State agencies to the opportunity to reduce Medicaid payments by limiting reimbursement rates for oxygen-related DME and supplies to the Medicare allowable amounts.

3. AHRQ MEPS CHART BOOK: "Health Care in Urban and Rural Areas, Combined Years 1998-2000," by Sharon L. Larson, Steven R. Machline, Alice Nixon, and Marc Zodet (Agency for Healthcare Research and Quality, Medical Expenditure Survey, AHRQ Pub. No. 04-0001, July 2004, .pdf and HTML format, 39p.).

4. SSA OP PERIODICAL: "International Update, July 2004," (US Social Security Administration, Office of Policy, HTML and .pdf format, 4p.).


A. "Medicare Expands Drugs Available Under Program to Help Beneficiaries with Severe Illnesses," (August 13, 2004).

B. "CMS Encourages States to Give Medicaid Beneficiaries more Control Over the Long-Term Care Services they Receive," (August 17, 2004).

C. "CY 2005 Hospital Outpatient Prospective Payment System," (Centers for Medicare and Medicaid Services, August 16, 2004, zipped Excel and .pdf files). Note: This proposed rule appeared in the August 16, 2004 Federal Register.

6. STATISTICS CANADA PRESS RELEASE: "Employer pension plans 2002," (August 5, 2004).

7. _SCIENCE_ ARTICLE ABSTRACT: "Increased Nuclear NAD Biosynthesis and SIRT1 Activation Prevent Axonal Degeneration," by Toshiyuki Araki, Yo Sasaki, Jeffrey Milbrandt (_Science_, Vol. 305, No. 5686, August 13, 2004, .pdf and HTML format, p. 1010-1013).


A. "Inhibition of apoptosis in acute promyelocytic leukemia cells leads to increases in levels of oxidized protein and LMP2 immunoproteasome," by Mohammed A. S. Khan, Hammou Oubrahim, and Earl R. Stadtman (_Proceedings of the National Academy of Sciences_, Vol. 101, No. 32, August 10, 2004, .pdf and HTML format, p. 11560-11565).

B. "Pauling and Corey's {alpha}-pleated sheet structure may define the prefibrillar amyloidogenic intermediate in amyloid disease," by Roger S. Armen, Mari L. DeMarco, Darwin O. V. Alonso, and Valerie Daggett (_Proceedings of the National Academy of Sciences_, Vol. 101, No. 32, August 10, 2004, .pdf and HTML format, p. 11622-11627).

C. "Advanced glycation endproduct (AGE) receptor 1 is a negative regulator of the inflammatory response to AGE in mesangial cells," by Changyong Lu, John Cijiang He, Weijing Cai, Huixian Liu, Li Zhu, and Helen Vlassara (_Proceedings of the National Academy of Sciences_, Vol. 101, No. 32, August 10, 2004, .pdf and HTML format, p. 11767-11772).


A. "6-Month Androgen Suppression Plus Radiation Therapy vs Radiation Therapy Alone for Patients With Clinically Localized Prostate Cancer: A Randomized Controlled Trial," by Anthony V. D'Amico, Judith Manola, Marian Loffredo, Andrew A. Renshaw, Alyssa DellaCroce, and Philip W. Kantoff (_Journal of the American Medical Association_, Vol. 292, No. 7, August 18, 2004, .pdf and HTML format, p. 821-827).

B. "Effects of Extended Outpatient Rehabilitation After Hip Fracture: A Randomized Controlled Trial," by Ellen F. Binder, Marybeth Brown, David R. Sinacore, Karen Steger-May, Kevin E. Yarasheski, and Kenneth B. Schechtman (_Journal of the American Medical Association_, Vol. 292, No. 7, August 18, 2004, .pdf and HTML format, p. 837-846).

10. _BMJ_ ARTICLE: "Efficacy of topical non-steroidal anti-inflammatory drugs in the treatment of osteoarthritis: meta-analysis of randomised controlled trials," by Jinying Lin, Weiya Zhang, Adrian Jones, and Michael Doherty (_British Medical Journal_, Vol. 329, No. 7461, August 7, 2004, .pdf and HTML format, p. 324).

11. CENTER FOR RETIREMENT RESEARCH AT BOSTON COLLEGE ISSUE BRIEF: "Why Is Life Expectancy So Low in the United States?" by Alicia H. Munnell, Robert E. Hatch, and James G. Lee (IB #21, August 2004, .pdf format, 11p.).


The United States is the richest major country in the world in terms of per capita gross domestic product (GDP). Since longevity is clearly associated with income, America's older citizens must live longer than their counterparts in other large industrial nations. Right? Wrong! Among the 30 developed countries that comprise the Organization for Economic Cooperation and Development (OECD), American life expectancy at age 65 for both males and females falls in the middle of the group. More than that, we are not expected to catch up anytime soon. The improvement in U.S. life expectancy, as projected by the Social Security Administration, implies that a 65-year-old American woman in 2050 will live about as long as a 65-year-old Japanese woman lives today. What are the implications of this unimpressive showing? And what explains the poor U.S. performance?

12. KAISER FAMILY FOUNDATION CHART BOOK: "Views of the New Medicare Drug Law," (Kaiser Family Foundation, August 2004, .pdf format, 7p.).

Follow link to "Summary and Chartpack".

News Release:

13. RUPRI CENTER FOR RURAL HEALTH POLICY ANALYSIS/[NORC] WALSH CENTER FOR RURAL HEALTH ANALYSIS REPORT: "A Rural Perspective Regarding Regulations Implementing Titles I and II of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)," by Curt Mueller, Keith Mueller, and Janet Sutton (W Series No. 6, August 2004, .pdf format, 19p.).

14. ILCUSA REPORT: "ILC Policy Report" (International Longevity Center, USA, August 2004, .pdf format, 6p.). The ILC Policy Report is "a monthly compilation of longevity news and trends in the U.S. and abroad."

15. AARP PUBLIC POLICY RESEARCH INSTITUTE DATA DIGEST: "Disability: Federal Survey Definitions, Measurements, and Estimates," by Steven R. Gregory (DD #98, August 2004, .pdf format, 8p.).

16. AARP PRIME TIME RADIO: The following AARP _Prime Time Radio_ shows, for July 20 - August 10, 2004, are now available (RealPlayer plug-in or helper application required, audio transcripts run between 24 and 30 minutes).

August 10, 2004: Baby Boomers as Voters - What Will They Do?
August 3, 2004: Long-Term Care: A New Front for a Veteran Fighter for the Elderly


II. Working Papers:

17. NBER:

A. "Do the Rich Flee from High State Taxes? Evidence from Federal Estate Tax Returns," by Jon Bakija and Joel Slemrod (National Bureau of Economic Research Working Paper w10645, July 2004, .pdf format, 64p.).


This paper examines how changes in state tax policy affect the number of federal estate tax returns filed in each state, utilizing data on federal estate tax return filings by state and wealth class for 18 years between 1965 and 1998. Controlling for state- and wealth-class specific fixed effects, we find that high state inheritance and estate taxes and sales taxes have statistically significant, but modest, negative impacts on the number of federal estate tax returns filed in a state. High personal income tax and property tax burdens are also found to have negative effects, but these results are somewhat sensitive to alternative specifications. This evidence is consistent with the notion that wealthy elderly people change their real (or reported) state of residence to avoid high state taxes, although it could partly reflect other modes of tax avoidance as well. We discuss the implications for the debate over whether individual states should decouple' their estate taxes from federal law, which would retain the state tax even as the federal credit for such taxes is eliminated. Our results suggest that migration and other observationally equivalent avoidance activities in response to such a tax would cause revenue losses and deadweight losses, but that these would not be large relative to the revenue raised by the tax.

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

B. "Do a Firm's Equity Returns Reflect the Risk of Its Pension Plan?" by Li Jin, Robert Merton, and Zvi Bobie (National Bureau of Economic Research Working Paper w10650, July 2004, .pdf format, 38p.).


This paper examines the empirical question of whether systematic equity risk of U.S. firms as measured by beta from the Capital Asset Pricing Model reflects the risk of their pension plans. There are a number of reasons to suspect that it might not. Chief among them is the opaque set of accounting rules used to report pension assets, liabilities, and expenses. Pension plan assets and liabilities are off-balance sheet, and are often viewed as segregated from the rest of the firm, with its own trustees. Pension accounting rules are complicated. Furthermore, the role of Pension Benefit Guaranty Corporation further clouds the real relation between pension plan risk and firm equity risk. The empirical findings in this paper are consistent with the hypothesis that equity risk does reflect the risk of the firm's pension plan despite arcane accounting rules for pensions. This finding is consistent with informational efficiency of the capital markets. It also has implications for corporate finance practice in the determination of the cost of capital for capital budgeting. Standard procedure uses de-leveraged equity return betas to infer the cost of capital for operating assets. But the de-leveraged betas are not adjusted for the risk of the pension assets and liabilities. Failure to make this adjustment will typically bias upwards estimates of the discount rate for capital budgeting. The magnitude of the bias is shown here to be large for a number of well-known U.S. companies. This bias can result in positive net-present-value projects being rejected.

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

C. "Detecting Medicare Abuse," by David Becker, Daniel Kessler, and Mark McClellan (National Bureau of Economic Research Working Paper w10677, August 2004, .pdf format, 35p.).


This paper identifies which types of patients and hospitals have abusive Medicare billings that are responsive to law enforcement. For a 20 percent random sample of elderly Medicare beneficiaries hospitalized from 1994-98 with one or more of six illnesses that are prone to abuse, we obtain longitudinal claims data linked with Social Security death records, hospital characteristics, and state/year-level anti-fraud enforcement efforts. We show that increased enforcement leads certain types of patients and hospitals to have lower billings, without adverse consequences for patients' health outcomes.

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

18. CENTER FOR ECONOMIC STUDIES AND THE IFO INSTITUTE FOR ECONOMIC RESEARCH [UNIVERSITY OF MUNICH] (CESifo): "Public Pensions in the National Accounts and Public Finance Targets," by Heikki Oksanen (Working Paper 1214, 2004, .pdf format, 22p.).


Preparations are underway to revise national accounting to implement actuarial recording of pension liabilities for corporations and government as an employer. This paper extends this to unfunded public pensions with the help of 'implicit tax' in pension contributions. The clearest advantages of the revision appear in situations where pension liabilities are shifted from the corporate sector to government, and where part of the public pension system is privatised. The proposed revision raises public debt and deficit to new orders of magnitude. The paper provides a framework for setting the debt and deficit targets under both current and proposed definitions.

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

19. American Journal of Epidemiology (Vol. 160, No. 4, August 15, 2004).

20. Journals of Gerontology (A) Biological and Medical Sciences (Vols. 59A, Nos. 7, July 2004). Note: Full electronic text of these journals is available in the ProQuest Research Library. Check your library for the availability of this database and these issues.

21. INGENTA Tables of Contents: INGENTA provides fee based document delivery services for selected journals.

A. Point your browser to:

B. click on "browse by publication"
C. Click the "fax/ariel" radio button, type the Journal Name in the "by words in the title" search box and click "search".
D. View the table of contents for the issue noted.

Journal of Aging and Physical Activity (Vol. 12, No. 3, 2004).

Journal of the American Geriatrics Society (Vol. 52, No. 8, 2004).

22. 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 18, 2004:

B. Alzheimer's Disease: Literature for the week of August 18, 2004:

C. Parkinson's Disease: Literature for the week of August 18, 2004:

D. Prostate Cancer: Literature for the week of August 18, 2004:

AMADEO Literature Guide:


IV. Funding Opportunities:

23. NIH:

A. "Summer Research Training in Aging for Medical Students," (US National Institutes of Health, National Institute on Aging in conjunction with other foundations, RFA-AG-05-002, August 6, 2004).

B. "Alzheimer's Disease Clinical Scientist Development Award," (US National Institutes of Health, National Institute on Aging, RFA-AG-05-003, August 9, 2004).

C. "Joint Degeneration: Mouse Models," (US National Institutes of Health, National Institute on Aging in conjunction with other agencies, PA-04-139, August 12, 2004).


V. Conferences:

24. CONFERENCEALERTS.COM: has recently updated its Gerontology conference section:

25. UNIVERSITY OF WISCONSIN-MADISON INSTITUTE ON AGING: "16th Annual Colloquium on Aging," to be held October 13, 2004 at the Monona Terrace in Madison. For information about the Colloquium go to:


VI. Legislation Information Updates:

26. US HOUSE COMMITTEE ON EDUCATION AND THE WORKFORCE HEARING TRANSCRIPT: "Strengthening Pension Security for all Americans: Are Workers Prepared for a Safe and Secure Retirement?" a hearing held February 25, 2004 (Serial No. 108-44, .pdf and ASCII format, 74p.).

Scroll down to or "find in page" "108-44" (with the quotes).


VII. Websites of Interest:

27. NIH: "Inside the NIH Grant Review Process," is a video produced by the Center for Scientific Review to "how NIH grant applications are reviewed for scientific and technical merit." The video is available in Windows Media Player format (~39 minutes running time), at various download speeds. A text transcript of the video is also available.




Charlie Fiss
Information Manager
Center for Demography and Ecology and
Center for Demography of Health and Aging
Rm. 4470A Social Science Bldg
1180 Observatory Drive
Madison, WI 53706-1393
Phone: (608) 265-9240
Fax: (608) 262-8400