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  • The Effects of Arthroscopy for Symptomatic Femoroacetabular Impingement on Quality of Life and Economic Outcomes

    In collaboration with Dr. Richard Mather III, we examined the societal and economic impact of hip arthroscopy in patients with femoroacetabular impingement (FAI) syndrome under 50 years old. This study used a Markov decision model to assess the cost-effectiveness of hip arthroscopy compared to non-operative treatment. To populate the Markov decision model, we used literature review to determine utilities and other model assumptions. Direct cost estimates were calculated using a private insurance claims dataset within the PearlDriver Patient Records Database and indirect cost estimates were derived from the National Health Interview Survey and patient-reported outcomes collected from two FAI surgeons. Using the information collected, we calculated the incremental cost effectiveness ratio for the two treatment strategies. One, two and three-way sensitivity analyses were performed for all variables and a Monte Carlo simulation was used to assess uncertainty in the model assumptions. Our analysis found that hip arthroscopy provides economic benefits and reduces economic burden on society through indirect cost savings.

    Services : Health Economics & Outcomes Research Expertise: ,

    In collaboration with Dr. Richard Mather III, we examined the societal and economic impact of hip arthroscopy in patients with femoroacetabular impingement (FAI) syndrome under 50 years old. This study used a Markov decision model to assess the cost-effectiveness of hip arthroscopy compared to non-operative treatment. To populate the Markov decision model, we used literature

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  • Assessing the Utilization of Total Ankle Replacement in the United States

    Utilization of total ankle replacement (TAR) has increased in the United States over the last 20 years. In collaboration with Dr. Sudheer Reddy, we investigated the variation in TAR utilization across hospitals and hospital characteristics associated with that variation. We primarily focused on inpatient costs as it related to primary TAR. Data from the Nationwide Inpatient Sample was used to examine description statistics on all TAR patients. We used Medicare Inpatient Limited Data Sets and cost reports to calculate overall hospital all-payer margins and cost-to-charge ratios associated with overall services and “implantable devices” to compute the cost of surgery and the prosthesis, respectively. We found a significant financial burden on utilizing TAR as many health systems have been unable to generate profits despite an increased number of surgeries.

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    Services : Advanced Data Analytics Expertise:

    Utilization of total ankle replacement (TAR) has increased in the United States over the last 20 years. In collaboration with Dr. Sudheer Reddy, we investigated the variation in TAR utilization across hospitals and hospital characteristics associated with that variation. We primarily focused on inpatient costs as it related to primary TAR. Data from the Nationwide

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  • Skilled Nursing Facility Demand Projections and Market Analyses

    Skilled Nursing Facilities (SNFs) provide short-term skilled nursing care and rehabilitation services. As a critical sector of post-acute care (PAC), SNF spending accounted for 8% of all Medicare fee for service (FFS) spending in 2015, and over 20% of hospitalized FFS beneficiaries were discharged to SNFs. In this study, we estimated SNF occupancy using SNF cost reports, and we examined SNF beds and availability of other PAC providers using Provider of Service (POS) files and cost reports. We characterized Medicare FFS beneficiaries in SNFs using inpatient standard analytic files. We projected 2018-2022 Medicare SNF days at the county and MSA level using proprietary county-level population projections, projection of growth in Medicare Advantage (MA) penetration, and estimates of SNF utilization for Medicare FFS and MA. Nationally, the number of SNF days is projected to increase by 10.5% between 2018 and 2022, despite the per capita rate falling by 1.5%, accounting for the impact of projected trends in socio-demographic factors in the Medicare population and projected changes in MA penetration. Our study also an examination of SNF days in five states:  Florida, Illinois, Michigan, Ohio, and Pennsylvania. Our estimates vary by state, ranging from a 12.1% increase in total SNF days in Florida to s 9.0% increase in Pennsylvania. Per capita SNF day rates are projected to fall in all selected states.

    Services : Advanced Data Analytics Expertise: ,

    Skilled Nursing Facilities (SNFs) provide short-term skilled nursing care and rehabilitation services. As a critical sector of post-acute care (PAC), SNF spending accounted for 8% of all Medicare fee for service (FFS) spending in 2015, and over 20% of hospitalized FFS beneficiaries were discharged to SNFs. In this study, we estimated SNF occupancy using SNF

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  • Explaining Hospital Charge Variation for Members of America’s Essential Hospitals: The Role of Mark-ups and Underlying Costs

    In a changing healthcare environment in which providers are under increasing demands to demonstrate their value, providers with above-average prices are likely to face increased scrutiny.  In this study, we examined three research questions: How do the average charges for patients at America’s Essential Hospitals (AEH) member hospitals compare to other hospitals?; To what extent are these charge differences driven by differences in underlying costs?; What factors cause cost differences between AEH hospitals and other hospitals and among AEH member hospitals? We found that higher charges among AEH member hospitals are explained by higher costs, which in turn are explained by the intensive services these facilities provide and the environment in which they provide them.  If other hospitals operated under similar circumstances, the data suggests the costs would be similar, and the charges would be even higher than the current average charges among AEH members.

    Services : Advanced Data Analytics Expertise: , ,

    In a changing healthcare environment in which providers are under increasing demands to demonstrate their value, providers with above-average prices are likely to face increased scrutiny.  In this study, we examined three research questions: How do the average charges for patients at America’s Essential Hospitals (AEH) member hospitals compare to other hospitals?; To what extent

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  • Diagnosing Certain Conditions with Ultrasound over Other Technologies Can Save Money

    For certain types of conditions, different imaging technologies may serve as substitutes for one another. Rotator cuff tears, for example, can be diagnosed with ultrasound or magnetic resonance imaging (MRI).  Because both imaging technologies have been shown to be effective in diagnosing this type of injury, relative cost becomes an important consideration.  KNG Health conducted two studies to examine the potential cost savings to the Medicare program from the substitution of ultrasound for MRI and computed tomography (CT) in diagnosing certain musculoskeletal (MSK) conditions and renal colic. Cost-saving estimates were developed using Medicare claims data and assumptions relating to the use of diagnostic ultrasound, MRI, and CT in the Medicare population.  The studies found that using ultrasound over CT and MRI in diagnosing MSK conditions and renal colic would result in significant cost savings.

    Services : Advanced Data Analytics Expertise:

    For certain types of conditions, different imaging technologies may serve as substitutes for one another. Rotator cuff tears, for example, can be diagnosed with ultrasound or magnetic resonance imaging (MRI).  Because both imaging technologies have been shown to be effective in diagnosing this type of injury, relative cost becomes an important consideration.  KNG Health conducted

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  • Characteristics and Cost Drivers of High-Cost Hospitals

    A 2008 report produced by the Medicare Payment Advisory Commission (MedPAC) found that 20% of hospitals had consistently higher costs than other hospitals.  KNG Health identified key characteristics and cost drivers for those hospitals classified by MedPAC as high-cost hospitals.  The study compared low and high-cost hospitals across a number of dimensions, including hospital-wide and Medicare-specific cost factors, quality measures, and overall Medicare spending per beneficiary.  The study shows that, generally, high-cost hospitals have higher costs across multiple factors, but performed better on process-of-care quality measures than low-cost hospitals.

    Services : Advanced Data Analytics Expertise:

    A 2008 report produced by the Medicare Payment Advisory Commission (MedPAC) found that 20% of hospitals had consistently higher costs than other hospitals.  KNG Health identified key characteristics and cost drivers for those hospitals classified by MedPAC as high-cost hospitals.  The study compared low and high-cost hospitals across a number of dimensions, including hospital-wide and

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