Background: Before the COVID-19 pandemic, telemedicine for healthcare delivery was uncommon. Medicare restricted routine fee-for-service reimbursements for rural patients, with payments made under restricted circumstances. In response to the pandemic, the Department of HHS amended the Coronavirus Preparedness and Response Supplemental…

This interpretative phenomenological analysis explored licensed professional counselors' experiences of turning away Medicare beneficiaries because of the current Medicare mental health policy. Researchers used semi-structured interviews to explore the client-level barriers created by federal legislation that determines professional counselors as…

Estimating prescription medicine use is challenging due to recall bias associated with surveys and coverage bias in administrative data. This study assesses how making operational improvements and combining both survey and administrative data sources can increase data quality on filled prescriptions. We use data from the Medicare Current…

The authors analyzed data from 5,528 American Counseling Association members to examine advocacy beliefs and behavior regarding Medicare reimbursement and advocacy for counselors. Nearly half (49.3%) of the respondents had participated in one or more forms of Medicare reimbursement advocacy. Advocacy participation differed significantly by…

While the medical home has proven effective at improving continuity of care among other populations, there is a paucity of literature testing the effectiveness of medical homes in serving the healthcare needs of autistic adults. We conducted a retrospective cohort study to compare the continuity of care of autistic adult patients at a specialized…

Little is known about the extent to which the healthcare needs of autistic older adults with intellectual disability differ from autistic older adults without intellectual disability. We conducted a cross-sectional retrospective cohort study of Medicare claims data from 2016 to 2017 to compare the prevalence of physical and mental health…

The National Association of School Nurses (NASN) believes school nursing services that are reimbursed in other healthcare environments should also be reimbursed in the school setting. The registered professional school nurse (hereinafter referred to as the school nurse) bridges education and healthcare and delivers quality, cost-effective…

In May 2023, the Centers for Medicare and Medicaid Services (CMS) released new guidance on school Medicaid that is a clear victory for school health and student health. It affirms that states have flexibility in their school-based Medicaid program to allow school districts to bill Medicaid for health services delivered to all Medicaid-enrolled…

Medicare began reimbursing for outpatient diabetes self-management training (DSMT) in 2000; however, little is known about program utilization. Individuals diagnosed with diabetes in 2010 were identified from a 20% random selection of the Medicare fee-for-service population (N = 110,064). Medicare administrative and claims files were used to…

Inpatient hospitalizations for ambulatory care sensitive conditions (ACSC) among beneficiaries with and without intellectual and developmental disabilities (IDD) were examined using Medicaid and commercial claims from 2010-2014 in New Hampshire. IDD was defined with "International Classification of Diseases, Ninth Edition, Clinical…

Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…

This article describes the development of a service-learning project and analysis of student pharmacists' participation therein. Using a mixed-methods approach, this study analyzed student pharmacists' knowledge and attitudes after volunteering in the inaugural Medicare Outreach Program, a collaboration between the School of Pharmacy and State…

We examine the effect of gaining prescription drug insurance, as a result of Medicare Part D, on use of prescription drugs and other medical services for a nationally representative sample of Medicare beneficiaries. Given the heightened importance of prescription drugs for those with chronic illness, we provide separate estimates for elderly in…

Many adults with intellectual and/or developmental disabilities (IDD) can access health and long-term services and supports (LTSS) through Medicaid. States are reforming their Medicaid LTSS programs from a fee-for-service model to a Medicaid managed LTSS (MLTSS) approach, anticipating improved quality of care and reduced costs, although there is…

House Republicans passed a bill that would dismantle the Affordable Care Act (ACA), the current health care insurance plan provided to low income families. The non-Partisan Congressional Budget Office reviewed the legislation, and has determined that if some portion of the legislation is also passed by the Senate, it would leave 14 million more…