Profiling resource use by primary-care practices: managed Medicare implications

Published: June 1, 1996
Category: Papers
Authors: Fowles J, Garnick DW, Lawthers AG, Palmer RH, Parente ST, Weiner JP
Country: United States
Language: null
Type: Population Health
Settings: Government, Hospital

Health Care Financ Rev 17:23-42.

Project HOPE Center for Health Affairs, Bethesda, MD, USA

Variations in elderly Medicare beneficiaries’ health service use are examined using a 100-percent sample of fee-for-service (FFS) claims data from Alabama, Iowa, and Maryland. Provider specialty, group practice type, practice size, and location are found to be significant factors affecting hospital and ambulatory care utilization and cost, after controlling for patient and regional characteristics. These results provide insights into utilization and cost expectations from different types of primary-care gatekeepers as the Medicare managed care market develops.

PMID: 10165710

Age,Practice Patterns Comparison,Payment,Resource Use,United States,Aged,Alabama,Fee-for-Service Plans,Health Services Research/methods,Insurance Claim Review,Iowa,Least-Squares Analysis,Maryland,Multivariate Analysis,Primary Health Care/economics,Referral and Consultation/utilization

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