Search

Researchers from the University of Michigan conducted a study on the switching patterns between fee-for-service Medicare and Medicare Advantage among older beneficiaries. The study found that 3.3% of beneficiaries switched to Medicare Advantage annually, with higher switching percentages for those with prior Medicare Advantage enrollment. The research highlighted the importance of examining the vulnerabilities and long-term outcomes of this population for future health policy considerations. [Extracted from the article]

Keywords: Ann Arbor; State:Michigan; United States; North and Central America; Acute Myocardial Infarction; Congestive Heart Failure; Health Policy; Health and Medicine; Heart Attack; Heart Disorders and Diseases; Hospitals; Infectious Disease; Lung Diseases and Conditions; Medicare; Medicare and Medicaid; Pneumonia; Pulmonology; Respiratory Tract Diseases and Conditions; Respiratory Tract Infections EN Ann Arbor State:Michigan United States North and Central America Acute Myocardial Infarction Congestive Heart Failure Health Policy Health and Medicine Heart Attack Heart Disorders and Diseases Hospitals Infectious Disease Lung Diseases and Conditions Medicare Medicare and Medicaid Pneumonia Pulmonology Respiratory Tract Diseases and Conditions Respiratory Tract Infections 370 370 1 11/06/23 20231109 NES 231109 2023 NOV 6 (NewsRx) -- By a News Reporter-Staff News Editor at Heart Disease Weekly -- Investigators discuss new findings in Heart Disorders and Diseases - Congestive Heart Failure. Keywords for this news article include: Ann Arbor, Michigan, United States, North and Central America, Acute Myocardial Infarction, Congestive Heart Failure, Health Policy, Health and Medicine, Health and Medicine, Heart Attack, Heart Disorders and Diseases, Hospitals, Infectious Disease, Lung Diseases and Conditions, Medicare, Medicare and Medicaid, Pneumonia, Pulmonology, Respiratory Tract Diseases and Conditions, Respiratory Tract Infections, University of Michigan. Ann Arbor, State:Michigan, United States, North and Central America, Acute Myocardial Infarction, Congestive Heart Failure, Health Policy, Health and Medicine, Heart Attack, Heart Disorders and Diseases, Hospitals, Infectious Disease, Lung Diseases and Conditions, Medicare, Medicare and Medicaid, Pneumonia, Pulmonology, Respiratory Tract Diseases and Conditions, Respiratory Tract Infections. [Extracted from the article]

The article examines medical care in the U.S as of September 2014 with regards to for-profit dominance of care and risk-based Medicare. It provides a background of Medicare funding for for-profit home health agencies and discusses the increase in for-profit long-term care facilities. It details a study on the managed-care model which revealed that it is not cost-effective and does not deliver quality care.

Objective: To assess whether Medicare's Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in severe fall-related injuries (FRIs). Data Sources and Study Setting: Secondary data from Medicare were used. Study Design: Using an event study design, among older ([greater than or equal to]65) Medicare fee-for-service beneficiaries, we assessed changes in 30- and 90-day FRI readmissions before and after HRRP's announcement (April 2010) and implementation (October 2012) for conditions targeted by the HRRP (acute myocardial infarction [AMI], congestive heart failure [CHF], and pneumonia) versus ''non-targeted' (gastrointestinal) conditions. We tested for modification by hospitals with 'high-risk' before HRRP and accounted for potential upcoding. We also explored changes in 30-day FRI read-missions involving emergency department (ED) or outpatient care, care processes (length of stay, discharge destination, and primary care visit), and patient selection (age and comorbidities). Data Collection: Not applicable. Principal Findings: We identified 1.5 million (522,596 pre-HRRP, 514,844 announcement, and 474,029 implementation period) index discharges. After its announcement, HRRP was associated with 12%-20% reductions in 30- and 90-day FRI readmissions for patients with CHF (-0.42 percentage points [ppt], p = 0.02; -1.53 ppt, p < 0.001) and AMI (-0.35, p = 0.047; -0.97, p = 0.001). Two years after implementation, HRRP was associated with reductions in 90-day FRI readmission for AMI (-1.27 ppt, p = 0.01) and CHF (-0.98 ppt, p = 0.02) patients. Results were similar for hospitals at higher versus lower baseline risk of FRI readmission. After HRRP's announcement, decreases were observed in home health (AMI: -2.43 ppt, p < 0.001; CHF: -8.83 ppt, p < 0.001; pneumonia: -1.97 ppt, p < 0.001) and skilled nursing facility referrals (AMI: -5.95 ppt, p < 0.001; CHF: -3.19 ppt,p < 0.001; pneumonia: -10.27 ppt,p < 0.001). Conclusions: HRRP was associated with reductions in FRIs, primarily for HF and pneumonia patients. These decreases may reflect improvements in transitional care including changes in post-acute referral patterns that benefit patients at risk for falls. KEYWORDS fall injury, HRRP, Medicare, policy, readmissions What is known on this topic * Medicare's policy to reduce readmissions, the Hospital Readmissions Reduction Program (HRRP), was associated with modest, early reductions in 30-day all-cause readmissions. * Fall injuries are common before and after hospital admission and are a leading diagnosis at readmission. * Interventions to prevent readmission, including transitional care and medication management, address risk factors associated with fall injury. What this study adds * HRRP reduced fall injuries for congestive heart failure and pneumonia patients. * Effects on fall injury and all-cause readmission were primarily observed after the program's announcement, in 2010, as opposed to after implementation in 2012. * Reductions in fall injury readmission may reflect spillovers from transitional care implementation to prevent readmissions and fewer skilled nursing facility referrals., 1 | INTRODUCTION Fall injuries can threaten older Americans' well-being and independence, with risks substantially increasing after a hospitalization when patients are often most vulnerable. (1-4) Fall injuries are common, [...]

Objective: To assess whether the intensity of family and friend care changes after older individuals enroll in Medicare at age 65. Data Sources: Health and Retirement Study survey data (1998-2018). Study Design: We compared informal care received by patients hospitalized for stroke, heart surgery, or joint surgery and who were stratified into propensityweighted pre- and post-Medicare eligibility cohorts. A regression discontinuity design compared the self-reported likelihood of any care receipt, weekly hours of overall informal care, and intensity of informal care (hours among those receiving any care) at Medicare eligibility. Data Collection: Not applicable. Principal Findings: A total of 2270 individuals were included; 1674 (73.7%) stroke, 240 (10.6%) heart surgery, and 356 (15.7%) joint surgery patients. Mean (SD) care received was 20.0 (42.1) weekly hours. Of the 1214 (53.5%) patients who received informal care, the mean (SD) care receipt was 37.4 (51.7) weekly hours. Mean (SD) overall weekly care received was 23.4 (45.5), 13.9 (35.8), and 7.8 (21.6) for stroke, heart surgery, and joint surgery patients, respectively. The onset of Medicare eligibility was associated with a 13.6 percentage-point decrease in the probability of informal care received for stroke patients (p = 0.003) but not in the other acute care cohorts. Men had a 16.8 percentage-point decrease (p = 0.002) in the probability of any care receipt. Conclusions: Medicare coverage was associated with a substantial decrease in family and friend caregiving use for stroke patients. Informal care may substitute for rather than complement restorative care, given that Medicare is known to expand the use of postacute care. The observed spillover effect of Medicare coverage on informal caregiving has implications for patient function and caregiver burden and should be considered in episode-based reimbursement models that alter professional rehabilitative care intensity. KEYWORDS caregiving, discontinuity, Medicare, stroke, surgery What is known * Family and friend care is received by millions of older Americans * Medicare spends $124 billion on surgical care, $30 billion on stroke care, and is known to increase the use of postacute services for new enrollees * Informal care can substitute for maintenance and well-being assistance requiring less skilled support What this study adds * Older Medicare beneficiaries receive substantial family and friend caregiving after acute health events * Medicare eligibility is associated with decreased informal caregiving use for those who experience a stroke * Ongoing restorative services for stroke patients may decrease the need for complementary support from family and friends, 1 | INTRODUCTION Each year, Medicare spends approximately $124 billion on surgical care, $30 billion on stroke care, and $60 billion on posthospital care. (1-4) It is well recognized that [...]

For some seniors, pandemic isolation has created a perfect storm of physical inactivity and deconditioning that has resulted in increased falls risk and greater fear of falling, researchers say. More [...]

Objective. To estimate expenditures for fall-related injuries (FRIs) among older Medicare beneficiaries. Data Sources. The 2007-2009 Medicare claims and 2008 Health and Retirement Study (HRS) data for 5,497 (228 FRI [...]