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Biomedical subjects

Bruce C Vladeck

Publications and source records attributed to Bruce C Vladeck.

8 recordsLinked to original sources
PubMed2004

Everything new is old again.

For more than thirty years, John Wennberg and his colleagues have been documenting variations in patterns of health care use from one community to the next, which are not explained by illness or demographic patterns. Twenty years ago Health Affairs devoted an issue to a symposium on this work, and it is striking how little some things have changed in the intervening years. In fact, there have been enormous changes in physicians' behavior and patterns of medical practice, but our cost problems seem as intractable as ever, perhaps because policymakers continue to focus erroneously on the relationship between use and costs.

Delivery of Health Care↗
PubMedDate not supplied

Where the action really is: Medicaid and the disabled.

Discussions of Medicaid tend to focus on low-income children and their mothers and the institutionalized elderly as the principal beneficiaries, but Medicaid spends more on the nonelderly disabled than on any other group. In the past two decades Medicaid has helped finance the deinstitutionalization of the mentally retarded and a growing proportion of the mentally ill, but implementation of the Olmstead decision has deflected advocates' attention from the more important issue of how managed care plans treat disabled Medicaid beneficiaries.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Ineffective approach.

Explore the source record for details and available documents.

Health Care Reform↗
PubMedDate not supplied

Avoidance of health care services because of cost: impact of the medicare savings program.

The Qualified Medicare Beneficiary (QMB) program, part of the Medicare Savings Program, provides Medicare premium and cost-sharing assistance to low-income beneficiaries but has low participation rates. We examined the potential for QMB coverage to reduce the avoidance of health care services because of cost among low-income seniors in eight states. Only one-third of eligible seniors participated. Adjusted for demographics and health status, QMB enrollees were half as likely as nonenrollees to avoid physician visits because of cost. Despite its potential to improve access to primary care, the QMB program is underused. Future policy and research efforts should address low participation rates.

Aged↗