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Vol. 1, No. 4, 2011

Indirect Medical Education and Disproportionate Share Adjustments to Medicare Inpatient Payment Rates

Our analyses suggest that the empirical level for IME would be much smaller than under current law—about one-third to one-half. Our analyses also support the DSH adjustment prescribed by the Affordable Care Act of 2010 (ACA)—about one-quarter of the pre-ACA level.


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Disparities in Routine Breast Cancer Screening for Medicaid Managed Care Members with a Work-Limiting Disability

Nationwide, rates of routine mammography for Medicaid managed care plans averaged below 50% in 2006. Given that a majority of eligible women served by Medicaid have disabilities, and studies have shown that women with disabilities are more likely to be diagnosed with late stage disease, a focus on improving rates of screening for women with disabilities is overdue.

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Health Spending by State of Residence, 1991–2009

Cuckler et al. provide a detailed discussion of baseline health spending by state of residence (per capita personal health care spending, per enrollee Medicare spending, and per enrollee Medicaid spending) in 2009, over the last decade (1998–2009), as well as the differential regional and state impacts of the recent recession.

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Endocrine therapy use among elderly hormone receptor-positive breast cancer patients enrolled in Medicare Part D

Examines utilization and adherence to therapy for SERMs and AIs in Medicare Part D prescription drug plans. Many elderly breast cancer patients were not receiving therapy for the recommended five years following diagnosis. Choosing a Part D plan that minimizes out-of-pocket costs is critical to ensuring beneficiary access to essential medications.

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Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

This paper (1) assesses non-compliance among Medicare Part D recipients for the cardiovascular medication classes; (2) identifies the probability of noncompliance for each medication class when controlling for the potential risk factors of age, gender, race/ethnic origin, census region, disease burden, dual eligibility enrollment status, Part D plan status, relative out-of-pocket (OOP) non-class costs, and relative OOP daily class costs.

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