The diffusion of health care fraud: A bipartite network analysis.

Many studies have examined the diffusion of health care innovation but less is known about the diffusion of health care fraud. In this paper, we consider the diffusion of potentially fraudulent Medicare home health care billing in the United States during 2002-16, with a focus on the 21 hospital referral regions (HRRs) covered by local Department of Justice (DOJ) anti-fraud "strike force" offices. We hypothesize that patient-sharing across home health care agencies (HHAs) provides a mechanism for the rapid diffusion of fraudulent strategies.

Local population characteristics and hemoglobin A1c testing rates among diabetic medicare beneficiaries.

Background: Proposed payment reforms in the US healthcare system would hold providers accountable for the care delivered to an assigned patient population. Annual hemoglobin A1c (HbA1c) tests are recommended for all diabetics, but some patient populations may face barriers to high quality healthcare that are beyond providers' control. The magnitude of fine-grained variations in care for diabetic Medicare beneficiaries, and their associations with local population characteristics, are unknown.

Accountability for end-stage organ care: implications of geographic variation in access to kidney transplantation.

Background: The provision of effective surgical care for end-stage renal disease (ESRD) requires efficient evaluation and transplantation. Prior assessments of transplant access have focused primarily on waitlisted patients rather than the overall populations served by "accountable" providers of transplant services.

Methods: Novel transplant referral regions (TRRs) were defined using United Network for Organ Sharing registry data for 301,092 kidney transplant listings to assign zip codes to "accountable" transplant programs.

State spending on dual eligibles under age 65 shows variations, evidence of cost shifting from Medicaid to Medicare.

Roughly half of Medicare beneficiaries under age sixty-five are also eligible for Medicaid. These "dual eligibles" have been the subject of much research because of their low income and poor health status. Previous studies suggest that some states seek to shift costly health care services for this group out of state-run Medicaid programs and into the federally funded Medicare program--for example, replacing nursing home care with hospital care.

Who will need long-term care? Creation and validation of an instrument that identifies older people at risk.

The aim of this study was to create and measure the predictive validity of a screening instrument that identifies older people who are at risk for developing a need for long-term care within a year. This was an observational study, with participants allocated to either a derivation cohort or a validation cohort, in the United States. A nationally representative sample of older community-dwelling Medicare beneficiaries (n = 6,538) participated in the Medicare Current Beneficiary Survey.

Use of Medicare services by elderly residents of Puerto Rico.

Objectives: We describe hospitalization rates among Medicare beneficiaries resident in Puerto Rico compared to beneficiaries in the mainland U.S., in 1999.

Prostate biopsies in men with limited life expectancy.

Context: Authorities discourage prostate screening in men who are likely to die from causes other than prostate cancer.

Practice Pattern Examined: Use of prostate biopsy-a proxy for screening-in men aged 65 and older with limited life expectancy (i.e.