HCMG EXAM 2 (2024)
LATEST QUESTIONS
WITH COMPLETE
SOLUTIONS, GRADED
A+
HCMG
Evatee 8/15/24 HCMG
,HCMG EXAM 2 (2024) LATEST QUESTIONS
WITH COMPLETE SOLUTIONS, GRADED A+
Association of Medicaid Expansion with Qualify in Safety Net Hospitals
(Chatterjee, Werner)
Research Question Answer - This study uses differeence in differences to
compare changes in quality of SNHs in states that expanded medicaid
compared to those that did not
Data Source Answer - Rand Corporation Healthcare Provider Cost Reporting
Information System (HCRIS) from 2010 to 2018
American Hospital Associations Annual Survey to characterise hospital
resources and services
The Center of Medicare & Medicaid Services (CMS) Hospital Compare database
Key Findings Answer - SNHs in expansion states were bigger, for profit, higher
income and urban areas
we found no statistically significant differential changes in patient reported
experience, health care associated infections, readmissions, or mortality
between SSNHs in expansion and non expansion states
,uncompensated care decline more among SNHs in expansion states than non
expansion states
Limitations Answer - no universal definition of an SNH
Definition of quality may be limited as it focused on measures that improved
among some hospitals after incentivization
medicaid expansion may have simultaneous downstream consequences that
affect hospital care, limiting out ability to detect changes in quality
SNHs may have used resources in other ways that increase quality (staffing)
policy implications Answer - local and state subsidies used to support these
hospitals are emerging as an area of importance. The CMS might also consider
additional funding for SNHs
Ongoing challenges may be the result of anticipated withdrawals of Medicaid
disproportionate share hospital payments
State Nurse Practitioner Practice Regulations and US Health Care Delivery
Outcomes: A systematic review ( Yang, Johantgen, Trinkoff)
Research Question Answer - Examine the effect of NP practice regulations on a
broader array of US health care delivery outcomes
Data source Answer - 1,051 studies screened for quality, components, time,
location etc
, Key Findings Answer - FPA associated with higher number of NPs in rural area
of primary care, where there is a shortage of physicians
FPA positively associated with access to care and health service utilization,
especially in primary care settings
- more routine checkups, screenings (mammograms), education, prescriptions
- no difference in opioid and benzodiazepine prescription
Care quality / outcomes was not affected by FPA
- hospital readmissions, reduced opioid and mental health mortality, increased
patient reported quality
More NP supply, autonomy, and practicing primary care, less in nursing homes
limitations Answer - data examining the policy effects were mostly from
national / state level surveys or claims, which can increase risk of
misidentification bias for NP practice
unable to conduct a quantitative data synthesis due to heterogeneity of NP
practice regulation measures and analyses used across studies
most studies published prior to 2018 used cross sectional study designs
policy implications Answer - providing further support for regulations that
allow NPs to have FPA
Effects of Health Care payment Models on Physician Practice In the United
States - Friedbrug, Chen, White
LATEST QUESTIONS
WITH COMPLETE
SOLUTIONS, GRADED
A+
HCMG
Evatee 8/15/24 HCMG
,HCMG EXAM 2 (2024) LATEST QUESTIONS
WITH COMPLETE SOLUTIONS, GRADED A+
Association of Medicaid Expansion with Qualify in Safety Net Hospitals
(Chatterjee, Werner)
Research Question Answer - This study uses differeence in differences to
compare changes in quality of SNHs in states that expanded medicaid
compared to those that did not
Data Source Answer - Rand Corporation Healthcare Provider Cost Reporting
Information System (HCRIS) from 2010 to 2018
American Hospital Associations Annual Survey to characterise hospital
resources and services
The Center of Medicare & Medicaid Services (CMS) Hospital Compare database
Key Findings Answer - SNHs in expansion states were bigger, for profit, higher
income and urban areas
we found no statistically significant differential changes in patient reported
experience, health care associated infections, readmissions, or mortality
between SSNHs in expansion and non expansion states
,uncompensated care decline more among SNHs in expansion states than non
expansion states
Limitations Answer - no universal definition of an SNH
Definition of quality may be limited as it focused on measures that improved
among some hospitals after incentivization
medicaid expansion may have simultaneous downstream consequences that
affect hospital care, limiting out ability to detect changes in quality
SNHs may have used resources in other ways that increase quality (staffing)
policy implications Answer - local and state subsidies used to support these
hospitals are emerging as an area of importance. The CMS might also consider
additional funding for SNHs
Ongoing challenges may be the result of anticipated withdrawals of Medicaid
disproportionate share hospital payments
State Nurse Practitioner Practice Regulations and US Health Care Delivery
Outcomes: A systematic review ( Yang, Johantgen, Trinkoff)
Research Question Answer - Examine the effect of NP practice regulations on a
broader array of US health care delivery outcomes
Data source Answer - 1,051 studies screened for quality, components, time,
location etc
, Key Findings Answer - FPA associated with higher number of NPs in rural area
of primary care, where there is a shortage of physicians
FPA positively associated with access to care and health service utilization,
especially in primary care settings
- more routine checkups, screenings (mammograms), education, prescriptions
- no difference in opioid and benzodiazepine prescription
Care quality / outcomes was not affected by FPA
- hospital readmissions, reduced opioid and mental health mortality, increased
patient reported quality
More NP supply, autonomy, and practicing primary care, less in nursing homes
limitations Answer - data examining the policy effects were mostly from
national / state level surveys or claims, which can increase risk of
misidentification bias for NP practice
unable to conduct a quantitative data synthesis due to heterogeneity of NP
practice regulation measures and analyses used across studies
most studies published prior to 2018 used cross sectional study designs
policy implications Answer - providing further support for regulations that
allow NPs to have FPA
Effects of Health Care payment Models on Physician Practice In the United
States - Friedbrug, Chen, White
