This paper develops and implements a statistical methodology to account for the equilibrium effects (aka adverse selection) in design of risk adjustment formula in health insurance markets. Our setting is modeled on the situation in Medicare and the new state Exchanges where individuals sort...

Quality reports or profiles of health care providers are inevitably based on only a measurable subset of the ``outputs" of the organization. Hospitals, for example, are being profiled on their mortality in the cardiac area but not in some other areas where mortality does not seem to be the...

Using hospital and outpatient Medicare claims between 2006 and 2009, this cross-sectional study describes patterns of hospital and regional performance in the outcomes of elderly patients with pneumonia, a leading cause of hospitalization and death in this population. Risk-standardized 30-day...

We examine the use of fixed-effects and random-effects moment-based meta-analytic methods for analysis of binary adverse-event data. Special attention is paid to the case of rare adverse events that are commonly encountered in routine practice. We study estimation of model parameters and...

In 2009, the Centers for Medicare & Medicaid Services publicly reported hospital-level risk-standardized 30-day mortality and readmission rates after acute myocardial infarction (AMI) and heart failure (HF). The authors calculated 30-day mortality and readmission rates for all Medicare...

This article counters concerns that benefit expansion under parity would increase spending. The study finds that mental health parity provisions in the Federal Employees Health Benefits program reduced total out-of-pocket spending for patients with more-severe behavioral health conditions, while...