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Medicare Coverage (medicare + coverage)

Distribution by Scientific Domains

Medical Sciences	85%

Selected Abstracts

Appeals Court Rejects Federal Jurisdiction Over Chiropractors Challenge to Medicare Coverage- Am.

THE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 2 2006
Chiropractic Ass'n, Inc. v. Leavitt
No abstract is available for this article. [source]

Impact of Medicare Coverage on Disparities in Access to Simultaneous Pancreas and Kidney Transplantation

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 12 2009
J. K. Melancon
In the setting of disparities in access to simultaneous pancreas and kidney transplantation (SPKT), Medicare coverage for this procedure was initiated July 1999. The impact of this change has not yet been studied. A national cohort of 22 190 type 1 diabetic candidates aged 18,55 for kidney transplantation (KT) alone or SPKT was analyzed. Before Medicare coverage, 57% of Caucasian, 36% of African American and 38% of Hispanic type 1 diabetics were registered for SPKT versus KT alone. After Medicare coverage, these proportions increased to 68%, 45% and 43%, respectively. The overall increase in SPKT registration rate was 27% (95% CI 1.16,1.38). As expected, the increase was more substantial in patients with Medicare primary insurance than those with private insurance (Relative Rate 1.18, 95% CI 1.09,1.28). However, racial disparities were unaffected by this policy change (African American vs. Caucasian: 0.97, 95% CI 0.87,1.09; Hispanic vs. Caucasian: 0.94, 95% CI 0.78,1.05). Even after Medicare coverage, African Americans and Hispanics had almost 30% lower SPKT registration rates than their Caucasian counterparts (95% CI 0.66,0.79 and 0.59,0.80, respectively). Medicare coverage for SPKT succeeded in increasing access for patients with Medicare, but did not affect the substantial racial disparities in access to this procedure. [source]

The Impact of Private Insurance Coverage on Veterans' Use of VA Care: Insurance and Selection Effects

HEALTH SERVICES RESEARCH, Issue 1p1 2008
Yujing Shen
Objective. To examine private insurance coverage and its impact on use of Veterans Health Administration (VA) care among VA enrollees without Medicare coverage. Data Sources. The 1999 National Health Survey of Veteran Enrollees merged with VA administrative data, with other information drawn from American Hospital Association data and the Area Resource File. Study Design. We modeled VA enrollees' decision of having private insurance coverage and its impact on use of VA care controlling for sociodemographic information, patients' health status, VA priority status and access to VA and non-VA alternatives. We estimated the true impact of insurance on the use of VA care by teasing out potential selection bias. Bias came from two sources: a security selection effect (sicker enrollees purchase private insurance for extra security and use more VA and non-VA care) and a preference selection effect (VA enrollees who prefer non-VA care may purchase private insurance and use less VA care). Principal Findings. VA enrollees with private insurance coverage were less likely to use VA care. Security selection dominated preference selection and naïve models that did not control for selection effects consistently underestimated the insurance effect. Conclusions. Our results indicate that prior research, which has not controlled for insurance selection effects, may have underestimated the potential impact of any private insurance policy change, which may in turn affect VA enrollees' private insurance coverage and consequently their use of VA care. From the decline in private insurance coverage from 1999 to 2002, we projected an increase of 29,400 patients and 158 million dollars for VA health care services. [source]

Assessing the Validity of Insurance Coverage Data in Hospital Discharge Records: California OSHPD Data

HEALTH SERVICES RESEARCH, Issue 5 2003
Thomas C. Buchmueller
Objective. To assess the accuracy of data on "expected source of payment" in the patient discharge database compiled by the California Office of Statewide Health Planning and Development (OSHPD). Data Sources. The OSHPD discharge data for the years 1993 to 1996 linked with administrative data from the University of California (UC) health benefits program for the same years. The linked dataset contains records for all stays in California hospitals by UC employees, retirees, and spouses. Study Design. The accuracy of the OSHPD data is assessed using cross-tabulations of insurance type as coded in the two data sources. The UC administrative data is assumed to be accurate, implying that differences between the two sources represent measurement error in the OSHPD data. We cross-tabulate insurance categories and analyze the concordance of dichotomous measures of health maintenance organization (HMO) enrollment derived from the two sources. Principal Findings. There are significant coding errors in the OSHPD data on expected source of payment. A nontrivial percentage of patients with preferred provider organization (PPO) coverage are erroneously coded as being in HMOs, and vice versa. The prevalence of such errors increased after OSHPD introduced a new expected source of payment category for PPOs. Measurement problems are especially pronounced for older patients. Many patients over age 65 who are still covered by a commercial insurance plan are erroneously coded as having Medicare coverage. This, combined with the fact that during the period we analyzed, Medicare HMO enrollees and beneficiaries in the fee-for-service (FFS) program are combined in a single payment category, means that the OSHPD data provides essentially no information on insurance coverage for older patients. Conclusions. Researchers should exercise caution in using the expected source of payment in the OSHPD data. While measures of HMO coverage are reasonably accurate, it is not possible in these data to clearly identify PPOs as a distinct insurance category. For patients over age 65, it is not possible at all to distinguish among alternative insurance arrangements. [source]

Impact of Medicare Coverage on Disparities in Access to Simultaneous Pancreas and Kidney Transplantation

Medicare Part D Coverage and Its Influence on Transplant Patients' Out-of-Pocket Prescription Expenses

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2006
M. A. Chisholm
Since Medicare is available for qualifying individuals because of age (65 years or greater), disability, or end-stage renal disease, many transplant recipients have Medicare coverage. Everyone who is entitled to Medicare will qualify to enroll in a Part D plan,a voluntary prescription drug coverage option offered by private insurance companies who meet the standards established by Medicare. The addition of Medicare Part D may help reduce out-of-pocket medication expenses for transplant recipients who have Medicare; however, the reality of utilizing Part D to maximize recipients' benefits is not simple, but rather complicated. The intricacies of Part D involve not only understanding premium costs and benefit stages, but formularies, and, particularly for transplant patients, deciphering how Medicare Part B immunosuppressant coverage influences Part D coverage. This article details significant information concerning Part D that transplant health care professionals should know in order to maximize patients' benefits and minimize their out-of-pocket medication expenses. [source]

Influence of economic and demographic factors on quality of life in renal transplant recipients

CLINICAL TRANSPLANTATION, Issue 2 2007
Marie A. Chisholm
Abstract:, Background:, The purpose of this study was to determine the influence of annual income, Medicare status, and demographic variables on the health-related quality of life (HQoL) of renal transplant recipients. Methods:, A cross-sectional survey was mailed to 146 Georgia renal transplant recipients who had functional grafts. Data were collected using the SF-12 Health Survey (version 2), a demographics survey, and 2003 tax documents. One-way ANOVAs and Pearson's R correlations were used to examine relationships between annual income, Medicare status, demographic variables and SF-12 scores. Significant variables were included in stepwise multiple regression analyses. Results:, Data from 130 participants (89% response rate) were collected. Recipients with no Medicare coverage had significantly higher scores on the Physical Functioning and Role Physical SF-12 scales (p = 0.005) compared to recipients with Medicare. Annual income was positively correlated with General Health (p < 0.05). Age and race were significant predictors of Vitality (p = 0.004) and Physical Component Summary (p < 0.001) scores. Age, race, and Medicare status were significant predictors of Physical Functioning and Role Physical scores (p < 0.001). Age, annual income, race, and years post-transplant were significant predictors of General Health score (p < 0.001). Age was the sole predictor of Bodily Pain score (p = 0.002), and marital status was the sole predictor of Social Functioning score (p = 0.005). Conclusions:, Interventions designed to offset financial barriers may be needed to bolster renal transplant recipients' HQoL. [source]