The Hilltop Institute, University of Maryland, Baltimore County, 1000 Hilltop Circle, Sondheim Hall, 3rd Floor, Baltimore, MD 21250. Email: mmouslim@hilltop.umbc.edu.
From the University of California, Berkeley, Berkeley (J.C.R.); Brown University, Providence, RI (C.W.); and the University of California, San Francisco, School of Medicine, San Francisco (S.S.D.).
Section of General Medicine and the National Clinician Scholars Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
Department of Health Policy and Management, Yale University School of Public Health, New Haven, Connecticut.
Center for Outcomes Research and Evaluation, Yale-New Haven Health, New Haven, Connecticut.
National Institute of Health Research and Development, the Ministry of Health of the Republic of Indonesia, Jakarta, Indonesia. ratna-d-w@fkm.unair.ac.id.
Persakmi Institute, Surabaya, Indonesia. ratna-d-w@fkm.unair.ac.id.
Head and Neck Oncology Fellow, University of Maryland Medical Center, Baltimore, MD; Clinical Research Fellow, Oral & Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
Chair, Oral & Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA. Electronic address: zpeacock@partners.org.
Department of Dermatology, University of Connecticut, School of Medicine Farmington, CT, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA. Electronic address: grant@uchc.edu.
To use publicly available price transparency data files to establish empirical regularities about hospital-insurer contracting....
Retrospective analysis of 10 price transparency data files from HCA Healthcare....
Cross-sectional qualitative analysis of 524 hospital-insurer contracts across 10 hospitals....
We ascertain 4 empirical regularities in these files. First, hospitals contract with many payers, ranging from 35 to 82 across the hospitals in the sample. Second, contract structure varies significan...
Hospital-insurer contracts dictate the flow and structure of a significant portion of total health care expenditure in the US. Increased attention by both researchers and policy makers would lead to a...
Despite most Americans having healthcare coverage, coverage does not equate to access. For many, healthcare coverage is being threatened by contractual disagreements between major health insurers and ...
Given recent congressional interest in codifying price transparency regulations, it is important to understand the extent to which newly available price transparency data capture true underlying proce...
Over 25% of the 27 million uninsured individuals in the United States are eligible for Medicaid. Many hospitals have insurance linkage programs that assist eligible patients with enrollment, but littl...
This retrospective cohort study included adults aged 18-64 admitted to the hospital from 2016 to 2021. Those who obtained insurance retroactively via insurance linkage (RI) were compared with those wh...
Of 3882 patients admitted with no insurance, 2905 (74.8%) were enrolled in insurance (RI). In multivariable analysis, RI patients were 14% more likely (OR 1.14, p = 0.020) to have completed at least o...
Hospital-based insurance linkage reached three-quarters of uninsured patients and was associated with increased utilization of acute and outpatient health care services. An acute care encounter repres...
The Australian government pays $6.7 billion per year in rebates to encourage Australians to purchase private health insurance (PHI) and an additional $6.1 billion to cover services provided in private...
To evaluate hospital performance and behaviors in the first 2 years of a statewide commercial insurance episode-based incentive pay-for-performance (P4P) program....
Retrospective cohort study of price- and risk-standardized episode-of-care spending from the Michigan Value Collaborative claims data registry....
Changes in hospital-level episode spending between baseline and performance years were estimated during the program years (PYs) 2018 and 2019. The distribution and hospital characteristics associated ...
Hospital-level episode spending for all conditions declined significantly from the baseline year to the performance year in PY 2018 (-$671; 95% CI, -$1113 to -$230) but was not significantly different...
There was little evidence for overall reductions in spending associated with the program, but the performance of the hospitals that achieved greatest savings and incentives provides insights into the ...
Immediate complications of appendicitis are common, but the prevalence of long-term complications is uncertain....
We studied all publicly-insured children in the US with uncomplicated or complicated appendicitis in 2018-2019 using administrative claims. The main outcome was late hospital care defined as hospitali...
Among 95,942 children with appendicitis, 5727 (6.0%) had late hospital care, with 5062 requiring rehospitalization and 2012 (2.1%) surgery. The median time to late hospital care was 10 d (interquartil...
Late hospital care is uncommon in pediatric appendicitis but is costly. Prevention efforts should be targeted to the youngest, most complex children, and those with complicated appendicitis at present...
The aims of the study are to investigate differences in rates of adverse safety events between nonelderly adult patients with Medicaid and those with private insurance and to assess whether difference...
Inpatient records from 26 states in 2017 were collected from the Agency for Health Care Research and Quality's Hospital Cost and Utilization Project....
This study measures differences in 11 patient safety indicators between patients with Medicaid coverage and patients with private insurance coverage. I use regression analysis to investigate differenc...
This study uses hospital discharge data that is restricted to adults ages 19-64 with Medicaid or private coverage....
Relative to privately insured patients, Medicaid patients had significantly higher rates of adverse safety events on 8 of 11 patient safety indicators, including on 6 of 7 surgery-related patient safe...
Medicaid patients received lower quality of care, based on patient safety metrics, relative to privately insured patients within the same hospitals. Reducing payer disparities in adverse safety events...
Analysis for this study was conducted in 2023 at the Urban Institute and at Loyola University Chicago....
Opioids are vital to pain management and sedation after trauma-related hospitalization. However, there are many confounding clinical, social, and environmental factors that exacerbate pain, post-injur...
The objective of this study was to examine insurance-based disparities in mortality, non-home discharges, and ECMO utilization in patients hospitalized with COVID-19....
Using a national database of U.S. academic medical centers and their affiliated hospitals, the risk-adjusted association between mortality, non-home discharge, and ECMO utilization and (1) the type of...
Among 760,846 patients hospitalized with COVID-19, 214,992 had private insurance, 318,624 had Medicare, 96,192 were dually enrolled in Medicare and Medicaid, 107,548 had Medicaid, and 23,560 had no in...
Among patients with COVID-19, insurance-based disparities in mortality, non-home discharges, and ECMO utilization were substantial, but these disparities did not increase as the hospital COVID-19 burd...
