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Dissertations / Theses on the topic 'Medicare'

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Published: 4 June 2021
Last updated: 29 July 2024

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1

Adomako, Godfred. "Strategies in Mitigating Medicare/Medicaid Fraud Risk." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3738.

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In the fiscal year 2014, approximately 1,337 health care providers lost their provider license to Medicare/Medicaid fraud. Out of the 1,318 criminal convictions reported by the U.S. Medicaid Fraud Control Units (MFCU), 395 (30%) were home health care aides who claimed to have rendered services not provided. The purpose of this multiple case study was to explore licensed and certified home health care business managers' strategies to mitigate Medicare/Medicaid fraud risk. A purposive sampling of 9 business managers and chief executive officers from 3 licensed and certified home health care businesses in Franklin County, Ohio participated in semistructured face-to-face interviews. Data from the interviews were transcribed, coded, and analyzed to identify themes regarding Medicare/Medicaid fraud risk management strategies. Drawing from the Committee of Sponsoring Organization's internal control framework and fraud management lifecycle theory, 5 themes emerged: the control environment, risk assessment, control activities, information and communication, and monitoring activities. Findings from this study included maintenance of integrity and culture, training and educating both staff and clients about fraud reporting processes and the consequences of fraud, rotating staff on a regular basis, performing fraud risk assessments, implementing remote timekeeping and monitoring system, and compensating shift leaders to coordinate activities in the clients' residences. The implication for positive social change includes reducing healthcare cost for all taxpayers through Medicare/Medicaid fraud reduction.
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2

Carmichael, Timothy Roy. "Improving Medicare beneficiary recall and comprehension of Medicare information." Thesis, The University of Arizona, 2001. http://hdl.handle.net/10150/278774.

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The Health Care Finance Administration is challenged with improving enrollment into the alternative managed health care system called Medicare+Choice. The current Medicare cohort is knowledgeable about where to obtain information about Medicare+Choice, but they cannot recall the terminology or comprehend the concepts of the program. This study attempts to improve older adult recall and comprehension of Medicare managed care written text, with the goal of improving their attitude toward Medicare managed care. Older adults (n = 49) from a community located in the Southwest were randomly assigned to one of three study conditions. Analysis of Variance, Tukey HSD, and correlation analysis were conducted on questionnaire responses measuring for recall, comprehension and attitude. An "Elderspeak Process" improved older adult recall of specific terms, words, and phrases about Medicare and Medicare managed care. Medicare managed care organizations can use the process to simplify information about their managed care programs to knowledgeable older adults.
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3

Nash, Lucilla A. D. "An analysis of the utilization of selected prescribed medical services by Medicaid and Medicare recipients." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 1989. http://digitalcommons.auctr.edu/dissertations/3754.

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The purpose of the study is to analyze the difference in the utilization of prescribed medications by Medicaid and Medicare recipients. This study examines problems many individuals in longterm care facilities face, when they are medicare recipients and unable to receive medical care which is as adequate as those who are beneficiaries of Medicaid. This study involved thirty residents, divided equally into two groups. They resided in a small long-term care facility located in Fulton County (Georgia). Findings revealed that Medicare recipients tend to visit their health providers less frequently, purchase fewer prescribed medications, and therefore, receive less adequate medical care than Medicaid recipients.
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4

Engels, Colin. "Medicare & Medicaid vs. TRICARE: a benefits and cost comparison." Thesis, Monterey, California: Naval Postgraduate School, 2014. http://hdl.handle.net/10945/43907.

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Approved for public release; distribution is unlimited
The current fiscal environment for the Department of Defense (DOD) is constrained. TRICARE and the military health system are an area where DOD military leaders have expressed serious concern over the balance between rising costs and retention. Medicare and Medicaid face similar budgetary challenges as spending for both these federal programs continues to rise. The purpose of this research was to determine the similarities and differences in coverage provided between TRICARE, Medicare, and Medicaid, compare costs and provider payment rates, and analyze cost implications for the federal budget. This research project accomplished the following: 1) determined that TRICARE and Medicare exhibited almost identical provider payment rates across all three of the states compared in this study, 2) determined that Medicaid payment rates in California and Connecticut are higher than TRICARE while rates in Mississippi are lower, 3) determined that TRICARE exhibited lower per capita spending and lower spending growth rates than Medicare or Medicaid.
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5

Stretton, David. "The effect of governmental reimbursement policies on curriculum and programs in medical education through their impact on clinical organizations associated with colleges of medicine /." View abstract, 2005. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3191720.

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6

Brown, Allison Marie. "Evaluating the success of Medicare Part D and its impact on Medicare beneficiaries." Connect to Electronic Thesis (CONTENTdm), 2010. http://worldcat.org/oclc/643083295/viewonline.

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7

Greenhalgh-Stanley, Nadia. "Three empirical papers on Medicaid, Medicare, and long-term care insurance." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2009. http://wwwlib.umi.com/cr/syr/main.

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8

Davidson, Binzie Roy. "Medicare and Medicaid Regulations' Financial Effects on Home Health Agencies' Performance." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7131.

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Some owners of small to medium-sized managed care businesses lack strategies to address the effects of healthcare regulations on their businesses. The purpose of this multiple case study was to identify strategies that owners of small to medium-sized managed care businesses used to address the financial effects of healthcare regulations on their businesses. The conceptual framework for this study was profit maximization and adaptation in changing contexts. Data were gathered from company documents, observations, and semistructured interviews with 5 home healthcare business owners in Los Angeles County, California. Data were coded to identify themes from the narrative segments. Key themes that emerged from the data analysis include home health strategic management, application of business strategies, healthcare reform, and strategic business processes. The implications of this study for social change include the potential to catalyze economic, intellectual, and social developments that improve community health and wellness programs and related activities in home health.
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9

Poteet, Christopher Douglas. "Reduction of Centers for Medicare and Medicaid Services Reimbursement Penalty Risk." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6650.

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Healthcare centers face increasing revenue risk under the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA). The purpose of this multiple case study was to explore strategies that successful leaders of healthcare centers use to mitigate the risk of reimbursement penalties under MACRA. The conceptual framework of this study was Generation 3 cultural-historical activity theory (CHAT-III), and the analysis process used was Yin's recursive and iterative phases. Participants of this study were 6 leaders of healthcare centers in the United States identified as having high quality and low cost via the Centers for Medicare and Medicaid public use files. Semistructured interviews were used to explore the identification of strategic opportunity, strategy formation, implementation, and control. Themes for organizational culture that emerged from data analysis included a foundation core with flexibility and iterative process-improvement practice. Themes in the strategy formation process included total employee involvement and a quality-first, cost-benefit strategy structure. Themes in the implementation process included multiple departmental and organizational collaboration, task-based implementation, and data transparency. Localized cadence meetings were a theme in the control process. Improvements to the organization as a result of this study include a series of standards for organizational culture, a toolbox including CHAT-III as a tool for the identification of strategic opportunity and a methodology for strategy formation and implementation, and control to help ensure financial sustainability. Implications for positive social change include the increased probability of continued ready access to healthcare, improved population health, and lower mortality rates for the communities served.
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10

Valenzuela, Jose. "Medicare advantage's population make-up and its impact on the future of Medicare financing." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1526966.

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The objective of the study was to validate the assumption that respondents who self-identified as white, were more likely to be enrolled in a Medicare Advantage HMO Plan and underutilize health care services when compared to their non-white counterparts.

The results showed that the majority of the respondents in the stratified population of Medicare eligible respondents were categorized as White, 11,271 out of 15,297, and 42% reported being enrolled in a Medicare Advantage HMO Plan. A total of 3,685 of the White respondents on Medicare Advantage HMO Plans indicated they were in "Good" or better health, which was 78% of all White respondents in this population. The mean number of times that White respondents were seen by an MD (Figure 2) fell within the same range of 5-6 times for the majority of the Race/Ethnic groups. The mean number of hospital stays for Whites and the other Race/Ethnic groups ranged from 1.86-1.92 within the same 12 month period, with the exception of Pacific Islanders.

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11

Rosomoff, Sara Stephanie. "Promote the General Welfare: A Political Economy Analysis of Medicare & Medicaid." Miami University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=miami1574263717055768.

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12

Striegel, Mary. "A Paradigm Shift in the Golden Years The Transition from Federal Medicare to Managed Care Medicare." Youngstown State University / OhioLINK, 1999. http://rave.ohiolink.edu/etdc/view?acc_num=ysu998075386.

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13

Yip, Winnie Chi-man. "Physician response to medicare fee regulations." Thesis, Massachusetts Institute of Technology, 1994. http://hdl.handle.net/1721.1/11950.

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14

Grant, Taniesha Michelle. "Leadership Strategies for Combating Medicare Fraud." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4446.

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Healthcare fraud is threatening the economic stability of the U.S. healthcare system and negatively affecting organizational costs. Financial losses from healthcare fraud account for approximately $80 billion per year of the $2.4 trillion healthcare budget. Leadership strategies that may aid in combating Medicare fraud were explored in this qualitative single case study. The criminal violation of trust theory guided the study as it provides healthcare leaders with an understanding of the portion of the fraud triangle over which they have the most control to combat fraud: the opportunity to commit fraud. Data were gathered from review of publically available documents and information received from 10 semistructured interviews with health care leaders in the Mid-Atlantic area of the United States who have the responsibility of overseeing, developing, monitoring, or implementing control mechanisms for Medicare services. Yin's 5-step data analysis process and thematic analysis were used to analyze the data. Three key themes emerged from the study: an effective control environment, an adequate accounting system, and adequate control procedures. Health care leaders in the study recognized that the control environment plays a crucial role on the integrity and ethical values of its employees. The health care leaders acknowledged that an effective accounting system ensures Medicare funds are properly tracked and accounted for. Health care leaders also shared that adequate control procedures aid in deterring fraud and provide reasonable assurance that leaders meet the fiscal and programmatic objectives of the Medicare program. Social implications include reducing healthcare costs for U.S. citizens and creating control strategies that may contribute to a healthcare system to lead to a healthier citizenry.
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15

Amoh, John K. "Impact of Medicare and Medicaid Beneficiaries with Selected Conditions on Emergency Department Utilization." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2951.

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Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) are conditions that represent significant and ongoing medical costs, including frequent emergency department (ED) visits, hospitalizations, work absences, and disability. This retrospective cross-sectional study, examined the effects of the frequent ED visits due to COPD and CHF on the beneficiaries of Medicare and Medicaid in Maryland. The goal was to identify the factors that led these patients to visit the ED, the impact of these visits on Medicare utilization and costs across Maryland, and preventative intervention strategies to control this population's costs of care. Secondary data were analyzed from 2010-2012 using the Administrative Claims Data in Chronic Condition Warehouse (CCW). The results for the first research question revealed that an increase in the number of primary care physicians was correlated with a decrease in ED visits; thus, persons living in areas with higher PCPs also had lower ED visits therefore the first null hypothesis was rejected (Ï?2 = 3.85, p=.05) . The results for the second research question revealed that ED visits had no significant relationship with death in a given year; thus, patients may be diverted to less expensive care sites to minimize cost and ED overcrowding, therefore the second null hypothesis was not rejected (Ï?2 = 0, p=.98). In both cases, the confounding variables of gender, age, and race had significant effects upon the relationship. Health Professionals and policy makers may use the findings to develop strategies to increase supply of PCPs, adapt patient centered interventions and modify existing chronic disease care strategies to minimize or prevent lifestyle and environmental factors that affect chronic disease outcomes. Such improvements could contribute to positive social change by eliminating or reducing the overcrowding that occurs in emergency departments in Maryland and other states.
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16

Jones, Carla D. "Adding a prescription drug benefit to Medicare : an analysis of the Medicare Prescription Drug, improvement, and modernization act of 2003 /." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 2004. http://library.nps.navy.mil/uhtbin/hyperion/04Sep%5FJones.pdf.

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17

Cammack, Susan E. "An examination of firms charged with medicare and medicaid fraud : does corporate governance matter? /." free to MU campus, to others for purchase, 2002. http://wwwlib.umi.com/cr/mo/fullcit?p3060090.

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18

Yang, Yan. "Medicare Supplemental Insurance Purchasing Decisions and Ownership." Case Western Reserve University School of Graduate Studies / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=case1184215611.

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19

Sparkman, Thomas Bryant. "Prescription drug expenditures for the medicare and medicaid dually eligible a study conducted in the context of the Medicare prescription drug benefit and its corresponding policies for state government /." CONNECT TO ELECTRONIC THESIS, 2006. http://hdl.handle.net/1961/3617.

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20

Welton, William E. "The impact of differences in market structure on community-wide Medicare expenditures." Ann Arbor, Mich. : University of Michigan, 1999. http://books.google.com/books?id=YC9YAAAAMAAJ.

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21

Turner, Stephanie Hope. "Increasing the Value of Medicare Annual Wellness Visits for Patients and Providers." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5953.

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The Medicare Annual Wellness Visit (AWV) has been available to Medicare beneficiaries since 2005; however, most eligible individuals have not taken advantage of this benefit. The literature supports that patients are willing to schedule and complete an AWV if urged to do so by their primary care provider; however, providers are reluctant to advise patients to pursue the AWV due to the lack of perceived value and overall health benefit. The integrative theory of health behavior change was used as the theoretical framework for the project. By increasing patient self-management skills through education, engagement, and support, the project was designed to create a positive impact on the overall health of individuals eligible for the AWV, as demonstrated by evidence of a long-term decrease in chronic conditions and related complications. A retrospective chart review was conducted to evaluate the number of preventive care measures completed in 2 patient populations: -¬those with a completed AWV in 2017, and those without a completed AWV in 2017. The number of completed preventive screenings for colon cancer, breast cancer, fall risk, and depression was as much as 41.6% higher among patients that had completed an AWV. The project's findings will be used to educate providers and patients about the usefulness of Medicare AWVs. Finally, the project findings support positive social change through enhanced patient activation in preventive health strategies.
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22

Saverno, Kim R. "Impact of Medicare Part D on Pharmaceutical and Medical Utilization in Arizona's Dual Eligible Population." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/203013.

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Purpose: The purpose of this research was to estimate the impact of Medicare Part D on prescription and medical utilization among Arizona's senior dual eligible population.Methods: Generalized estimating equations were used to analyze changes in utilization among dual eligibles (Arizona Health Care Cost Containment (AHCCCS) beneficiaries between the ages of 66 and 80 as of January 1, 2006) relative to a "comparison" group ineligible for Part D (AHCCCS beneficiaries between the ages of 50 and 62 as of January 1, 2006) for the first two years following the implementation of Part D. Medical and pharmacy claims from AHCCCS from January 1, 2005 to December 31, 2007 were used in this analysis.Results: The dual eligibles and Part D ineligible comparison group were similar in their level and trend of utilization of over-the-counter (OTC) medications and benzodiazepines in the pre-Part D period. Following implementation of Part D, there was an immediate decline in utilization of both OTC medications and benzodiazepines in the dual eligibles relative to the comparison group (p<0.001).Increasing trends for both the dual eligible and comparison group were observed during the pre-Part D period for total prescription utilization, generic medication utilization and antidepressant use. After the implementation of Medicare Part D, utilization of these drug classes was significantly lower among the dual eligibles relative to the comparison group.Trends in physician office visits were similar between the dual eligible group and comparison group for the entire study period. During the first month of Part D, the dual eligibles had a statistically significantly larger increase in physician visits over the previous month relative to the comparison group (p=0.001). The trend in hospitalizations between the two groups significantly differed during the pre-period, precluding meaningful comparisons between the groups for this particular outcome.Conclusion: This study supports the belief that medication use for dual eligible Medicare beneficiaries was disrupted by the transition of outpatient drug benefits from Medicaid to Medicare Part D.
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23

Miller, Bruce M. "Medicare subvention and the Military Health Services System." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1995. http://handle.dtic.mil/100.2/ADA305882.

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24

Starks, Anthony D. "Evaluating medicare subvention in the military healthcare system." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1999. http://handle.dtic.mil/100.2/ADA369918.

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Thesis (M.S. in Management) Naval Postgraduate School, September 1999.
"September 1999". Thesis advisor(s): William Gates, Jim Scaramozzino. Includes bibliographical references (p. 55-57). Also Available online.
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25

Li, Qian. "Studies of choice behaviors in the Medicare market." [Bloomington, Ind.] : Indiana University, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3386697.

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Thesis (Ph.D.)--Indiana University, Dept. of Economics, 2009.
Title from PDF t.p. (viewed on Jul 15, 2010). Source: Dissertation Abstracts International, Volume: 70-12, Section: A, page: 4783. Adviser: Pravin K. Trivedi.
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26

Reich, Heather M. "Medication management among Medicare eligible Ball State retirees." Virtual Press, 2008. http://liblink.bsu.edu/uhtbin/catkey/1399188.

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This study investigated the personal medication management practices of some Medicare eligible university retirees and their dependents. This is important since older adults often take multiple medications and are more susceptible to adverse reactions and interactions. The general hypothesis regarding where retirees medications are obtained and their understanding of their use was not supported. Responses to the research questions revealed a higher level of understanding and compliance than previously reported by others. Also, they are unlikely to participate in an employer sponsored educational intervention. This may be related to the educational level of the sample. Suggestions for future research including sample selection, questionnaire wording and scaling are discussed.
Fisher Institute for Wellness and Gerontology
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27

Peterson, Mikael, and Matthew Martin. "Statin Medication Acquisition Among Medicare Beneficiaries 1992-2002." The University of Arizona, 2007. http://hdl.handle.net/10150/624409.

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Class of 2007 Abstract
Objectives: To investigate the relationship of price and prevalence of statins when new mediations enter the market and when old medications are withdrawn from the market. Methods: Patients that received a statin were enrolled in the Medicare Current Beneficiary Survey (MCBS) from 1992 to 2002. The overall prevalence of each statin as well as the prevalence of each statin for a patient’s drug coverage (no coverage, Medicaid, Medigap, employer coverage, or other public coverage) were analyzed. Results: The overall prevalence of statin was statistically significant for 1992 versus 2002 (p<0.001). When atorvastatin came to the market towards the end of 1996, there was no difference between simvastatin (p=0.24) and pravastatin (p=0.12) in 1997 versus 1998. Conclusions: There was a difference in the prevalence of statins when atorvastatin entered the market. When cerivastatin left the market, there was a difference in the prevalence of statin use. Atorvastatin became the most prevalent statin by the end of 2002. The price of statins appeared to decrease over time from $39.01 in 1992 to $31.95 in 2002. Also, the year atorvastatin was released the average price of statins increased to $36.57 in 1997.
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28

Burk, David Morris. "Estimating the Effect of Disability on Medicare Expenditures." BYU ScholarsArchive, 2009. https://scholarsarchive.byu.edu/etd/2127.

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We consider the effect of disability status on Medicare expenditures. Disabled elderly historically have accounted for a significant portion of Medicare expenditures. Recent demographic trends exhibit a decline in the size of this population, causing some observers to predict declines in Medicare expenditures. There are, however, reasons to be suspicious of this rosy forecast. To better understand the effect of disability on Medicare expenditures, we develop and estimate a model using the generalized method of moments technique. We find that newly disabled elderly generally spend more than those who have been disabled for longer periods of time. Also, we find that increases in expenditures have risen much more quickly for those disabled Medicare beneficiaries who were at the higher ends of the expenditure distribution before the increases.
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29

Eldridge, Houser Jennifer L. "Health educators’ perceived preparedness to provide the centers for Medicare and Medicaid services’s Annual Wellness Visit." Diss., University of Iowa, 2019. https://ir.uiowa.edu/etd/6941.

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The Annual Wellness Visit (AWV) is a benefit available to Medicare beneficiaries. This benefit has the potential to address many areas of prevention in one focused visit to the primary care clinic, yet it is currently being provided to only 19% of Medicare beneficiaries. This research attempted to examine the extent to which certified health education specialists (CHES) have provided and perceive themselves to be prepared to provide the preventive health services (PHS) within the AWV, along with seven additional preventive counseling services (PCS). A web-based survey assessed the perceived preparedness of health educators, specifically CHES (N=998), to deliver these PHS. The results of these surveys include the development of a single factor internally consistent scale to measure perceived preparedness for the PHS within the AWV. They reveal health educators were least prepared to assist with end-of-life-planning and conduct a basic hearing test. No association was found for education level and perceived preparedness; however, prior experience did account for a significant amount of the variance in perceived preparedness to provide AWV services. Lastly, when compared to historical data regarding physician’s perceived preparedness to provide PCS, health educators were more prepared to counsel on diet and exercise and less prepared to counsel on six other PCS. These results may aid in the understanding of whether CHES perceive they are prepared to provide (PHS) and demonstrate the experience CHES have with each of these PHS.
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30

Nosal, Kathleen Elizabeth. "Switching Costs in the Market for Medicare Advantage Plans." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/228491.

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Medicare eligibles have the option of choosing from a menu of privately administered managed care plans, known as Medicare Advantage (MA) plans, in lieu of conventional fee-for-service Medicare coverage ("original Medicare"). These plans often provide extra benefits to enrollees, but may impose large switching costs as a result of restrictive provider networks, differences in coverage across plans, and learning and search costs. I propose a structural dynamic discrete choice model of how consumers who are persistently heterogeneous make the choice among MA plans and original Medicare based on the characteristics of the available MA plans. The model explicitly incorporates a switching cost and changes over time in choice sets and plan characteristics. I estimate the parameters of the model, including the switching cost, using the methods developed by Gowrisankaran and Rysman (2011). The estimates indicate that the switching cost is statistically and economically significant. Through a series of counterfactual analyses, I find that the share of consumers choosing MA plans in place of original Medicare would more than triple in the absence of switching costs, and nearly double if plan exit and quality changes were eliminated. I also find that when switching costs are accounted for the Medicare Advantage program only minimally increases consumer welfare.
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31

Chaudhary, Sirmad. "The Cost of the Benefit: How Wilbur Mills's Expansion of Medicare Led to Escalating Medical Costs." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/honors/194.

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For much of the early 1960s, House Ways and Means chairman Wilbur Mills represented the “One-Man Veto” on Medicare before eventually offering his reluctant support to the measure in 1964 and 1965. Ironically, this longtime opponent would be the one to suggest an expansion in the scope of the bill. Early proposals for Medicare only offered to cover hospital costs; Mills would call for physician costs to be covered, as well. The aim of this thesis is to show how Mills’s expansion of Medicare benefits in 1965 caused health care costs to skyrocket in the late 1960s, causing the fiscally conservative Mills to co-sponsor legislation for a single-payer national health insurance program along with Senator Edward Kennedy almost a decade later.
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32

Anvarovich, Eraj Ghiyosov Bryant John Robert. "Payment for healthcare in post-Soviet Kazakhstan /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd405/4938547.pdf.

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33

Shlifer, Marc. "Determinants of physician participation in the medicare assignment program." Thesis, Virginia Tech, 1988. http://hdl.handle.net/10919/43055.

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The Medicare Participating Physician Program was enacted in 1984 in an effort to increase physician assignment of Medicare claims, and thereby reduce beneficiary out of-pocket expenses. The program offers the physician the security of near-certain payment on all claims, although at rates that are in many cases, at levels substantially, less than actual physician fees. This paper examines the economic factors that influence the physician's decision on participation. Physicians of the Medical Society of Prince William County, Virginia, were surveyed for information relevant to making the participation decision and the responses tabulated and used as input to a ergre rgersessisioonn equation estimated using the logit technique. Physicians are more likely to participate the higher the relative price received for participating and the lower the probability of payment by Medicare-eligible patients. Additionally, salaried physicians are more likely to partiCipate than those who are self-employed.
Master of Arts
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34

Moore, D. Helen. "Evaluation of the prognostic criteria for medicare hospice eligibility." [Tampa, Fla.] : University of South Florida, 2004. http://purl.fcla.edu/fcla/etd/SFE0000606.

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35

Hall, Anne Elizabeth 1971. "Essays on prescription drug benefits in Medicare managed care." Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/32411.

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Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Economics, 2005.
Includes bibliographical references.
In this thesis, I estimate a structural demand model for prescription drug benefits by Medicare beneficiaries using data from the Medicare HMO program. I then use the utility parameter estimates to explore other questions of interest relating to the elderly's demand for prescription drug benefits. In Chapter 1, I study the question of how much Medicare beneficiaries value prescription drug benefits. Using data from the Medicare HMO program, I find that Medicare beneficiaries are willing to pay $33 to increase their brand-name coverage limit by $100. I also estimate marginal cost for each HMO and regress it on prescription drug benefits. I find that raising brand-name coverage by $100 costs $30. These estimates suggest that Medicare HMO enrollees are less than average prescription drug users and the results give a lower bound for the welfare derived by the elderly from prescription drug benefits. Chapter 2 addresses the question of how Medicare HMOs' choices of premiums and benefits affect selection. Changes in demographic factors (a measure of risk based on beneficiaries' characteristics) and risk scores (a measure based on beneficiaries' inpatient diagnoses) in the fee-for-service sector are regressed on changes in premiums and benefits in the HMO sector. The results show that increasing premiums and lowering benefits raise the demographic factor but have no effect on the risk score, suggesting that beneficiaries in more expensive demographic categories switch out of HMOs when premiums rise and benefits fall but these beneficiaries are healthy for their demographic category.
(cont.) Chapter 3 measures the welfare loss from the withdrawals from the HMO program following the Balanced Budget Act of 1997, using the utility parameter estimates from Chapter 1. The changes to the Medicare HMO program in the Balanced Budget Act triggered many plan withdrawals from the program. The welfare and costs are calculated under two counterfactual scenarios. The results show that the Medicare HMO program generates more welfare than costs and that the withdrawals resulted in a net loss for society. The estimates of the loss range from $4.3 billion to $16.6 billion.
by Anne Elizabeth Hall.
Ph.D.
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36

Garcia-Arce, Andres Patricio. "Strategies for Reducing Preventable Hospital Readmissions on Medicare Patients." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6653.

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The high expenditure of healthcare in the United States (U.S.) does not translate into better quality of care. Indeed, the U.S. healthcare system is recognized by its lack of efficiency and waste (which represents about 20% of the country’s healthcare expenses). Lack of coordination is one of the most referenced causes of waste in the U.S. healthcare system, and preventable hospital readmissions have been acknowledged to be evidence of poor coordination of care. In fiscal year 2013, the Centers for Medicare and Medicaid Services (CMS) established financial penalties for inpatient care reimbursements in hospitals with excessive readmissions. All the same, the preliminary results of this effort have yet to result in a consistent reduction of readmission rates. Research in healthcare policy is usually reported through case studies, which makes it difficult to apply that research to different spatiotemporal contexts. Additionally, relevant research can remain overlooked due to the challenge of translating it from other fields. Therefore, in order to create effective healthcare policies, a system that can provide the most accurate information to stakeholders about their decisions and the future impact of those decisions should be developed. This dissertation proposes a decision-based support system that could aid hospital administrators in the design of disease-specific interventions that target specific groups of patients who are at risk for readmission. First, the use of disease-specific interventions that were designed to reduce readmissions will be explored. Second, a variety of predictive tools for readmissions will be developed and compared to complete the search for the best tool. Finally, an optimization model bringing together the two ideas will be formulated so that hospitals can use it to design interventions. This model will target specific patients depending on their risk for readmission and minimize the cost of intervention while ensuring quality hospital performance. In sum, this work will help hospital administrators to better plan in the reduction of readmissions and in the implementation of interventions. In addition, it will deepen knowledge about the impacts of economic penalties on hospitals and facilitate the construction of stronger arguments for decisions about healthcare policy.
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37

Joo, Jee Young. "Community-based case management and outcomes in Medicare beneficiaries." Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/4658.

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This study evaluated the effect of community-based case management (CM) intervention on patient outcomes in Medicare beneficiaries with chronic illness in a rural Midwest region from 2002 to 2004. The relationships between 252 patients' access and clinical outcomes (the number of hospitalizations, length of stay (LOS), and emergency department (ED) visits) and CM were investigated. CM services were provided as four types: high home, high clinic, high telephone, and mixed-care services by nurse case managers. A descriptive, repeated-measurement design was used, and a secondary analysis of a data set containing longitudinal community-based CM data was conducted. The transitional care model and transition theory served as the theoretical background for the study. Descriptive statistics and frequency analysis, t-test, and a repeated-measure ANOVA analysis were used to analyze the data. Characteristic profiles of the patients were analyzed with their self-care Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scores. The patients in this study were relatively healthy on their self-care functional status at the beginning of the study. The four types of CM services were compared with patient-reported clinical outcomes (the self-care ADL, IADL, symptom control, quality-of-life, and personal well-being scores) in each year. Analyses showed that patients' clinical outcomes were similar regardless of the type of CM services in each year. Two years of longitudinal CM intervention greatly affected patient's clinical outcomes and access outcomes. The study found that CM significantly reduced the number of hospital days and influenced patients' quality of life and symptom control. The impact of CM on LOS and ED visits was indeterminate. Further research is needed-including the effect of type and dosage of CM services and outcomes and the development of a comprehensive CM model-to guarantee CM as a core intervention in health care reconfiguration.
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38

Ezell, Wandella. "Length of Stay and Reimbursement Rates for Medicare Patients." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/5005.

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Medicare reimbursement rates across the United States have varied by as much as 49-130% across healthcare facilities. Geographic adjustments and severity of medical diagnoses attribute to some dissimilarity; however, the source of longer hospitalization and higher re-admission rates among Medicare patients requires financial consistency. The research encompassed (N = 3000) patients with hypertension as the focus for the study because this is a critical group of Medicare patients with a chronic disease that has been identified as a silent killer. The principal goal that drove this research study was to explain the variations in length of stay for Medicare patients with hypertension. The theoretical framework was the epidemiological triad model composed of person, place, and time variables. A secondary data set was acquired from the Healthcare Cost and Utilization Project Nationwide database of the National Inpatient Sample for the duration of 2011 - 2013. A multiple logistic regression analysis was conducted to determine if there was a correlation between length of stay and reimbursement rates for hypertensive Medicare patients. The findings of this research study provided an analytical explanation for the forces that have been driving Medicare patients' LOS, and rate of reimbursement. The research study yielded variations in the rate of reimbursement for a government entity in medical charges by illustrating the utilization of geographic price variations. The findings revealed that the categorical variable LOS and reimbursement rates for Medicare hypertensive patients had a significant correlation, and with higher reimbursement rates that were associated with longer hospital duration. The findings of the research study may inform Medicare decision-makers to eliminate geographic price variation and provide greater consistency in the rate of reimbursement, as well as a uniformity in length of stay across all regions of the United States.
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39

Nowatzki, Hesper B. "Initial Findings of a Medicare Annual Wellness Visit Program." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4088.

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Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of people 65 years and older. The rural health clinic failed to capture a single AWV in the previous year, despite having 1300 active Medicare patients in the clinic. The clinical question asked whether the implementation of an AWV program by nurse practitioners can yield improved compliance with recommended health screenings and vaccinations and diagnosed previously unrecognized clinical conditions. The Iowa model, health belief model and Donebedian's structure-process-outcome model were utilized for the introduction and implementation of the practice change. Evidence was derived from chart review of 50 patients and administration of the SF-36 survey before and following the AWV. Findings and conclusions suggest that the AWV generated improved compliance of preventive services and improved patient quality of life. Addressing preventive health strategies for aging adults is relevant to nursing practice because of the complex and chronic health challenges of this age group. These efforts can reduce the burden of suffering from chronic illness, prevent exacerbation and decline, improve quality of life, and reduce federal and individual health care expenditures to minimize the cost of advanced disease treatment.
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40

House, Donald Reed. "The cost of dying on Medicare: an analysis of expenditure data." Texas A&M University, 2005. http://hdl.handle.net/1969.1/2559.

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Roughly one third of Medicare expenditures are made on behalf of beneficiaries in their terminal year, though only five percent of the Medicare-covered population dies annually. Per-capita spending on decedents is as much as six times the level of spending on survivors. The demographic, technological and political trends that will determine the future path of spending on terminal-year beneficiaries have important implications for the fiscal well-being of the Medicare program, and by extension, the American taxpayer. Coming to an understanding of the moving parts that will control the path of the cost of dying on Medicare is vital for careful consideration of Medicare??s future, and for any discussions about further reform of the program. Analysis of expenditures in the terminal year must be made while keeping in mind the fact that major expenditures are often made in surviving years. The spike in spending in the terminal period rightly focuses attention to expenditures near death, but also we should proceed in its analysis keeping in mind that it is not the only spell of elevated medical spending for a typical individual. Given those cautions, however, the cost of dying on Medicare stands as an important area of economic inquiry and policy consideration. As total Medicare expenditures top a quarter trillion dollars, the third of that spending which covers treatments in beneficiaries?? terminal years ought to be understood more fully than it is currently.
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41

Laulu, Alva S. "The implementation of Total Quality Management and Six Sigma for LBJ Tropical Medical Center in American Samoa to help improve Medicare and Medicaid survey outcomes." Thesis, California State University, Dominguez Hills, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10020134.

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This project presents a theory and an application for using the integrated systems of Total Quality Management (TQM) and Six Sigma (SS) for the American Samoa Lyndon B Johnson (LBJ) Tropical Medical Center to improve results for the random survey and recertification process for Medicare and Medicaid. Identified aspects of the project include roles, responsibilities, and measurement requirements of the TQM framework, using the Juran Quality Trilogy, cost of quality, and investment training in SS. The basis of the research that forms the foundation of the project comes from a review of related literature. Methods are presented in order to clarify where improvement processes are required. This project provides the LBJ center with a proven approach that has found success for implementing TQM and an SS foundation to ensure efficient compliance with The Center of Medicare and Medicaid Services (CMS) and other regulatory government agencies.

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42

Sechrist, Joan B. "Impact of the 1983 Medicare regulations on ten foodservice facilities in Kentucky /." This resource online, 1987. http://scholar.lib.vt.edu/theses/available/etd-08062007-094358/.

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43

Camano, Javier. "Integrated Marketing Communications: Branding Plan for Medicare y Mucho Mas." BYU ScholarsArchive, 2006. https://scholarsarchive.byu.edu/etd/472.

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The purpose of this paper is to explain the appropriate and effective use of branding as a vital part of the communication process of an organization. In addition, this project will help identify issues to improve enthusiasm for the use of the brand, help managers become aware of brand loyalty, and show how to measure the effectiveness of the brand.
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44

Ininns, Graham D. "Applying Resource Based Relative Value Scales (RBRVS) to the CHAMPUS program." Thesis, Monterey, California : Naval Postgraduate School, 1990. http://handle.dtic.mil/100.2/ADA246396.

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Thesis (M.S. in Management)--Naval Postgraduate School, December 1990.
Thesis Advisor(s): Doyle, Richard. Second Reader: Gates, William R. "December 1990." Description based on title screen as viewed on March 30, 2010. DTIC Identifier(s): Cost Analysis, Medical Services, RBRVS(Resource Based Relative Value Scales Theses), CHAMPUS, Physicians, Medicare. Author(s) subject terms: RBVS, CHAMPUS, RBVS and CHAMPUS. Includes bibliographical references (p. 64). Also available in print.
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45

Flynn, James K. "Fiscal policy implications of the 1988 Medicare Catastrophic Coverage Act." Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1997. http://handle.dtic.mil/100.2/ADA343410.

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Thesis (M.S. in Management) Naval Postgraduate School, December 1997.
"December 1997." Thesis advisor(s): Richard B. Doyle, William R. Gates. Includes bibliographical references (p. 107-112). Also available online.
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46

Huff, Billie Kathryn Ingman Stanley R. "Medicare Plan D impact on medication compliance in the elderly /." [Denton, Tex.] : University of North Texas, 2007. http://digital.library.unt.edu/permalink/meta-dc-3662.

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47

Cutone, Benjamin. "Female urinary incontinence and treatment rates among a Medicare population." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12340.

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Thesis (M.S.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
Introduction and Hypothesis: The objective ofthis study was to determine the treatment rates of urinary incontinence (UI) in women 65 years old and older by education, poverty, and socioeconomic status (SES). Additionally, it was investigated ifhaving a discussion with a health care provider about UI had any effect on treatment rates. Methods: The publicly available 2007-2009 Medicare Health Outcome Survey data was examined in regards to four items that query about UI. All women 65 years old and older who provided data on UI and level of education were included in the analysis. United States Census Bureau data were used to establish poverty and SES variables. Results: In total, 87,805 women met inclusion criteria and 43.2% reported experiencing some UI in the past 6-months with only 28.6% receiving any treatment for UI. Women with a college education who self-reported either a "small" or "big" UI problem were more likely to receive treatment for their UI (OR = 0.84 (95% CI 0.79, 0.89)) and (OR= 0.77 (95% CI 0.69, 0.86). Women with a college education and any magnitude ofUI were also more likely to discuss their UI problem with a health care provider (OR = 0.93 (95% CI 0.88, 0.97)) and (OR= 0.80 (95% CI 0.72, 0.89)). For women with a small UI problem, a discussion with a provider was most impactful in regards to treatment for women without a college education. For women with a big UI problem, a discussion was most beneficial to treatment for women with a college education. Conclusion: UI is a prevalent condition among women 65 years old and older. Women without a college education are disadvantaged in regards to receiving any treatment for UI. Treatment rates may be improved among less educated women if providers initiate discussions regarding UI during the clinical encounter.
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48

Moe, Christine. "Medicare Managed Care Penetration and Prevalence of Older Adult Disability." VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1663.

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OBJECTIVE: To investigate the relationship between Medicare Managed Care (MMC) penetration and percentage of disability in older adults (individuals age 65 and older). Considering disability as an indicator of one or more unsuccessfully managed chronic diseases, this study investigates the assumption that managed care improves coordination of care, as well as access to preventive care. If managed care’s mandate is being met, then it should be evidenced in decreased prevalence of older adult disability. METHOD: Taking an ecological approach, this study used data from the Agency for Healthcare Research and Quality (AHRQ, 2003) to compare the percentage of older adult disability in counties from 30 states and the District of Columbia with high and low MMC penetration. Covariates representing various aspects of community context were introduced into a final multivariate linear regression to examine whether MMC penetration was a significant predictor of countywide percent of older adult disability. RESULTS: While MMC penetration was a significant predictor of prevalence of older adult disability in a bivariate analysis (r=-0.197, p < .001), it lost its significance in the final multivariate model. CONCLUSION: While this study does not demonstrate a relationship between MMC penetration and prevalence of older adult disability, it is possible that MMC, once fully implemented under the 2003 Medicare Prescription Drug, Improvement, and Modernization Act, could lead to reduced prevalence of disability.
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49

Huff, Billie Kathryn. "Medicare Plan D: Impact on Medication Compliance in the Elderly." Thesis, University of North Texas, 2007. https://digital.library.unt.edu/ark:/67531/metadc3662/.

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This dissertation examined the impact of Medicare Plan D on medication compliance in Medicare beneficiaries at University of Texas Health Center at Tyler, TX. Data were collected before and after the implementation of Plan D. The impacts of various types of benefits, such as private insurance, employer insurance and pharmacy assistance programs were evaluated in terms of impact on drug compliance. Medication compliance was found to increase in those respondents without Plan D. Plan D was found to be a predictor of those who spent less on basics in order to buy medications. Although compliance increased in general, these increases could not be attributed to the acquisition of a Plan D policy.
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Blodgett, Elizabeth Geneva. "The intersection of age and eligibility variation in health services use for medicare beneficiaries /." Pullman, Wash. : Washington State University, 2010. http://www.dissertations.wsu.edu/Thesis/Spring2010/E_Blodgett_041910.pdf.

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Thesis (Master of health policy and administration)--Washington State University, May 2010.
Title from PDF title page (viewed on July 6, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 26-30).
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