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Medicare Prescription Drug Benefit, Nonprofit Hospitals, Ambulatory Surgery Centers, Statistical Methods, and Pay-For-Performance Highlighted In the Latest INQUIRY Journal

ROCHESTER, N.Y., Sept. 13 /PRNewswire-USNewswire/ -- Summaries of the articles in the journal INQUIRY's recently-released Vol. 44, No. 2 issue:

"Will Part D Produce Savings in Part A and Part B? The Impact of Prescription Drug Coverage on Medicare Program Expenditures," by Bruce C. Stuart, Becky A. Briesacher, Jalpa A. Doshi, Marian V. Wrobel, and Fatima Baysac -- While prescription drug coverage significantly increases spending on medications, this study finds no consistent evidence of more or less Medicare spending for hospital or physician services. Thus it is unlikely that the Part D drug benefit will produce cost offsets in other areas of the Medicare program.

"Perverse Incentives in the Medicare Prescription Drug Benefit," by David McAdams and Michael Schwarz -- Because of unique risk adjustment problems, Medicare's drug benefit will require ongoing regulatory oversight, this analysis concludes. Alternatively, if all drug plans were required to charge the same premium, there would be less diversity in plan quality, but also less need to regulate formulary composition, less budgetary uncertainty, and less upward pressure on drug prices.

"Nurse Staffing, Mortality, and Length of Stay in For-Profit and Not-for- Profit Hospitals," by Barbara A. Mark and David W. Harless -- This study found that over the 1990-1995 period, case mix-adjusted staffing of registered nurses (RNs) was significantly lower in for-profit hospitals compared to nonprofit hospitals, and that for-profits had a better distribution of outcomes with fewer nurses. However, differences in patient mortality and length of stay disappeared after controlling for population and market characteristics.

"Paying Their Way? Do Nonprofit Hospitals Justify Their Favorable Tax Treatment?" by Helen Schneider -- Examining data on California hospitals, this study found that in similar markets, nonprofit hospitals supply an approximately equivalent amount of community benefits as investor-owned hospitals. Whether nonprofits justify their tax-exempt status depends on the definition of "community dividends," the author notes.

"Free-Standing Ambulatory Surgery Centers and Hospital Surgery Volume," by John Bian and Michael A. Morrisey -- This study found that from 1993 to 2001, the addition of one ambulatory surgery center (ASC) per 100,000 population in a metropolitan area was associated with 4.3 percent fewer hospital outpatient surgeries each year; ASCs had no effect on hospital inpatient procedures.

"Estimating Regression Standard Errors with Data from the Current Population Survey's Public Use File," by Michael Davern, Arthur Jones Jr., James Lepkowski, Gestur Davison, and Lynn A. Blewett -- This analysis evaluates three methods of estimating standard errors for use with the Current Population Survey's Annual Social and Economic Supplement.

"The McNerney Forum: Public Reporting and Pay-for-Performance: Safety-Net Hospital Executives' Concerns and Policy Suggestions," by L. Elizabeth Goldman, Stuart Henderson, Daniel P. Dohan, Jason A. Talavera, and R. Adams Dudley -- This article reports on interviews with California safety-net hospital (SNH) administrators, whose main concerns were that human and financial resource constraints impede the ability of SNHs to accurately measure their performance.

"The View from Here: Thoughts on Health Insurance Expansions and the Value of Coverage" -- INQUIRY's new editor, Alan Monheit, discusses the goals of improved health status and risk protection as they relate to expanding health insurance (Article available at ).

Recent release of note: Alan C. Monheit to succeed Katherine Swartz as INQUIRY editor -- Alan C. Monheit has been named the new editor of the health policy journal INQUIRY, succeeding Katherine Swartz, who has been the journal's editor for more than 11 years (release: ).

INQUIRY is a peer-reviewed scholarly publication. Now in its 44th year, it is published quarterly by Excellus Health Plan, Inc. Press releases and article abstracts are available at

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