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Vol. 4, No. 1, 2014

Evaluating Whether Changes in Utilization of Hospital Outpatient Services Contributed to Lower Medicare Readmission Rate

Increased use of hospital outpatient services is not directly related with the decline in the 2012 readmission rate. The frequency of readmissions fell markedly more in 2012 than any of the previous five years, but the annual change in ED visits was largely steady and observation stays increased over the study period.

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The Impact of Medicaid Peer Support Utilization on Cost

Peer support programs for those with mental health conditions increase Medicaid costs per patient without reducing other costs. Policy makers must weigh this with efforts to change the delivery of mental health services.

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The Policy Implications of the Cost Structure of Home Health Agencies

Researchers analyzed the relationships between total costs, type of patients, quality of care, and market environment for home health agencies, and they discovered added costs due to size for both non-profit and for-profit agencies and suggest ways to achieve efficiencies.

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The Medicaid Medically Improved Group: Losing Disability Status and Growing Earnings

The Ticket to Work and Work Incentives Improvement Act gives states the choice to extend Medicaid Buy-In coverage to a medically improved group. This study shows that participation has been limited, with 233 participants in 2009 whose earnings grew significantly, with mean earnings at 52% of the federal poverty level.

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Medicare Post-Acute Care Episodes and Payment Bundling

To inform policy makers testing bundled payment alternatives, Morley et al. describe the changes in Medicare service payments and use that result from different definitions of an episode of post-acute care (PAC); that is, the set of services provided after a hospitalization. The authors looked at the impact of changing the length in time after a hospitalization to count as an episode, including or excluding certain events—like readmissions, and using the services or payments associated with any person with a hospitalization or only those persons discharged with PAC in the denominator of measures. Finally, they considered the variations in types of PAC use across different areas, including states.

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