Author Interviews, JAMA, Kidney Disease, Medicare / 10.04.2020

MedicalResearch.com Interview with: Lead and Senior coauthors contributing to this interview: Abby Hoffman, BA is a Pre-Doctoral Fellow in Population Health Sciences at Duke University and a PhD Candidate in Health Policy and Management University of North Carolina at Chapel Hill. Virginia Wang, PhD, MSPH is an Associate Professor in the Department of Population Health Sciences, Associate Director of the Center for Health Innovation and Outcomes Research, and Core Faculty in the Margolis Center for Health Policy at Duke University and Investigator at the Durham VA HSR&D Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT).   MedicalResearch.com: What is the background for this study? Response: It is well established that healthcare providers are sensitive to changes in price, though their behavioral response varies. Dialysis facilities are particularly responsive to changes in Medicare reimbursement. Many dialysis patients are eligible for Medicare regardless of age, but dialysis facilities generally receive significantly higher reimbursement from private insurers than from Medicare. In 2011, Medicare implemented a new prospective bundled payment for dialysis that was expected to decrease Medicare payment and reduce overall revenues flowing into facilities. Then the Affordable Care Act (ACA) rules against refusing to insure patients for preexisting conditions and the 2014 ACA Marketplace provided an additional avenue for patients to purchase private insurance. As a result of these policies, dialysis facilities had a strong motivation and opportunity to increase the share of patients with private insurance coverage. We were interested in understanding whether dialysis facilities were shifting their payer mix away from Medicare, possibly in response to these policy changes.  (more…)
Aging, Author Interviews, Circadian Rhythm / 21.03.2019

MedicalResearch.com Interview with: Adrian Bejan PhD ( MIT 1971, 1972, 1975 ) J.A. Jones Distinguished Professor Duke University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Among the most common human perceptions is that time passes faster as an individual becomes older. The days become shorter, and so do the years. We all have stories of this kind, from the long days of childhood and the never-ending class hours in elementary school, to days, months and years that now pass in a blur. Why does it feel that the time passes faster as we get older? What is the physical basis for the impression that some days are slower than others? Why do we tend to focus on the unusual (the surprise), not on the ever present? This new article unveils the physics basis for these common observations. The reason is that the measurable ‘clock time’ is not the same as the time perceived by the human mind. The ‘mind time’ is a sequence of images, i.e. reflections of nature that are fed by stimuli from sensory organs. The rate at which changes in mental images are perceived decreases with age, because of several physical features that change with age: saccades frequency, body size, pathways degradation, etc. The misalignment between mental-image time and clock time serves to unite the voluminous observations of this phenomenon in the literature with the constructal law of evolution everywhere, as physics. (more…)