R A Hirth
Affiliation: University of Michigan
- The initial impact of Medicare's new prospective payment system for kidney dialysisRichard A Hirth
School of Public Health, Health Management and Policy, University of Michigan, Ann Arbor, MI Electronic address
Am J Kidney Dis 62:662-9. 2013..This PPS covers an expanded bundle of services, including services previously paid on a fee-for-service basis. The objectives of the new PPS include more efficient decisions about treatment service combinations and modality choice...
- Is case-mix adjustment necessary for an expanded dialysis bundle?Richard A Hirth
University of Michigan, School of Public Health, Department of Health Management and Policy, 109 S Observatory, Ann Arbor, MI 48109 2029, USA
Health Care Financ Rev 24:77-88. 2003..Results indicate considerable variability in costs and case mix across facilities and a significant and substantial relationship between case mix and facility cost, suggesting case mix payment adjustment may be important...
- Does quality influence consumer choice of nursing homes? Evidence from nursing home to nursing home transfersRichard A Hirth
Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109 2029, USA
Inquiry 40:343-61. 2003..The apparent responsiveness to quality is encouraging. Nonetheless, because the absolute transfer rate is low, significant barriers to movement among nursing homes still may exist...
- Economic impact of case-mix adjusting the dialysis composite rateRichard A Hirth
Kidney Epidemiology and Cost Center, Department of Biostatistics, The University of Michigan School of Public Health, 315 West Huron, Suite 240, Ann Arbor, MI 48109 4262, USA
J Am Soc Nephrol 16:1172-6. 2005..g., ownership, chain membership, size) will be substantially advantaged or disadvantaged by case-mix adjustment. There do seem to be modest changes in the regional distribution of payments...
- Worker preferences, sorting and aggregate patterns of health insurance coverageRichard A Hirth
Department of Health Management and Policy, School of Public Health, University of Michigan, 109 S Observatory, Ann Arbor, MI, 48109 2029, USA
Int J Health Care Finance Econ 6:259-77. 2006..Extrapolating from the analysis sample, these involuntarily uninsured workers and their uninsured dependents may represent up to one in six uninsured individuals in the United States...
- The organization and financing of kidney dialysis and transplant care in the United States of AmericaRichard A Hirth
Health Management and Policy, University of Michigan School of Public Health, 109 S Observatory, Ann Arbor, MI 48109 2029, USA
Int J Health Care Finance Econ 7:301-18. 2007..Proposed reforms include bundling more services into a prospective payment system, developing case-mix adjustments, and financially rewarding providers for quality...
- Case-mix adjustment for an expanded renal prospective payment systemRichard A Hirth
University of Michigan School of Public Health, Department of Health Management and Policy, 109 South Observatory, Ann Arbor, MI 48109 2029, USA
J Am Soc Nephrol 18:2565-74. 2007..However, systematic gains or losses for different classes of providers were modest...
- Out-of-pocket spending and medication adherence among dialysis patients in twelve countriesRichard A Hirth
Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, USA
Health Aff (Millwood) 27:89-102. 2008..However, inconsistencies in the relationship between patient costs and nonadherence suggested that other social or policy factors also matter...
- Insurers' competitive strategy and enrollment in newly offered preferred provider organizations (PPOs)Richard A Hirth
Department of Health Management and Policy, University of Michigan School of Public Health, 109 S Observatory, Ann Arbor, MI 48109 2029, USA
Inquiry 44:400-11. 2007..Because PPOs drew few enrollees from health maintenance organizations (HMOs), there was little evidence of a backlash against managed care in the context of the University of Michigan employee group...
- Provider monitoring and pay-for-performance when multiple providers affect outcomes: An application to renal dialysisRichard A Hirth
Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, 48109 2029, USA
Health Serv Res 44:1585-602. 2009..To characterize the influence of dialysis facilities and nephrologists on resource use and patient outcomes in the dialysis population and to illustrate how such information can be used to inform payment system design...
- Efficient utilization of the expanded criteria donor (ECD) deceased donor kidney pool: an analysis of the effect of labelingR A Hirth
Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
Am J Transplant 10:304-9. 2010..Overall, implementation of the ECD definition coincided with a reversal of an apparent reluctance to recover kidneys from donors over age 59, but increased selectiveness on the part of surgeons/centers with respect to these kidneys...
- Do resource utilization and clinical measures still vary across dialysis chains after controlling for the local practices of facilities and physicians?Richard A Hirth
Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, MI, USA
Med Care 48:726-32. 2010..Prior studies showed more aggressive anemia management in dialysis facilities owned by for-profit chains, but have been criticized for not accounting for practices of individual physicians and facilities...
- Chronic illness, treatment choice and workforce participationRichard A Hirth
Department of Health Policy and Management, University of Michigan School of Public Health, 109 S Observatory, Ann Arbor, MI 48109 2029, USA
Int J Health Care Finance Econ 3:167-81. 2003..However, the effect size is considerably smaller than in models that do not consider the joint nature of these choices...
- Willingness to pay for a quality-adjusted life year: in search of a standardR A Hirth
Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor 48109 2029, USA
Med Decis Making 20:332-42. 2000..With the exception of HK, these far exceed the "rules of thumb" that are frequently used to determine whether an intervention produces an acceptable increase in health benefits in exchange for incremental expenditures...
- Extent and sources of geographic variation in Medicare end-stage renal disease expendituresR A Hirth
Departments of Health Management and Policy and Internal Medicine and the Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, MI, USA
Am J Kidney Dis 38:824-31. 2001..Interventions designed to increase transplantation rates, ensure access to peritoneal dialysis, and reduce hospitalization appear most promising...
- Nursing home-to-nursing home transfers: prevalence, time pattern, and resident correlatesR A Hirth
Department of Health Management and Policy, University of Michigan, Ann Arbor 48109 2029, USA
Med Care 38:660-9. 2000..To characterize the time pattern of nursing home-to-nursing home transfers and assess which resident characteristics are associated with transfers...
- Consumer information and competition between nonprofit and for-profit nursing homesR A Hirth
Department of Health Management and Policy, Department of Economics, Department of Internal Medicine, University of Michigan, School of Public Health, Ann Arbor, MI 48109 2029, USA
J Health Econ 18:219-40. 1999..Applicability to long-term care and implications for empirical research and policy towards nonprofits in health care are discussed...
- Heterogeneity of risk in a managed home health care populationM E Chernew
Department of Health Management and Policy, University of Michigan, Ann Arbor 48109 2029, USA
Med Care 39:1002-13. 2001..To examine the distribution of risk and the correlation between risks in a home care population with regard to several important adverse outcomes...
- Cost-effectiveness of hospital pay-for-performance incentivesTammie A Nahra
University of Michigan, USA
Med Care Res Rev 63:49S-72S. 2006..Cost per QALY was found to be between dollar 12,967 and dollar 30,081, a level well under consensus measures of the value of a QALY...
- Clinical and economic effects of population-based Helicobacter pylori screening to prevent gastric cancerA M Fendrick
Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies, University of Michigan School of Medicine, Ann Arbor, USA
Arch Intern Med 159:142-8. 1999..However, the extent to which H. pylori eradication decreases the risk of gastric cancer is unknown, raising the question of whether population-based H. pylori screening should be undertaken...
- Using race as a case-mix adjustment factor in a renal dialysis payment system: potential and pitfallsJesse L Roach
University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, MI 48103 4262, USA
Am J Kidney Dis 56:928-36. 2010..This research determines whether costs associated with end-stage renal disease (ESRD) care varied by race and whether this variance affected payments to dialysis facilities...
- Immediate endoscopy or initial Helicobacter pylori serological testing for suspected peptic ulcer disease: estimating cost-effectiveness using decision analysisA M Fendrick
Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor 48109, USA
Yale J Biol Med 69:187-95. 1996..To compare the clinical and economic effects of a strategy using immediate endoscopy to a non-invasive strategy utilizing a serologic test for Helicobacter pylori infection for individuals with symptoms suggestive of peptic ulcer disease...
- Optimal health insurance: the case of observable, severe illnessM E Chernew
Department of Health Management and Policy, University of Michigan, Ann Arbor 48109, USA
J Health Econ 19:585-609. 2000..A simulation of the effect of such a policy, based on prostate cancer, indicates a substantial reduction in moral hazard...
- Understanding the basic case-mix adjustment for the composite rateJohn R C Wheeler
Kidney Epidemiology and Cost Center and Internal Medicine, University of Michigan, Ann Arbor, MI, USA
Am J Kidney Dis 47:666-71. 2006..The basic case-mix adjustment reflects an initial and partial adjustment for the cost of providing composite-rate services...
- What is the price of life and why doesn't it increase at the rate of inflation?Peter A Ubel
University of Michigan Health Systems 300 N Ingalls, Room 7C27 Ann Arbor, MI 48109 0429, USA
Arch Intern Med 163:1637-41. 2003
- Using knowledge of multiple levels of variation in care to target performance incentives to providersMarc N Turenne
Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, Michigan 48103, USA
Med Care 46:120-6. 2008..In developing "pay-for-performance" and capitation systems that provide incentives for improving the quality and efficiency of care, policymakers need to determine which healthcare providers to evaluate and reward...
- When payment systems collide: the effect of hospitalization on anemia in renal dialysis patientsMarc N Turenne
Kidney Epidemiology and Cost Center, University of Michigan School of Public Health, 315 W Huron St, Ann Arbor, MI 48103, USA
Med Care 48:296-305. 2010..Different types of providers often face differing financial incentives for providing similar types of care. This may have implications for payment systems that target improvements in care requiring multiple types of providers...
- Willingness to pay for diagnostic certainty: comparing patients, physicians, and managed care executivesR A Hirth
Department of Health Management and Policy, University of Michigan, Ann Arbor, Mich. 48109-2029, USA
J Gen Intern Med 14:193-5. 1999..Although nearly all patients valued diagnostic certainty, its value was generally small and insufficient to change the cost-effectiveness ranking of treatment alternatives...
- Increased spending on health care: how much can the United States afford?Michael E Chernew
Department of Health Management and Policy, University of Michigan, Ann Arbor, USA
Health Aff (Millwood) 22:15-25. 2003..The value of care, which determines willingness to pay, and distributional issues are more important than our ability as a society to pay for care...
- The effects of preferred provider organizations on costs and utilization of hysterectomyConstance A Currier
College of Nursing, Michigan State University, East Lansing, MI, USA
Nurs Econ 22:14-20, 3. 2004..PPOs were associated with significant cost savings, achieved primarily through lower utilization rates...
- The effect of Medicare's prospective payment system on discharge outcomes of skilled nursing facility residentsWalter P Wodchis
Toronto Rehabilitation Institute, Queen Elizabeth Centre, 130 Dunn Ave, Toronto, Ontario M6K 2R7
Inquiry 41:418-34. 2004..The results indicate that PPS reduced the relative risk of discharge to home and to death for Medicare residents (compared to non-Medicare residents) and had no significant effect on hospitalizations or transfers...
- Competitive spillovers across non-profit and for-profit nursing homesDavid C Grabowski
Department of Health Care Organization and Policy, University of Alabama at Birmingham, 330 RPHB 1655 University Boulevard, Birmingham, AL 35294, USA
J Health Econ 22:1-22. 2003..These findings are consistent with the hypothesis that non-profits serve as a quality signal for uninformed nursing home consumers...
- Effect of Medicaid payment on rehabilitation care for nursing home residentsWalter P Wodchis
Department of Health Policy, Management and Evaluation, University of Toronto, Ontario
Health Care Financ Rev 28:117-29. 2007..Retrospective payment for Medicaid resident care was associated with greater use of therapy for Medicaid residents...
- What does a serum sodium cost?Richard A Hirth
J Am Soc Nephrol 19:654-5. 2008
- Factor substitution in nursing homesJohn Cawley
Department of Policy Analysis and Management, College of Human Ecology, Cornell University, Ithaca, NY 14853 4401, USA
J Health Econ 25:234-47. 2006..The results from the IV models yield evidence of factor substitution: higher nursing home wages are associated with greater use of psychoactive drugs and lower quality...
- Using a standardized donor ratio to assess the performance of organ procurement organizationsSheryl Stogis
Alexian Brothers Health System, Elk Grove Village, IL, USA
Health Serv Res 37:1329-44. 2002..To develop a Standardized Donor Ratio (SDR) as an outcome measure for evaluating the effectiveness of organ procurement organizations (OPOs)...
- Case management: effects of improved risk and value informationWilliam G Weissert
Department of Political Science, Florida State University, 234 Bellamy Hall, Tallahassee, FL 32306 2230, USA
Gerontologist 43:797-805. 2003..The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services...
- HEALTH SERVICES RESEARCH TRAININGRichard Hirth; Fiscal Year: 2007....
- New Evidence on the Persistence of High Health SpendingRichard Hirth; Fiscal Year: 2009..We will provide an example of how such estimates can inform the evaluation of risk-adjustment and reinsurance as mechanisms to improve the functioning of small group health insurance markets. ..