Aaron L. Schwartz
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View article: Spending by the Veterans Affairs Health Care System for Medicare Advantage Enrollees
Spending by the Veterans Affairs Health Care System for Medicare Advantage Enrollees Open
This cohort study estimates US Department of Veterans Affairs (VA) spending for veterans dually enrolled in the VA health care system and Medicare Advantage from 2019 to 2023.
View article: Payments to Physician Practices and Incentives to Serve Different Racial and Ethnic Groups
Payments to Physician Practices and Incentives to Serve Different Racial and Ethnic Groups Open
Importance In the US, a physician can be paid very different amounts for treating different patients, even when providing identical services. Understanding physician practices’ financial incentives to serve different racial and ethnic grou…
View article: Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries
Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries Open
Loss of drug subsidies after Medicaid disenrollment was associated with higher mortality among low-income Medicare beneficiaries. (Funded by the National Institute on Aging and others.).
View article: Association of Participation in Medicare's Oncology Care Model With Spending, Utilization, and Quality Outcomes Among Commercially Insured and Medicare Advantage Members
Association of Participation in Medicare's Oncology Care Model With Spending, Utilization, and Quality Outcomes Among Commercially Insured and Medicare Advantage Members Open
PURPOSE The Oncology Care Model (OCM), a value-based payment model for traditional Medicare beneficiaries with cancer, yielded total spending reductions that were outweighed by incentive payments, resulting in net losses to the Centers for…
View article: 12420 Effects Of A Continuous Glucose Monitoring (CGM) Optimization Program On Prescribing Behavior And Glycemic Outcomes
12420 Effects Of A Continuous Glucose Monitoring (CGM) Optimization Program On Prescribing Behavior And Glycemic Outcomes Open
Disclosure: A. Sterbenz: None. J. Fuentes Rosales: None. S. Abraham: None. P. Siroya: None. R. Middelbeek: None. J. Mitri: None. F. Rossitto: None. E. Cabana: None. A. Gharse: None. L. Collins: None. L. Aliaga: None. A. Millan Ferro: None.…
View article: Trends in Low-Value Cancer Care During the COVID-19 Pandemic
Trends in Low-Value Cancer Care During the COVID-19 Pandemic Open
Low-value cancer care remained prevalent throughout the pandemic. Policy makers should consider changes to payment and incentive design to turn the tide against low-value cancer care.
View article: Comparison of prior authorization across insurers: cross sectional evidence from Medicare Advantage
Comparison of prior authorization across insurers: cross sectional evidence from Medicare Advantage Open
Objective To measure and compare the scope of US insurers’ policies for prior authorization (PA), a process by which insurers assess the necessity of planned medical care, and to quantify differences in PA across insurers, physician specia…
View article: Growth of Medicare Advantage After Plan Payment Reductions
Growth of Medicare Advantage After Plan Payment Reductions Open
Importance Various policy proposals would reduce federal payments to Medicare Advantage (MA) plans. However, it is unclear whether payment reductions would compromise beneficiary access to the MA program. Objective To quantify the associat…
View article: Assessment of Care Cascades Following Low-Value Prostate-Specific Antigen Testing Among Veterans Dually Enrolled in the US Veterans Health Administration and Medicare Systems
Assessment of Care Cascades Following Low-Value Prostate-Specific Antigen Testing Among Veterans Dually Enrolled in the US Veterans Health Administration and Medicare Systems Open
Importance Older US veterans commonly receive health care outside of the US Veterans Health Administration (VHA) through Medicare, which may increase receipt of low-value care and subsequent care cascades. Objective To characterize the fre…
View article: Trends in Low-Value Cancer Care During the COVID-19 Pandemic
Trends in Low-Value Cancer Care During the COVID-19 Pandemic Open
Background Low-value services are common in cancer care. The onset of the COVID-19 pandemic caused a dramatic decrease in health care utilization, leading many to suspect that low-value cancer services may decrease. Methods In this retrosp…
View article: Comparison of Low-Value Services Among Medicare Advantage and Traditional Medicare Beneficiaries
Comparison of Low-Value Services Among Medicare Advantage and Traditional Medicare Beneficiaries Open
In this cross-sectional study of Medicare beneficiaries, those enrolled in MA had lower rates of low-value care than those enrolled in TM; elements of insurance design present in the MA program and absent in TM were associated with reducti…
View article: Use and Cost of Low-Value Health Services Delivered or Paid for by the Veterans Health Administration
Use and Cost of Low-Value Health Services Delivered or Paid for by the Veterans Health Administration Open
Importance Within the Veterans Health Administration (VA), the use and cost of low-value services delivered by VA facilities or increasingly by VA Community Care (VACC) programs have not been comprehensively quantified. Objective To quanti…
View article: Spatial changes in park visitation at the onset of the pandemic
Spatial changes in park visitation at the onset of the pandemic Open
The COVID-19 pandemic disrupted the mobility patterns of a majority of Americans beginning in March 2020. Despite the beneficial, socially distanced activity offered by outdoor recreation, confusing and contradictory public health messagin…
View article: Coverage Denials: Government And Private Insurer Policies For Medical Necessity In Medicare
Coverage Denials: Government And Private Insurer Policies For Medical Necessity In Medicare Open
Little is publicly known about coverage denials for medical services that do not meet medical necessity criteria. We characterized the extent of these denials and their key features, using Medicare Advantage claims for a large insurer from…
View article: Health Care Utilization and Spending in Medicare Advantage vs Traditional Medicare
Health Care Utilization and Spending in Medicare Advantage vs Traditional Medicare Open
In this cohort study with a difference-in-differences analysis, during the first year of Medicare coverage, MA was associated with large reductions in institutional (Part A) utilization and spending.
View article: Coverage Denials for Medical Necessity Rules in Medicare
Coverage Denials for Medical Necessity Rules in Medicare Open
Research Objective Coverage policy may be an important tool to reduce spending while discouraging low‐value medical services. Government and private insurers may also differ in their scope of coverage restrictions for suspected low‐value s…
View article: Measuring the Scope of Prior Authorization Policies
Measuring the Scope of Prior Authorization Policies Open
In this cross-sectional study, a large portion of fee-for-service Medicare Part B spending would have been subject to prior authorization under private insurance coverage policies. Prior authorization requirements for Part B drugs have bee…
View article: Association of Low-Value Care Exposure With Health Care Experience Ratings Among Patient Panels
Association of Low-Value Care Exposure With Health Care Experience Ratings Among Patient Panels Open
This quality improvement study found that more low-value care exposure for a PCP patient panel was not associated with more favorable patient ratings of their health care experiences.
View article: Assessment of Overuse of Medical Tests and Treatments at US Hospitals Using Medicare Claims
Assessment of Overuse of Medical Tests and Treatments at US Hospitals Using Medicare Claims Open
This cross-sectional study used a novel measurement of hospital-associated overuse; results showed that the highest scores in this Medicare population were associated with nonteaching and for-profit hospitals, particularly in the South.
View article: Differences in the Receipt of Low-Value Services Between Publicly and Privately Insured Children
Differences in the Receipt of Low-Value Services Between Publicly and Privately Insured Children Open
BACKGROUND: Children frequently receive low-value services that do not improve health, but it is unknown whether the receipt of these services differs between publicly and privately insured children. METHODS: We analyzed 2013–2014 Medicaid…
View article: Analysis of Physician Variation in Provision of Low-Value Services
Analysis of Physician Variation in Provision of Low-Value Services Open
Physician practices may substantially contribute to low-value service use, which is prevalent even among the least wasteful physicians. Because little variation is predicted by measured physician characteristics, direct measures of low-val…
View article: Low-Value Service Variation and Physician Characteristics
Low-Value Service Variation and Physician Characteristics Open
Importance: Reducing spending on unnecessary medical procedures is a global priority. Understanding patterns of low-value service use across physicians can inform efforts to reduce wasteful care.\n\nObjective: To quantify the extent of phy…
View article: 0008 CHEMOGENETIC STIMULATION OF THE HYPOGLOSSAL NEURONS IMPROVES THE UPPER AIRWAY PATENCY
0008 CHEMOGENETIC STIMULATION OF THE HYPOGLOSSAL NEURONS IMPROVES THE UPPER AIRWAY PATENCY Open
Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction during sleep. OSA leads to high cardiovascular morbidity and mortality. The pathogenesis of OSA has been linked to a defect in neuromuscular control of th…
View article: Focusing on High-Cost Patients — The Key to Addressing High Costs?
Focusing on High-Cost Patients — The Key to Addressing High Costs? Open
In reducing wasteful health care utilization, patient-focused strategies targeting high-cost patients may be less effective than systems-focused strategies intended to reduce low-value services for everyone. But current incentives favor a …
View article: Use of Low-Value Pediatric Services Among the Commercially Insured
Use of Low-Value Pediatric Services Among the Commercially Insured Open
BACKGROUND: Claims-based measures of “low-value” pediatric services could facilitate the implementation of interventions to reduce the provision of potentially harmful services to children. However, few such measures have been developed. M…
View article: Low‐Value Service Use in Provider Organizations
Low‐Value Service Use in Provider Organizations Open
Objective To assess whether provider organizations exhibit distinct profiles of low‐value service provision. Data Sources 2007–2011 Medicare fee‐for‐service claims and enrollment data. Study Design Use of 31 services that provide minimal c…