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Examining the Relationships between Excess Body Weight, Health and Disability
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Author(s): Vicki Freedman, Christine Himes and Saad Ahmad |
Organization(s): University of Medicine and Dentistry of New Jersey, Syracuse University and Urban Institute |
The recent rise in the prevalence of obesity and overweight in the overall U.S. population has raised many concerns about the future. In addition to concerns about the medical costs of treating obesity-related illness, an apparent correlation between obesity and disability has led to concern that the recent declines in rates of disability among the elderly may cease or reverse. In this report, the authors explore the relationship between excess weight and obesity in a series of cross sectional and longitudinal analyses in an attempt to evaluate these concerns. Using data from the 1998-2004 waves of the Health and Retirement Study, the authors find evidence that the risks of developing difficulties with activities of daily living (ADLs) does increase with the prevalence of obesity, but the effects appear to be less dramatic than the effects on the limitations in physical functioning, which can be precursors of ADL disability. Further, the authors find only a weak relationship between excess weight and the onset of difficulties with instrumental ADLs. [45 PDF pages] |
Published: May, 2008 |
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Examining Relationships in an Integrated Hospital System
(Report)
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Author(s): Barbara Gage, Melissa Morley, Roberta Constantine, Pamela Spain, Justine Allpress, Megan Garrity, Melvin Ingbe |
Organization(s): RTI International |
The Examining Relationships in an Integrated Hospital System research project with RTI explores whether an organizational link between a Medicare hospital and a Medicare post-acute care (PAC) setting, such as a long term care hospital, inpatient rehabilitation facility, skilled nursing facility, or home health agency, increases the likelihood of transfer to a Medicare PAC setting. RTI uses calendar year 2005 data to build patient-level episodes beginning with an acute hospital discharge and tracking patient transfer patterns across settings. The project provides information on the national distribution of Medicare acute and PAC providers and their organizational relationships, both formal and informal. The organizational relationships are defined as freestanding PAC providers, provider-based PAC, or co-located providers (i.e., those within 250 yards of other providers). The initial findings include multivariate analysis of the effects of these organizational relationships on PAC site of care choices. |
Published: March, 2008 |
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Medicaid-Financed Nursing Home Services: Characteristics of People Served and Their Patterns of Care, 2001-2002
(Report)
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Author(s): Audra T. Wenzlow, Robert Schmitz and Jill Gurvey |
Organization(s): Mathematica Policy Research |
The goal of this study was to describe patterns of Medicaid nursing home utilization for each state and nationally. The authors address three specific research questions in this report: (1) What are the characteristics of people who use Medicaid nursing home services? (2) How do people who use Medicaid nursing home services become eligible for Medicaid? What proportion are long-time Medicaid enrollees entering a nursing home? What proportion are new enrollees? (3) How long do Medicaid-covered nursing home spells last and how often do individuals return to nursing homes? While addressing these questions, the authors also examine how state long-term care policies are associated with variation across states in patterns of nursing home utilization. [63 PDF pages] |
Published: January, 2008 |
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Performance Measurement in the Hospital Outpatient Setting: Final Report
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Author(s): Stephanie Teleki, Melony Sorbero, Lee Hilborne, Susan Lovejoy , Lily Bradley, Ateev Mehrotra, and Cheryl Damberg |
Organization(s): RAND |
The Assistant Secretary for Planning and Evaluation in collaboration with the Centers for Medicare and Medicaid Services contracted with RAND to conduct an environmental scan of hospital outpatient performance measurement for visits, services, and procedures paid under the Medicare Outpatient Prospective Payment System. This report presents the results from the environmental scan including analysis of data to determine leading conditions and services/procedures provided in the outpatient setting and a scan of publicly available measures being used across a variety of settings to identify those that potentially apply to care delivered in the hospital outpatient setting and potential gaps. |
Published: December, 2007 |
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An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report
(Report)
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Author(s): Chery Damberg, Melony Sorbero, Ateev Mehrotra, Stephanie Teleki, Susan Lovejoy, and Lily Bradley |
Organization(s): RAND |
Section 5001(b) of the Deficit Reduction Act of 2005 requires the Secretary to develop a plan to implement a value- based purchasing program for payments under Medicare for subsectioin (d) hospitals beginning with fiscal year 2009. To inform the development of the plan, the Assistant Secretary for Planning and Evaluation in collaboratioin with the Centers for Medicare and Medicaid Services contracted with RAND to conduct an environmental scan of hospital pay for performance programs. This report presents the results from the environmental scan, includes a review of the empirrical evidence about the impact of these hospital programs, a description of program design features and a summary of lessons learned from currently operating hospital programs. |
Published: November, 2007 |
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A Profile of Medicaid Institutional and Community-Based Long-Term Care Service Use and Expenditures Among the Aged and Disabled Using MAX 2002
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Author(s): Audra T. Wenzlow, Robert Schmitz and Kathy Shepperson |
Organization(s): Mathematica Policy Research |
This report examines how person-level data in the Medicaid Analytic eXtract (MAX) data system can be used to better understand Medicaid long-term care service use and expenditures, and to evaluate the utility of MAX data for further study of long-term care. In the analysis, the authors: compare expenditure and utilization-based measures of the balance of institutional and community-based long-term care services; examine Medicaid long-term care expenditures and utilization for two key groups of enrollees--young disabled enrollees and enrollees ages 65 and older; decompose community-based long-term care service expenditures by type of service; and summarize other Medicaid services used and costs incurred by long-term care users. [74 PDF pgs] |
Published: September, 2007 |
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Following an Admissions Cohort: Care Management, Claim Experience and Transitions among an Admissions Cohort of Privately Insured Disabled Elders over a 16 Month Period
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Author(s): Marc A. Cohen, Jessica S. Miller and Xiaomei Shi |
Organization(s): LifePlans, Inc. |
This is the second in a series of reports based on longitudinal information collected from a sample of 1400 individuals with long-term care (LTC) insurance, who notified their insurance company that they are receiving or intend to receive paid services for which they will file or have filed a claim under their LTC policy. These individuals comprise an admissions cohort of new LTC service users. This admissions cohort has been tracked over a period of 16 months. The purpose of this report is to report on selected findings of data collected from the first four follow-up telephone interviews completed after the initial in-person baseline assessment. These interviews were conducted at four-month intervals and examine key issues related to changes in disability status, the use of care management services, individuals experience with the claims filing process, and transitions through the continuum of care. The authors also report on individuals satisfaction with providers and their experiences with their LTC insurance. [36 PDF pages] |
Published: May, 2007 |
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An Overview of the US Health System Chart Book
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Author(s): George Greenberg and Nancy DeLew |
Organization(s): In House Research |
This chart book provides data on various aspects of the US health system including public and private health care coverage, provider data, and international comparisons of the US to OECD countries. |
Published: January, 2007 |
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Toward an Evaluation of the Quality Improvement Organization Program:
(Report)
Beyond the 8th Scope of Work |
Author(s): Janet P. Sutton, Lauren Silver, Lucia Hammer, Alycia Infante |
Organization(s): NORC |
This project developed an inventory of Quality Improvement Program (QIO) activities and then proposed methodologies to evaluate Medicare's QIO in the future. The contractor gathered information from publicly available sources, from CMS data when available, and from nine site visits to a variety of QIOs. Based on the findings, NORC developed a list of potential projects to evaluate the QIO program. These were presented to a Technical Expert Panel, who provided input on their feasibility and priority. NORC used this information to prepare a report describing potential evaluation approaches. |
Published: January, 2007 |
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Continuation of Drug Risk Adjustment
(Report)
Drug Risk Adjustment |
Author(s): Claudia Schur, Jack Hoadley, Chris Hogan |
Organization(s): NORC (National Opinion Research Center) |
This project reports on analysis using linked Medicaid and FEHBP data examining refinements to the risk adjustment factors for drug plans for low income and institutionalized populations; geographic variation in drug spending by health plan area; and prior use models of drug plan risk-adjustment. |
Published: December, 2006 |
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