Inpatient Admissions and Re-Admissions in Medicare Beneficiaries Initiating Umeclidinium/Vilanterol or Tiotropium Therapy.

Purpose: Patients with chronic obstructive pulmonary disease (COPD) who are hospitalized are more likely to die from their illness and have increased likelihood of re-admission than those who are not. Subsequent re-admissions further increase the burden on healthcare systems. This study compared inpatient admission rates and time-to-first COPD-related inpatient admission among Medicare beneficiaries with COPD indexed on umeclidinium/vilanterol (UMEC/VI) versus tiotropium (TIO).

Chronic physical conditions in older adults with mental illness and/ or substance use disorders.

Objectives: To examine the association between mental illness and chronic physical conditions in older adults and investigate whether co-occurring substance use disorders (SUDs) are associated with greater risk of chronic physical conditions beyond mental illness alone.

Design: A retrospective cross-sectional study.

Setting: Medicare and Medicaid programs in Massachusetts.

Twelve-month diagnosed prevalence of behavioral health disorders among elderly medicare and medicaid members.

Objectives: We examined the 12-month diagnosed prevalence of behavioral health disorders (BHDs) and dementia among elderly Medicare and Medicaid members in Massachusetts by primary payment source group (dual eligible, Medicare only, and Medicaid only) and age group (65-74 years, 75-84 years, and 85 years and older).

Design: A retrospective cross-sectional study.

Setting: Medicare and Medicaid programs.

The evidence doesn't justify steps by state Medicaid programs to restrict opioid addiction treatment with buprenorphine.

Many state Medicaid programs restrict access to buprenorphine, a prescription medication that relieves withdrawal symptoms for people addicted to heroin or other opiates. The reason is that officials fear that the drug is costlier or less safe than other therapies such as methadone. To find out if this is true, we compared spending, the use of services related to drug-use relapses, and mortality for 33,923 Massachusetts Medicaid beneficiaries receiving either buprenorphine, methadone, drug-free treatment, or no treatment during the period 2003-07.

Behavioral health disorders and adherence to measures of diabetes care quality.

Objective: To investigate whether Medicare and/or Medicaid beneficiaries with behavioral health disorders (BHDs) receive lower quality diabetes care.

Study Design: Retrospective observational study using merged Medicare and Medicaid claims data from Massachusetts in calendar years 2004 and 2005.

Methods: The study included beneficiaries who had type 2 diabetes, stayed at nursing homes for fewer than 90 days, and were enrolled in Medicare and/or Medicaid for at least 10 months during the study period.

Factors associated with Medicaid patients' access to buprenorphine treatment.

Some studies have shown that patients entering buprenorphine treatment differ from those in other modalities. This study compares Massachusetts Medicaid beneficiaries who received buprenorphine, methadone or other treatment for opioid addiction in 2007. Patients' characteristics and comorbidities were identified through claims data, and associations between these factors and treatment type were investigated using multivariate analysis.