Author Interviews, Cost of Health Care, Heart Disease, JAMA, University of Pennsylvania / 07.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49581" align="alignleft" width="180"]Sameed Khatana, MD, MPH Fellow, Cardiovascular Medicine, Perleman School of Medicine Associate Fellow, Leonard Davis Institute of Health Economics University of Pennsylvania Dr. Khatana[/caption] Sameed Khatana, MD, MPH Fellow, Cardiovascular Medicine, Perleman School of Medicine Associate Fellow, Leonard Davis Institute of Health Economics University of Pennsylvania  MedicalResearch.com: What is the background for this study?   Response: The Affordable Care Act (ACA) led to the largest increase in Medicaid coverage since the beginning of the program. However, a number of states decided not to expand eligibility. Studies of prior smaller expansions in Medicaid, such as in individual states, have suggested evidence of improved outcomes associated with Medicaid expansion. Additionally, studies of Medicaid expansion under the ACA of certain health measures such as access to preventive care and medication adherence have suggested some improvements as well. However, there have been no large, population-level studies to examine whether Medicaid expansion under the ACA led to changes in mortality rates. Given, a high burden of cardiovascular risk factors in the uninsured, we examined whether states that had expanded Medicaid had a change in cardiovascular mortality rates after expansion, compared to states that have not expanded Medicaid.
Alzheimer's - Dementia, Author Interviews, End of Life Care, JAMA, University of Pennsylvania / 30.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48887" align="alignleft" width="180"]Emily Largent, PhD, JD, RNAssistant Professor, Medical Ethics and Health PolicyPerelman School of MedicineLeonard Davis Institute of Health EconomicsUniversity of Pennsylvania Dr. Largent[/caption] Emily Largent, PhD, JD, RN Assistant ProfessorMedical Ethics and Health Policy Perelman School of Medicine Leonard Davis Institute of Health Economics University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  Public support for aid in dying in the United States is rapidly growing.  As a result, we’re now seeing debates about whether to expand access to aid-in-dying to new populations – such as people with Alzheimer’s disease – who wouldn’t be eligible under current laws. With those debates in mind, we asked currently healthy people who recently learned about their risk for developing Alzheimer’s disease dementia (i.e., due to the presence of amyloid, an Alzheimer’s disease biomarker) whether they would be interested in aid-in-dying. Our findings suggest that about 20% of individuals with elevated amyloid may be interested in aid-in-dying if they become cognitively impaired.  
Author Interviews, Cost of Health Care, JAMA, University of Pennsylvania / 09.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44314" align="alignleft" width="180"]Amol Navathe, MD, PhD Assistant Professor, Health Policy and Medicine Perelman School of Medicine Penn Leonard Davis Institute of Health Economics Dr. Navathe[/caption] Amol Navathe, MD, PhD Assistant Professor, Health Policy and Medicine Perelman School of Medicine Penn Leonard Davis Institute of Health Economics MedicalResearch.com: What is the background for this study? What are the main findings? Response: Medicare’s voluntary Bundled Payments for Care Improvement (BPCI) initiative for lower extremity joint replacement (LEJR) surgery has been associated with reduced episode spending and stable-to-improved quality. However, BPCI may create unintended effects by prompting participating hospitals to increase the overall volume of episodes covered by Medicare. This could potentially eliminate Medicare-related savings or prompt hospitals to shift case mix to lower-risk patients. Among the Medicare beneficiaries who underwent LEJR, BPCI participation was not significantly associated with a change in market-level volume (difference-in-differences estimate . In non-BPCI markets, the mean quarterly market volume increased 3.8% from 3.8 episodes per 1000 beneficiaries before BPCI to 3.9 episodes per 1000 beneficiaries after BPCI was launched. In BPCI markets, the mean quarterly market volume increased 4.4% from 3.6 episodes per 1000 beneficiaries before BPCI to 3.8 episodes per 1000 beneficiaries after BPCI was launched. The adjusted difference-in-differences estimate between the market types was 0.32%. Among 20 demographic, socioeconomic, clinical, and utilization factors, BPCI participation was associated with changes in hospital-level case mix for only one factor, prior skilled nursing facility use in BPCI vs. non-BPCI markets.