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The article focuses on long-term clinical care for cancer patients. It states that the data from surveillance, epidemiology, and end results were used to describe the physicians' specialties that render care for Medicare recipients diagnosed with cancer for more than 5 years. It notes that less than half of the long-term cancer survivors continuously see an oncologist yearly and continue to decline every year.

Objective. To examine the number of cancer specialists identified in three national datasets, the effect of combining these datasets, and the use of refinement rules to classify physicians as cancer specialists. Data Sources. 1992–2003 linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data and a cancer-free comparison population of Medicare beneficiaries, Unique Physician Identification Number (UPIN) Registry, and the American Medical Association (AMA) Masterfile. Study Design. We compared differences in counts of cancer specialists identified in Medicare claims only with the number obtained by combining data sources and after using rules to refine specialty identification. Data Extraction. We analyzed physician specialty variables provided on Medicare claims, along with the specialties obtained by linkage of unencrypted UPINs on Medicare claims to the UPIN Registry, the AMA Masterfile, and all sources combined. Principle Findings. Medicare claims identified the fewest number of cancer specialists ( n=11,721) compared with 19,753 who were identified when we combined all three datasets. The percentage increase identified by combining datasets varied by subspecialty (187 percent for surgical oncologists to 50 percent for radiation oncologists). Rules created to refine identification most affected the count of radiation oncologists. Conclusions. Researchers should consider taking the additional effort and cost to refine classification by using additional data sources based on their study objectives. [ABSTRACT FROM AUTHOR]

Examines the enrollment effects of congressionally mandated Medicaid coverage in the United States during the late 1980s. Medicaid eligibility criteria; Comparison of the national enrollment trends from 1975-1992; Multivariate analysis of eligibility criteria and their enrollment impacts; Variables having impact to Aid to Families with Dependent Children.

In this paper we compare physician referral patterns, quality, patient satisfaction, and community benefits of physician-owned specialty versus peer competitor hospitals. Our results are based on evidence gathered from site visits to six markets, 2003 Medicare claims, patient focus groups, and Internal Revenue Service data. Although physician-owners are more likely than others to refer to their own facilities and treat a healthier population, there are rationales for these patterns aside from motives for profit. Specialty hospitals provide generally high-quality care to satisfied patients. Uncompensated care plus specialty hospitals' taxes represent a greater burden, in percentage terms, than community benefits provided by nonprofit providers. [ABSTRACT FROM AUTHOR]

In this paper we compare physician referral patterns, quality, patient satisfaction, and community benefits of physician-owned specialty versus peer competitor hospitals. Our results are based on evidence gathered from site visits to six markets, 2003 Medicare claims, patient focus groups, and Internal Revenue Service data. Although physician-owners are more likely than others to refer to their own facilities and treat a healthier population, there are rationales for these patterns aside from motives for profit. Specialty hospitals provide generally high-quality care to satisfied patients. Uncompensated care plus specialty hospitals' taxes represent a greater burden, in percentage terms, than community benefits provided by nonprofit providers. [ABSTRACT FROM AUTHOR]

Abstract: The Health Care Financing Administration (HCFA) initiated the Medicare Competition Demonstrations in 1982 in anticipation of congressional intent to establish a national program. Interim results on the 1984 service use and cost experience of the health maintenance organizations (HMOs) and competitive medical plans (CMPs) participating in the demonstrations indicate that Medicare enrollees in the demonstration experienced a median of 1,951 hospital days per 1,000 person years, 57 per ¢ of the median of 3,432 days per 1,000 in the local markets from which the plans drew enrollment. Independent practice association (IPA) HMOs experienced higher hospital use rates than staff and group model HMOs. These comparisons are not adjusted for various risk factors, the absence of which were likely to favor the demonstration plans. Plans with lower hospital service use were federally qualified and had been operating for more than five years. The median total annual revenue per enrollee across all plans was $2,312, compared to median annual expenses per enrollee of $2,250. The distribution of median annual expenses per enrollee by major category of expense was: institutional expenses ($1,038/enrollee), medical expenses ($720/enrollee), supplemental services expenses ($154/enrollee), and administrative and other expenses ($295/enrollee). Future analysis, using beneficiary-level data, will examine the impact of the demonstration and the nature and extent of evident biased selection and will compare the quality of care in the demonstrations to that in the fee-for-service sector. (Am J Public Health 1988; 78:937-943. INSET: Joint Federal Effort to Assist Recruitment of Disadvantaged.... [ABSTRACT FROM AUTHOR]