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Vol. 3, No. 4, 2013

Examination of the Accuracy of Coding Hospital-Acquired Pressure Ulcer Stages

Analyses of 2009 and 2010 Medicare claims data show that 54% of claims with a secondary diagnosis code of a pressure ulcer site did not include a stage code, compared to only 10% of claims with a pressure ulcer as a primary diagnosis. The new “5010” claim format and the change to ICD-10 will likely reduce underreporting stages for hospital-acquired pressure ulcers.

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Migration Patterns for Medicaid Enrollees 2005–2007

Enrollee moves between states can result in Medicaid enrollment gaps that may indicate a lack of continuous care and a risk to patient health, an increased use of emergency services, and higher health care costs. These findings encourage further study of the impact enrollee moves have on their health and health care program costs.

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Asthma Medication Ratio Predicts Emergency Department Visits and Hospitalizations in Children with Asthma

Children with a low controller-to-asthma medication ratio were 1.5–2.0 times more likely to have a subsequent emergent healthcare visit than those with higher ratios. Increasing controller medication use in these patients would lead to improved ratios and fewer emergent healthcare visits.

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Telehealth and Medicare: Payment Policy, Current Use, and Prospects for Growth

Researchers did not find substantial growth for telehealth services, although legislative changes increased Medicare payment rates and decreased regulatory burdens. Telehealth services may, in some cases, be socially desirable to expand when emergency access or reduced patient travel outweighs added costs to delivering care via telehealth.

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Modeling Per Capita State Health Expenditure Variation: State-Level Characteristics Matter

Authors studied average spending in personal health care per person at the state level for all payers. State-level income, amount of health care, and number of elderly residents explain variation in personal health care spending per person among states over time. The authors tested many models to get improved interpretations of the overall results.

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