Evidence map›Paper›PMID 31479364›Full record

ArticleHealth affairs (Project Hope)2019

Spending On Postacute Care After Hospitalization In Commercial Insurance And Medicare Around Age Sixty-Five.

Scott E Regenbogen, Anne H Cain-Nielsen, John D Syrjamaki, Lena M Chen, Edward C Norton

Registry-linked trialAbstract read
In one paragraph

Article in Health affairs (Project Hope), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07281638 (Bedside Bike Early Mobilization Program for Inpatients), which is not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07281638 nawithdrawnnot on this mapstarted 2026, after this paper: background citation

Bedside Bike Early Mobilization Program for Inpatients

TypeinterventionalSponsorIndiana UniversityRan2026 to 2026Enrolled0ConditionsImmobility Syndrome, Deep Venous Thrombosis, Delirium, Hospital Acquired ConditionArmsBedside Bike
3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Scott E RegenbogenScott E. Regenbogen ( sregenbo@med.umich.edu ) is an associate professor in the Department of Surgery and Center for Healthcare Outcomes and Policy, University of Michigan, in Ann Arbor.
Anne H Cain-NielsenAnne H. Cain-Nielsen is a lead statistician in the Department of Surgery and Center for Healthcare Outcomes and Policy, University of Michigan.
John D SyrjamakiJohn D. Syrjamaki is associate program manager and a senior analyst in the Michigan Value Collaborative, in Ann Arbor.
Lena M ChenLena M. Chen was an associate professor in the Department of Internal Medicine, University of Michigan.
Edward C NortonEdward C. Norton is a professor of health management and policy in the School of Public Health and a professor in the Department of Economics, University of Michigan.

Funding

UNDERSTANDING AND IMPROVING EPISODE-BASED HOSPITAL CAREP01AG019783 · NIA · DARTMOUTH COLLEGE · PI Alistair James O'MALLEY · 2001 to 2026
$52.9M
"Enhanced Recovery" Protocols and the Cost and Quality of Inpatient SurgeryK08AG047252 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI REGENBOGEN, SCOTT ELLIS · 2015 to 2019
$712k
Toward More Effective "Enhanced Recovery" Protocols for Major Surgery in Older AdR03AG047860 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI REGENBOGEN, SCOTT ELLIS · 2014 to 2015
$229k
AHRQ HHS R01 HS024698NIA NIH HHS K08 AG047252NIA NIH HHS P01 AG019783NIA NIH HHS R03 AG047860
6 · The paper itself

Abstract

Postacute care costs are the primary determinant of episode spending around hospitalization. Yet there is little evidence that greater spending on postacute care improves readmission rates or functional recovery. Recent Medicare payment reform evaluations have suggested that postacute care spending is responsive to episode-based incentives. However, it remains unknown whether Medicare payment policies are responsible for excess postacute care spending, compared with that of commercial payers. In a population-based, statewide collaborative of Michigan hospitals, we used regression discontinuity design among propensity-weighted, age-adjusted cohorts to compare postacute care spending between patients with commercial insurance and those with Medicare around age sixty-five. Spending was 68-230 percent greater among fee-for-service Medicare beneficiaries than among similar commercially insured people across varied medical and surgical conditions. Despite greater spending, there were no differences in readmission rates. These findings suggest that postacute care utilization is highly sensitive to payer influence, and there may be an opportunity for additional savings in Medicare without sacrificing quality.

Indexed as

HospitalizationInsurance CoverageInsurance, HealthMedicareAgedHealth ExpendituresHumansMichiganMiddle AgedPatient DischargeRegression AnalysisSubacute CareUnited Statesbundled paymentsepisode-based reimbursementinsurance designpost-acute careregression-discontinuityreimbursement reform

Identifiers

PMID31479364
PMCPMC7795720

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.