Joseph Newhouse

..Because insurance exchanges set up under the Affordable Care Act will employ similar policies to combat risk selection, our results give reason for optimism about managing competition among health plans...

..We examined knowledge of deductible plan details among new enrollees, as well as anticipated care-seeking changes in response to the deductible...

..We examined changes in ICS use following the introduction of generic-only coverage in a Medicare Advantage population from 2003-2004...

..Although not a panacea, all-payer rate setting, in which a federal or state agency establishes standard payment rates for each class of payer, may be the only feasible alternative, at least in the short run...

..However, if the prior rate of introduction resumes, the government may find itself with unacceptable expenditure levels...

..We illustrate the use of the technique with an application to aggressive treatment of acute myocardial infarction in the elderly...

..Finally, it is unclear how well nursing homes and the pharmacies they work with will work across Part D plans, and vigilance will be required as the benefit proceeds...

..To examine the impact of incentive formularies on prescription drug spending shifts in formulary compliance, use of generic medications, and mail-order fulfillment in the year after introduction of a new pharmacy benefit strategy...

..We make a modest proposal for how to improve purchasing of prescription drugs in Medicare...

..Finally, we obtained follow-up health-status data on the great majority of those who left prematurely. We found the health-status findings were insensitive to the inclusion of the attrition cases...

..We examined data on claims in rejected status for one large long-term care pharmacy as of December 2006. There was considerable variation across PDPs in both rejection rates and reasons for rejection...

..This evaluation describes six assumptions to which the results are likely to be relatively sensitive as well as a number of other assumptions to which the results are likely to be less sensitive...

..The purpose of this article is to explore how the introduction of Medicare Part D is changing the operations of long-term-care pharmacies (LTCPs) and nursing homes, as well as implications of those changes for nursing home residents...

..Additional research is needed before the potential causal impact of PCPs can be fully assessed. However, these findings suggest that changes in the composition of the physician workforce will not be sufficient to address spending growth...

..Nursing homes would be paid directly for end-of-life care services and held accountable for their quality...

..To investigate the correlation between geographic variation in inpatient days, total spending, and spending growth in traditional Medicare versus the large-firm commercial sector...

..This article also shows productivity changes varied widely across manufacturing industries, so that the use of an average across the economy or even across service industries could have substantial error for physician services...

..The effect of Part D will depend on the restrictiveness of the prior authorization and appeals processes, which is currently unknown...

..This article summarizes the 2005 conference and highlights changes made since the previous conference, commissioned papers on future directions for NHEA projects, and participant recommendations...

..The conclusion remarks on the prescription drug benefit and the possibility of paying higher quality providers additional amounts...

..Although the RAND experiment established the effects of varying prices to patients, future experiments with how physicians respond to the various tools of managed care may be useful...

..The complications suggest that the committee's cost estimates may be too low and that there may be sizable political barriers to the proposals...

..Even if total costs increase, the value of a change in health could increase more. In that case such a subsidy is consistent with recent work in behavioral economics for those with self-control problems...

..However, replicating these results using data from a broader, more representative sample of hospices is needed before making changes to the per diem system...

..Because all four methods have substantial drawbacks, Medicare should not initially attempt to set prices, but to prevent abuses in pricing, Congress should allow cost to be considered in coverage decisions...

..Further research on the nature of provider and consumer rationing decisions is needed to inform the design of supply-side and demand-side incentives that will lead to an efficient allocation of services...

..Using cost-effectiveness methods to profile hospital "value'' permits the comparison of the benefit of a service relative to the cost using existing societal weights...

..The use of information technology may result in a safer and more efficient health care system. However, consensus does not exist about the structure or costs of a national health information network (NHIN)...

..To the extent that the value of the health benefits is not offset by the value of the pleasure foregone, the economic impacts of the MSA will include a share of these health benefits...

..The number, nature, and costs of serious adverse effects experienced by younger women receiving chemotherapy for breast cancer outside of clinical trials are unknown...

..If there is to be a public trust fund to subsidize AHCs, it should be financed from general revenues...

..Despite substantial trial evidence that demonstrates the effectiveness of pharmacologic treatment for reducing blood pressure (BP) and cardiovascular events, many patients are nonadherent to their hypertension treatment...

..CONCLUSIONS: Relatively modest levels of patient cost-sharing for ED care decreased ED visit rates without increasing the rate of unfavorable clinical events...

..This transfer of costs from a less to a more generous plan increases the burden of adverse selection. Our data suggest that switching may be more important to the level of premiums than previously documented...

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..Little information exists about the consequences of limits on prescription-drug benefits for Medicare beneficiaries...

..Assess patient knowledge of and response to drug cost sharing...

..Although these causes suggest that the performance of medical care may always lag behind that of other industries, greater use of information technology and improved financial incentives will help to reduce the size of the quality chasm...

..The use of cost-sharing to control healthcare expenditures is increasing, but there is scant information about patients' knowledge of cost-sharing or its influence on behavior...

..Providers who were more generously reimbursed, however, prescribed more-costly chemotherapy regimens to metastatic breast, colorectal, and lung cancer patients...

..To evaluate survival rates and changes in weight-related comorbid conditions after bariatric surgery in a high-risk patient population as compared with a similar cohort of morbidly obese patients who did not undergo surgery...

..CONCLUSIONS: When faced with an ED copayment, patients in the health system most commonly shifted toward seeking care from other available alternatives, and rarely avoid medical care altogether...

..These results support varying the degree of cost sharing for services depending on the effect of the service on future health status and costs...

..There is limited information on patients' knowledge about their cost-sharing requirements and how that influenced their care-seeking behavior...

..Medicare Part D drug benefits include substantial cost sharing...

..We wish to expand the number of AHRQ predoctoral slots and add one postdoctoral slot, because we have high-quality applicants whom we cannot admit for lack of aid. ..

..Understanding its impact on chemotherapy treatment patterns has important implications not only for Medicare spending but also for the welfare of beneficiaries with cancer. ..