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1. Understanding common reasons for patient referrals in difficult-to-access specialties

Publication:
Oakland, Calif. : California HealthCare Foundation, c2009
Subject(s):
Community Health Services
Health Services Accessibility
Medicine
Referral and Consultation
Specialization
Dermatology
Gastroenterology
Health Resources
Health Services Needs and Demand
Insurance, Health, Reimbursement
Interviews as Topic
Neurology
Orthopedics
Primary Health Care
Telemedicine
Humans
California

3. CMS validated hospital inpatient quality reporting program data, but should use additional tools to identify gaming

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, April 2017
Subject(s):
Economics, Hospital
Insurance, Health, Reimbursement
Quality Indicators, Health Care
Reimbursement, Incentive
Cross Infection
Inpatients
Mandatory Reporting
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

4. Round 2 competitive bidding for CPAP/RAD: disrupted access unlikely for devices, inconclusive for supplies

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2017
Subject(s):
Competitive Bidding
Continuous Positive Airway Pressure -- economics
Continuous Positive Airway Pressure -- instrumentation
Durable Medical Equipment -- economics
Health Services Accessibility -- economics
Insurance Coverage -- economics
Insurance, Health, Reimbursement
Medicare -- economics
Respiration, Artificial -- economics
Respiration, Artificial -- instrumentation
Humans
United States
United States. Department of Health and Human Services.

6. Medicare Part B drug payments: impact of price substitutions based on 2014 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2017
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Medicare Part B -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

7. Enhancements needed in the tracking and collection of Medicare overpayments identified by ZPICS and PSCS

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Financial Audit
Insurance, Health, Reimbursement
Medicare -- economics
Contract Services
Durable Medical Equipment -- economics
Home Care Services -- economics
Hospice Care -- economics
Information Dissemination
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

8. Medicare Part B drug payments: impact of price substitutions based on 2015 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Medicare -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

9. Medicare payments for clinical diagnostic laboratory tests in 2016: year 3 of baseline data

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Clinical Laboratory Techniques -- economics
Insurance, Health, Reimbursement
Medicare Part B -- economics
Prospective Payment System
Rate Setting and Review
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

10. Followup review: CMS's management of the quality payment program

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, December 2017
Subject(s):
Insurance, Health, Reimbursement
Medical Informatics
Medicare Part B -- economics
Quality of Health Care -- economics
Reimbursement, Incentive
Diffusion of Innovation
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

11. Potential misclassifications reported by drug manufacturers may have led to $1 billion in lost Medicaid rebates

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, December 2017
Subject(s):
Drug Costs
Drug Industry -- economics
Medicaid -- economics
Pharmaceutical Preparations -- classification
Pharmaceutical Preparations -- economics
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

12. Round two competitive bidding for oxygen: continued access for vast majority of beneficiaries

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2018
Subject(s):
Competitive Bidding
Durable Medical Equipment -- economics
Health Services Accessibility
Insurance, Health, Reimbursement
Medicare -- economics
Oxygen Inhalation Therapy -- economics
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.

13. Round two competitive bidding for enteral nutrition: continued access for vast majority of beneficiaries

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2018
Subject(s):
Competitive Bidding
Durable Medical Equipment -- economics
Enteral Nutrition -- economics
Health Services Accessibility
Insurance, Health, Reimbursement
Medicare -- economics
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.

15. CMS did not detect some inappropriate claims for durable medical equipment in nursing facilities

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2018
Subject(s):
Durable Medical Equipment -- economics
Insurance, Health, Reimbursement
Medicare -- economics
Skilled Nursing Facilities
Home Care Services -- economics
Insurance Claim Review
Insurance Coverage
Medicaid -- economics
Nursing Homes
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

16. Medicare Part B drug payments: impact of price substitutions based on 2016 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2018
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Medicare Part B -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

17. Questionable billing for compounded topical drugs in Medicare Part D

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2018
Subject(s):
Dermatologic Agents -- economics
Dermatologic Agents -- therapeutic use
Drug Compounding -- economics
Drug Utilization -- trends
Fraud
Insurance, Health, Reimbursement
Medicare Part D -- economics
Skin Cream -- economics
Administration, Topical
Dermatologic Agents -- adverse effects
Drug Compounding -- standards
Forecasting
Health Expenditures -- trends
Insurance Coverage
Skin Cream -- adverse effects
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

18. Medicare payments for clinical diagnostic laboratory tests in 2017: year 4 of baseline data

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2018
Subject(s):
Clinical Laboratory Techniques -- economics
Insurance, Health, Reimbursement
Medicare Part B -- economics
Prospective Payment System
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

19. Medicare Advantage appeal outcomes and audit findings raise concerns about service and payment denials

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2018
Subject(s):
Health Services Accessibility
Insurance Claim Review -- statistics & numerical data
Insurance Coverage
Insurance, Health, Reimbursement
Medicare Part C
Financial Audit
Insurance Claim Review -- economics
Managed Care Programs
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

20. Evaluation of the Minnesota Accountable Health Model: first annual report : final

Publication:
[Minneapolis, Minnesota] : State Health Access Data Assistance Center, University of Minnesota, May 6, 2016
Subject(s):
Accountable Care Organizations -- economics
Delivery of Health Care, Integrated -- economics
Delivery of Health Care, Integrated -- methods
Electronic Health Records
Health Care Reform -- economics
Health Care Reform -- methods
Computer Security
Informed Consent
Insurance, Health, Reimbursement
Interinstitutional Relations
Health Information Exchange
Health Information Interoperability
Leadership
Patient Care Team
Privacy
Reimbursement Mechanisms
State Government
Humans
Minnesota
United States
Centers for Medicare & Medicaid Services (U.S.)

21. SIM "stack" in Minnesota: a case study of Otter Tail County Public Health

Author(s):
Napoles, Amanda, author
Worrall, Christina, author
Publication:
[Minneapolis, Minnesota] : State Health Access Data Assistance Center, University of Minnesota, December 15, 2016
Subject(s):
Health Care Reform -- methods
Insurance, Health, Reimbursement
Organizational Case Studies
Public Health Administration
Reimbursement Mechanisms
Accountable Care Organizations
Electronic Health Records
Models, Theoretical
Humans
Minnesota
United States

22. Evaluation of the Minnesota accountable health model: executive summary

Publication:
[Minneapolis, Minnesota] : State Health Access Data Assistance Center, University of Minnesota, September 2017
Subject(s):
Accountable Care Organizations -- organization & administration
Delivery of Health Care, Integrated -- organization & administration
Health Information Exchange
Medical Informatics
Models, Organizational
Reimbursement Mechanisms
Community Health Services
Decision Support Techniques
Diffusion of Innovation
Insurance, Health, Reimbursement
Population Health
State Government
Humans
Minnesota
United States
Centers for Medicare & Medicaid Services (U.S.)

23. Synchronizing the academic health center clinical enterprise and education mission in changing environments

Publication:
Atlanta, GA : Woodruff Health Sciences Center, Emory University, 2016
Subject(s):
Academic Medical Centers
Education, Medical -- organization & administration
Insurance, Health, Reimbursement
Education, Medical, Graduate -- organization & administration
Fee-for-Service Plans
Medicare
Reimbursement Mechanisms
Humans
Maryland
Michigan
Oregon
United States
Virginia

24. Partnerships between New York City health care institutions and community-based organizations: a qualitative study on processes, outcomes, facilitators, and barriers to effective collaboration

Author(s):
Griffin, Kerry, author
Nelson, Carla, author
Realmuto, Lindsey, author
Weiss, Linda, author
Publication:
New York, NY : New York Academy of Medicine, April 2018
Subject(s):
Community Health Services -- organization & administration
Community-Institutional Relations
Health Care Reform
Insurance, Health, Reimbursement
Interinstitutional Relations
Social Determinants of Health
Asthma -- prevention & control
Community Health Workers
Focus Groups
Medicaid
Religious Missions
Humans
New York
New York City
United States

26. Nursing in a transformed health care system: new roles, new rules

Author(s):
Fraher, Erin, author
Spetz, Joanne, author
Naylor, Mary, author
Publication:
[Philadelphia, Pennsylvania] : Leonard Davis Institute of Health Economics, June 2015
Subject(s):
Delivery of Health Care
Health Care Reform
Legislation, Nursing
Nurse's Role
Nursing
Professional Practice -- legislation & jurisprudence
Caregivers
Education, Nursing
Geriatric Nursing
Insurance, Health, Reimbursement
Interdisciplinary Communication
Job Description
Medical Informatics
Nurses -- supply & distribution
Transitional Care
Humans
United States

27. Enabling sustainable investment in social interventions: a review of Medicaid managed care rate-setting tools

Author(s):
Bachrach, Deborah, author
Guyer, Jocelyn, author
Meier, Sarah, author
Meerschaert, John, author
Brandel, Shelly, author
Publication:
[New York, N.Y.] : Commonwealth Fund, January 2018
Subject(s):
Managed Care Programs -- economics
Medicaid -- economics
Social Determinants of Health
Social Support
Socioeconomic Factors
Insurance, Health, Reimbursement
Reimbursement Mechanisms
Reimbursement, Incentive
State Government
Value-Based Purchasing
Humans
United States

28. Challenges and joys: pediatricians reflect on caring for children with special health care needs

Author(s):
Calvin, Kris, author
Okumura, Megumi , author
Knauer, Heather, author
Publication:
Palo Alto, CA : Lucile Packard Foundation for Children's Health, March 2017
Subject(s):
Child Health Services
Disabled Children
Patient-Centered Care
Pediatrics
Physician-Patient Relations
Caregivers
Child
Electronic Health Records
Insurance, Health
Insurance, Health, Reimbursement
Patient Care Team
Primary Health Care
Social Support
Humans
California
United States

29. Survey: quantifying pediatricians' views on caring for children with special health care needs

Author(s):
Calvin, Kris, author
Okumura, Megumi, author
Knauer, Heather, author
Publication:
Palo Alto, CA : Lucile Packard Foundation for Children's Health, March 2017
Subject(s):
Child Health Services
Disabled Children
Health Services Needs and Demand
Pediatrics
Primary Health Care
Child
Health Services Accessibility
Insurance, Health, Reimbursement
Patient Care Team
Patient-Centered Care
Humans
California
United States

30. Medicare physician payment: are we getting what we pay for? : Are we paying for what we want? : Invited testimony, Energy and Commerce Committee, Subcommittee on Health, U.S. House of Representatives hearing on "Medicare Physician Payment : how to Build a Payment System That Provides Quality, Efficient Care for Medicare Beneficiaries"

Publication:
[New York, N.Y.] : Commonwealth Fund, [2006]
Subject(s):
Insurance, Health, Reimbursement
Medicare Part B -- economics
Prospective Payment System -- economics
Cost Control
Health Services Accessibility -- economics
Quality of Health Care -- economics
Medical Informatics -- economics
Physician Incentive Plans -- economics
United States

32. Beyond health care: the role of social determinants in promoting health and health equity

Author(s):
Artiga, Samantha, author
Hinton, Elizabeth, author
Publication:
San Francisco, CA : Henry J. Kaiser Family Foundation, May 2018
Subject(s):
Delivery of Health Care -- organization & administration
Health Status Disparities
Social Determinants of Health
Community Health Services
Employment
Federal Government
Housing
Insurance, Health, Reimbursement
Managed Care Programs
Medicaid
Medicare
State Government
Humans
United States

33. Federal legislation to address the opioid crisis: Medicaid provisions in the SUPPORT Act

Author(s):
Musumeci, MaryBeth, author
Tolbert, Jennifer, author
Publication:
San Francisco, CA : Henry J. Kaiser Family Foundation, October 2018
Subject(s):
Opioid-Related Disorders -- prevention & control
Opioid-Related Disorders -- rehabilitation
Opioid-Related Disorders -- therapy
Rehabilitation -- legislation & jurisprudence
Substance-Related Disorders -- prevention & control
Substance-Related Disorders -- rehabilitation
Substance-Related Disorders -- therapy
Analgesics, Opioid -- therapeutic use
Federal Government
Insurance, Health, Reimbursement
Medicaid
Opiate Substitution Treatment
Pain Management
Prescription Drug Monitoring Programs
Humans
United States

34. Medicare-for-all and public plan buy-in proposals: overview and key issues

Author(s):
Neuman, Tricia, author
Pollitz, Karen, author
Tolbert, Jennifer, author
Publication:
San Francisco, CA : Henry J. Kaiser Family Foundation, October 2018
Subject(s):
Medicare -- organization & administration
Public Sector
Universal Health Insurance -- legislation & jurisprudence
Universal Health Insurance -- organization & administration
Adult
Aged
Child
Cost Control
Federal Government
Financing, Government
Health Insurance Exchanges
Insurance Coverage
Insurance, Health -- organization & administration
Insurance, Health -- legislation & jurisprudence
Insurance, Health, Reimbursement
Medicaid
Medicare -- legislation & jurisprudence
Middle Aged
State Government
Humans
United States
United States.
State Children's Health Insurance Program (U.S.)

35. Medicaid: what to watch in 2019 from the Administration, Congress, and the states

Author(s):
Rudowitz, Robin, author
Musumeci, MaryBeth, author
Artiga, Samantha, author
Publication:
San Francisco, CA : Henry J. Kaiser Family Foundation, January 2019
Subject(s):
Health Care Reform -- organization & administration
Medicaid -- organization & administration
Medicaid -- trends
Forecasting
Home Care Services
Insurance, Health, Reimbursement
Managed Care Programs
Opioid-Related Disorders
State Government
Substance-Related Disorders
Telemedicine
Humans
Puerto Rico
United States
United States Virgin Islands

36. CMS's 2018 proposed Medicaid managed care rule: a summary of major provisions

Author(s):
Hinton, Elizabeth, author
Musumeci, MaryBeth, author
Publication:
San Francisco, CA : Henry J. Kaiser Family Foundation, January 2019
Subject(s):
Managed Care Programs -- organization & administration
Medicaid -- organization & administration
Capitation Fee
Health Services Accessibility
Insurance, Health, Reimbursement
Quality of Health Care
Rate Setting and Review
Humans
United States
Centers for Medicare & Medicaid Services (U.S.)

38. Health care without the doctor: how new devices and technologies aid clinicians and consumers

Publication:
Oakland, Calif. : California HealthCare Foundation, c2009
Subject(s):
Decision Making, Computer-Assisted
Decision Support Techniques
Delivery of Health Care -- methods
Home Nursing
Internet
Patient Participation
Point-of-Care Systems
Reagent Kits, Diagnostic
Self Care
Allied Health Personnel
Ambulatory Care Facilities
Community Participation
Device Approval
Equipment Safety
Evidence-Based Medicine
Federal Government
Government Regulation
Health Care Sector
Health Policy
Insurance, Health, Reimbursement
Patient Advocacy
Privacy
State Government
Treatment Outcome
Humans
Diagnosis, Computer-Assisted
California

40. The effect of integration of hospitals and post-acute care providers on Medicare payment and patient outcomes

Author(s):
Konetzka, R. Tamara, author
Stuart, Elizabeth A., author
Werner, Rachel M., author
Publication:
Philadelphia, PA : Leonard Davis Institute of Health Economics, 2018
Subject(s):
Economics, Hospital
Home Care Services -- economics
Insurance, Health, Reimbursement
Medicare -- economics
Outcome Assessment (Health Care)
Reimbursement Mechanisms
Skilled Nursing Facilities -- economics
Episode of Care
Continuity of Patient Care -- economics
Cost Savings
Humans
United States

41. Status of U.S. health insurance coverage and the potential of recent congressional health reform bills to expand coverage and lower consumer costs: invited testimony : U.S. House of Representatives, Committee on Rules : hearing on "Medicare for All Act of 2019"

Author(s):
Collins, Sara R., author
Publication:
New York, NY : The Commonwealth Fund, April 30, 2019
Subject(s):
Insurance Coverage -- economics
Insurance Coverage -- legislation & jurisprudence
Insurance, Health -- economics
Insurance, Health -- legislation & jurisprudence
Financing, Personal
Forecasting
Health Benefit Plans, Employee -- economics
Health Benefit Plans, Employee -- statistics & numerical data
Health Benefit Plans, Employee -- trends
Health Care Costs -- trends
Health Expenditures -- statistics & numerical data
Health Expenditures -- trends
Income
Insurance Coverage -- trends
Insurance, Health -- trends
Insurance, Health, Reimbursement
Medically Uninsured -- statistics & numerical data
Prescription Drugs -- economics
Humans
United States
United States.

45. Key design components and considerations for establishing a single-payer health care system: testimony before the Committee on the Budget, United States House of Representatives

Publication:
[Washington, DC] : Congressional Budget Office, May 22, 2019
Subject(s):
Insurance, Health, Reimbursement
Single-Payer System -- organization & administration
Universal Health Insurance
Cost Sharing
Health Care Reform
Health Services Accessibility
Insurance Coverage
Insurance, Health -- organization & administration
Humans
United States

47. What could a Medicaid per capita cap mean for low-income people on Medicare?

Author(s):
Jacobson, Gretchen, author
Neuman, Tricia, author
Musumeci, MaryBeth, author
Publication:
Menlo Park, CA : Henry J. Kaiser Family Foundation, March 2017
Subject(s):
Capitation Fee
Health Care Reform -- legislation & jurisprudence
Medicaid -- economics
Medicare -- economics
Federal Government
Dual MEDICAID MEDICARE Eligibility
Insurance, Health, Reimbursement
Poverty
State Government
Humans
United States

48. Governor's proposed budgets for FY 2018: focus on Medicaid and other health priorities

Author(s):
Antonisse, Larisa, author
Hinton, Elizabeth, author
Rudowitz, Robin, author
Gifford, Kathleen, author
McMahon, Nicole, author
Publication:
Menlo Park, CA : Henry J. Kaiser Family Foundation, April 2017
Subject(s):
Budgets
Medicaid -- statistics & numerical data
Community Health Services
Cost Sharing
Eligibility Determination
Health Care Reform
Health Policy
Insurance, Health, Reimbursement
Long-Term Care
Managed Care Programs
Medicaid -- economics
Mental Health Services -- economics
Opioid-Related Disorders -- epidemiology
Public Health
State Government
Humans
United States
United States.

49. Projecting demand for the services of primary care doctors:

Author(s):
Duchovny, Noelia, author
Trachtman, Sam, author
Werble, Ellen, author
Publication:
Washington, D.C. : Congressional Budget Office, May 2017
Subject(s):
Health Services Needs and Demand -- statistics & numerical data
Physicians, Family -- supply & distribution
Primary Health Care -- statistics & numerical data
Primary Health Care -- trends
Federal Government
Forecasting
Health Manpower -- statistics & numerical data
Health Manpower -- trends
Health Policy
Health Services Needs and Demand -- trends
Insurance Coverage
Insurance, Health, Reimbursement
Medicaid
Medicare
Physicians, Family -- education
Population Dynamics
Population Growth
Telemedicine
Humans
United States

50. Post-acute and long-term care: a primer on services, expenditures, and payment methods

Author(s):
Grabowski, David C., author
Publication:
Washington, D.C. : Office of Disability, Aging and Long-Term Care Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, [2010]
Subject(s):
Long-Term Care -- economics
Insurance, Long-Term Care -- economics
Health Expenditures
Insurance, Health, Reimbursement
Residential Facilities
United States