Sensitivity of Medicare Data to Identify Oncologists.

Background: Health services researchers have studied how care from oncologists impacts treatment and outcomes for cancer patients. These studies frequently identify physician specialty using files from the Center for Medicare and Medicaid Services (CMS) or the American Medical Association (AMA). The completeness of the CMS data resources, individually or combined, to identify oncologists is unknown.

Early Findings From the Oncology Care Model Evaluation.

Purpose: The Oncology Care Model (OCM) is an alternative payment model administered by the Centers for Medicare & Medicaid Services (CMS) that is structured around 6-month chemotherapy treatment episodes. This report describes the CMS-sponsored OCM evaluation and summarizes early evaluation findings.

Methods: The OCM evaluation examines health care spending and use, quality of care, and patient experience during chemotherapy treatment episodes.

Increased observation services in Medicare beneficiaries with chest pain.

Introduction: We examined trends in the use of observation services and the relationship between index service type (observation services, emergency department [ED] visits, inpatient stays) and both clinical outcomes and Medicare payments.

Methods: We created a yearly cohort panel of Medicare beneficiaries with chest pain. We evaluate the relationships between index service type and 30-day clinical outcomes using a multinomial logit model and between index service type and Medicare payments using generalized linear models.

Patient financial responsibility for observation care.

Background: As observation care grows, Medicare beneficiaries are increasingly likely to revisit observation care instead of being readmitted. This trend has potential financial implications for Medicare beneficiaries because observation care-although typically hospital based-is classified as an outpatient service. Beneficiaries who are readmitted pay the inpatient deductible only once per benefit period.

Observation encounters and subsequent nursing facility stays.

Background: Medicare coverage of skilled nursing facility (SNF) care requires that beneficiaries have a 3-night inpatient stay in the prior 30 days to be eligible. Time spent by beneficiaries receiving hospital-based observation services does not count toward this requirement.

Objectives: To examine the frequency of Medicare beneficiary discharge from hospital-based observation services to SNFs and its impact on Medicare coverage.