Christopher C. Afendulis

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The availability of computed tomography (CT) and magnetic resonance imaging (MRI) scanning has grown rapidly, but the value of increased availability is not clear. We document the relationship between CT and MRI availability and use, and we consider potentially important sources of benefits. We discuss key questions that need to be addressed if value is to(More)
The proliferation of Medicare Advantage plans has given Medicare enrollees more choices, but these could be overwhelming for some, especially for those with impaired decision-making capabilities. We analyzed national survey data and linked Medicare enrollment data for the period 2004-07 to examine the effects on enrollment of expanded choices and benefits(More)
OBJECTIVE To obtain information about health outcomes in neonates in 9 subgroups of the Asian population in the United States. DESIGN Cross-sectional comparison of outcomes for births to mothers of Cambodian, Chinese, Filipino, Indian, Japanese, Korean, Laotian, Thai, and Vietnamese origin and for births to non-Hispanic white mothers. Regression models(More)
End-of-life medical expenses are a significant proportion of all health care expenditures. These costs were studied using costs of services from Medicare claims and cause of death (CoD) from death certificates. In the absence of a unique identifier linking the two datasets, common variables identified unique matches for only 33% of deaths. The remaining(More)
In the Medicare Advantage (MA) market, private health insurers compete to offer plans with the most attractive premium and benefit package. Medicare provides a subsidy, based on a \benchmark payment rate", for each Medicare beneficiary a plan enrolls. We investigate how this subsidy, the primary policy lever in the market, affects the equilibrium premiums(More)
OBJECTIVE To determine whether the change in prescription drug insurance coverage associated with Medicare Part D reduced hospitalization rates for conditions sensitive to drug adherence. DATA SOURCES/STUDY SETTING Hospital discharge data from 2005 to 2007 for 23 states, linked with state-level data on drug coverage. STUDY DESIGN We use a(More)
In 1998, Medicare adopted a per diem Prospective Payment System (PPS) for skilled nursing facility care, which was intended to deter the use of high-cost rehabilitative services. The average per diem decreased under the PPS, but because per diems increased for greater therapy minutes, the ability of the PPS to deter the use of high-intensity services was(More)
Anyone who has consulted a doctor, plumber, or auto mechanic has experienced the tradeoffs in consulting a single expert to both diagnose and treat a problem in the presence of asymmetric information. On one hand, integrated diagnosticians—those who also sell treatments—may have the incentive to give advice that is not in the buyer’s best interests. As the(More)
STUDY DESIGN Retrospective analysis of a population-based insurance claims data set. OBJECTIVE To determine the risk of repeat fusion and total costs associated with bone morphogenetic protein (BMP) use in single-level lumbar fusion for degenerative spinal disease. SUMMARY OF BACKGROUND DATA The use of BMP has been proposed to reduce overall costs of(More)
OBJECTIVE Many states expanded their Medicaid managed care programs during the 1990s, causing concern about impacts on health care for affected populations. We investigate the relationship between Medicaid managed care enrollment and health care for children. DATA SOURCES AND MEASURES: Repeated cross-sections of Medicaid-covered children under 18 years of(More)