Reducing HIV-Related Health Disparities in the Health Resources and Services Administration's Ryan White HIV/AIDS Program.

The Health Resources and Services Administration's Ryan White HIV/AIDS Program (RWHAP) supports direct health care treatment and support services to more than 50% of all people living with diagnosed HIV in the United States. A critical goal of the RWHAP is to reduce HIV-related health disparities to help end the HIV epidemic. From 2010 through 2016, the RWHAP made significant progress reducing viral suppression disparities among client populations, particularly among women, transgender persons, youths, Blacks or African Americans, and unstably housed clients.

The Impact of Enhanced Critical Care Training and 24/7 (Tele-ICU) Support on Medicare Spending and Postdischarge Utilization Patterns.

Objective: To estimate the effect of implementing a tele-ICU and a critical care residency training program for advanced practice providers on service utilization and total Medicare episode spending.

Data Sources/study Settings: Medicare claims data for fee-for-service beneficiaries at 12 large, inpatient hospitals in the Atlanta Hospital Referral Region.

Study Design: Difference-in-differences design where changes in spending and utilization for Medicare beneficiaries eligible for treatment in participating ICUs was compared to changes in a comparison group of clinically similar beneficiaries treated at similar hospitals' ICUs in the same hospital referral region.

Mandated Health Insurance and Provider Reimbursement via Private Insurance: Evidence From the Massachusetts Health Reform.

In 2006, Massachusetts passed a reform that required individuals to purchase health insurance and provided subsidized health insurance to low-income individuals. The US Patient Protection and Affordable Care Act (ACA) was modeled after this reform, making Massachusetts an ideal place to look at potential outcomes from the ACA. Postreform, the proportion of the health-insured population in Massachusetts greatly increased, which potentially changed physician reimbursement for procedures as usage of care, particularly preventative care for children increased.

Assessing variation in utilization for acute myocardial infarction in New York State.

Background: Wide variations exist in healthcare expenditures, though most prior studies have assessed aggregate utilization. We sought to examine healthcare utilization variation in New York State by assessing hospitals in peer groups of similar capabilities.

Methods: Using charge data in New York State from the 2008 Statewide Planning and Research Cooperative System (SPARCS) and cost-to-charge ratios at the cost-center level drawn from Institutional Cost Reports, we calculated total, routine, and ancillary costs for patients discharged with an acute myocardial infarction (AMI) diagnosis in 2008.

Improving prediction of fall risk among nursing home residents using electronic medical records.

Objective: Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls.

Where does the money go? Analyzing the patient experience in safety-net hospitals.

Background: Low-income, publicly insured admissions historically cost more to treat than does the average patient. To ensure that hospitals are reimbursed an adequate amount for care of indigent populations, Medicare reimburses hospitals an additional percentage amount according to federally set financial schedule. At 15% of a disproportionate patient percentage, a hospital is reimbursed an extra 2.

Effects of occupational regulations on the cost of dental services: evidence from dental insurance claims.

In the United States, occupational regulations influence the work tasks that may legally be performed by dentists and dental hygienists. Only a dentist may legally perform most dental procedures; however, a smaller list of basic procedures may be provided by either a dentist or a dental hygienist. Since dentists and hygienists possess different levels of training and skill and receive very different wages, it is plausible that these regulations could distort the optimal allocation of skills to work tasks.