Studies from Brigham and Women’s Hospital Further Understanding of Medicare and Medicaid (The Association Between Medicare Eligibility and Gains in…

Studies from Brigham and Women's Hospital Further Understanding of Medicare and Medicaid (The Association Between Medicare Eligibility and Gains in Access to Rehabilitative Care A National Regression Discontinuity Assessment of Patients Ages 64 ...)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- New research on Medicare and Medicaid is the subject of a report. According to news reporting originating in Boston, Massachusetts, by NewsRx journalists, research stated, "The aims of this study were to assess for changes in uninsured rates among trauma patients at age 64 versus 65 years and whether there are associated changes in post-discharge rehabilitation; determine whether changes are driven by rehabilitation provided at home, skilled nursing facilities (SNFs), or acute inpatient facilities; and determine whether changes vary among stratified subgroups of trauma-related 'best-practice'' factors. Rehabilitation is an important component of high-quality trauma systems with access heavily influenced by insurance status."

The news reporters obtained a quote from the research from Brigham and Women's Hospital, "In the wake of policy changes affecting insurance coverage, it remains unknown the extent to which insurance changes associate with variations in rehabilitation access/use among otherwise similar patients. Regression discontinuity models were used to assess for changes in insurance status and rehabilitation at age 64 versus 65 years among adults ages 54 to 75 years (+/- 10 years age-related Medicare eligibility). Data were extracted from the 2007-2012 National Trauma Data Bank. A total of 305,198 patients were included; 40.1% were discharged to rehabilitation. Medicare eligibility was associated with an abrupt 6.4 (95% confidence interval: 5.8-7.0) percentage-point decline in uninsured and a 9.6 (95% confidence interval: 6.5-12.6) percentage-point increase in rehabilitation at age 64 versus 65 years, enabling an additional 1-in-10 patients to access rehabilitation. Differences were driven by SNF use and were greatest among patients with less-severe clinical presentations. Restriction based on Medicare-payment eligibility to patients with length of stay >= 3days (SNF requirement) and >= 1 'presumptive diagnosis codes'' (inpatient facilities' 60% rule) demonstrated abrupt gains in both SNF and inpatient care. The results reveal the magnitude of changes in access to rehabilitation associated with changes in insurance coverage at age 65 years."

According to the news reporters, the research concluded: "Use of quasiexperimental models enabled meaningful consideration of health-policy change."

For more information on this research see: The Association Between Medicare Eligibility and Gains in Access to Rehabilitative Care A National Regression Discontinuity Assessment of Patients Ages 64 Versus 65 Years. Annals of Surgery, 2017;265(4):734-742. Annals of Surgery can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Annals of Surgery - journals.lww.com/annalsofsurgery/pages/default.aspx)

Our news correspondents report that additional information may be obtained by contacting A.H. Haider, Brigham & Women's Hospital, Div Trauma Burn & Surg Crit Care, Boston, MA, United States. Additional authors for this research include J.W. Scott, D. Metcalfe, A.J. Seshadri, T.C. Tsai, W.A. Davis, J.A. Rose, O.A. Olufajo, S.N. Zafar, A. Salim and A.H. Haider (see also Medicare and Medicaid).

Keywords for this news article include: Boston, Massachusetts, United States, North and Central America, Medicare and Medicaid, Health Policy, Medicare, Brigham and Women's Hospital.

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