ArticleHealth affairs (Project Hope)2026
Pre-Claim Review And Traditional Medicare Home Health Spending: Evidence From 4 States.
Article in Health affairs (Project Hope), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
The Centers for Medicare and Medicaid Services (CMS) is increasingly experimenting with prior authorization in traditional Medicare. In 2016, CMS began using pre-claim review, a prior authorization-like system in which claims are reviewed after the service begins but before the claim is paid, for home health care in Illinois. Beginning in 2019, a modified demonstration program was also implemented in Florida, North Carolina, and Ohio. We studied the effect of pre-claim review on health care spending, using a synthetic control approach and Medicare claims data. Pre-claim review led to an immediate 13 percent decline in home health spending in Illinois, driven by declines in home health spending in Chicago and a decrease in the number of home health users in the state. Pre-claim review did not reduce spending in Florida, North Carolina, or Ohio. Our results suggest that pre-claim review can reduce health care spending in traditional Medicare, although effects may vary considerably across states.
Indexed as
Identifiers
What OpenQuestion holds
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.