Deborah A Freund
Biographic Data
| ID | 5535301 |
|---|---|
| NAME | Deborah A Freund |
| GIVEN NAMES | Deborah A |
| FAMILY NAME | Freund |
| SIGNATURE | FREUND D A |
| AFFILIATIONS | University of North Carolina at Chapel Hill |
| VERIFIED | No |
| TOTAL WORKS | 21 |
| TOTAL CITATIONS | 27 |
| AUTHOR COUNT | 21 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1980 |
| LATEST PUBLICATION YEAR | 2019 |
| H-INDEX | 1 |
Medical Practice Consolidation and Physician Shared Patient Network Size, Strength, and Stability
BACKGROUND: Properties of social networks and shared patient networks of physicians are associated with important outcomes, including costs, quality, information exchange, and organizational effectiveness. OBJECTIVES: To determine whether practice consolidation affects size, strength, and stability of US practice-based physician shared patient networks. RESEARCH DESIGN: We used a dynamic difference-in-differences (event study) design to determine…
Racial Disparities in Service Use among Medicaid Beneficiaries after Mandatory Enrollment in Managed Care: A Difference-in-Differences Approach
Managed care may improve access to health care to previously underserved populations when providers need plan enrollees. However, capitation and utilization management often give providers the incentive to withhold care. Managed care organizations have yet to demonstrate that racial disparities in treatment are not exacerbated. Using Medicaid eligibility, claims, and managed care encounter data, we examine racial disparities in service use among …
A Longitudinal Evaluation of the Effect of Medi-Cal Managed Care on Supplemental Security Income and Aid to Families With Dependent Children Enrollees in Two California Counties
OBJECTIVE: We examined the differential effect of Medicaid managed care (MMC) among Aid to Families With Dependent Children (AFDC) and Supplemental Security Income (SSI) enrollees over time by comparing the experiences of adult nonelderly enrollees in the Health Plan of San Mateo in California versus Ventura County's fee-for-service (FFS) enrollees. RESEARCH DESIGN: Four years of administrative claims data were used to construct a longitudinal da…
Physician Enthusiasm As an Explanation for Area Variation in the Utilization of Knee Replacement Surgery
BACKGROUND: Explanations for regional variation in the use of many medical and surgical treatments is controversial. OBJECTIVES: To identify factors that might be amenable to intervention, we investigated the determinants of regional variation in the use of knee replacement surgery. RESEARCH DESIGN: We examined the effect of the following factors: characteristics and opinions of surgeons; family physicians and rheumatologists; patients' severity …
Revision Rates After Knee Replacement in the United States
OBJECTIVES: Each year approximately 100,000 Medicare patients undergo knee replacement surgery. Patients, referring physicians, and surgeons must consider a variety of factors when deciding if knee replacement is indicated. One factor in this decision process is the likelihood of revision knee replacement after the initial surgery. This study determined the chance that a revision knee replacement will occur and which factors were associated with …
Costing Medical Care: Using Medicare Administrative Data
This paper describes how the PORTS are using data from the Medicare administrative records systems to study the medical care costs of specific conditions. The general strengths and weaknesses of the Medicare databases for studying cost related issues are discussed, and the relevant data elements are examined in detail. Changes in the nature of the data collected over time are noted. Information is provided on how the PORTS are using these data to…
Managed Care for Children and Pregnant Women: Promises and Pitfalls
VB. Influence of Organizational Components on the Delivery of Asthma Care
The documented growing morbidity, mortality, and disability from asthma indicate a failure in effective delivery of appropriate care. This article reviews how different components of organizational technology in hospitals, free-standing emergency centers, physician practices, prepaid groups, and schools may be linked to asthma care and asthma outcomes. A framework to address how practice patterns, risk factors, and outcomes relate to organization…
Emergency room use and primary care case management: Evidence from four Medicaid demonstration programs
Claims-based utilization data collected in four Medicaid demonstration programs are used to examine the impact of primary care case management on patterns of reliance on the emergency room as a source of services. The experience of stratified random samples of AFDC (Aid to Families with Dependent Children) adults and children in the demonstration programs is compared with that of equivalent samples from comparison groups in traditional Medicaid p…
The Treatment of Patients with Asthma by Specialists and Generalists
The authors investigated possible differences between specialists and generalists in the intensity with which they treat patients with asthma by studying the care of 283 patients between the ages of six and 40 provided by 13 allergists and 40 randomly selected physicians in two primary care specialties: pediatrics and family practice. After excluding patients with more than one physician, allergists' patients were nearly identical to primary care…
A Typology of Medicaid Managed Care
This article presents a typology for use in classifying and interpreting the findings of the growing empirical literature on managed care initiatives in the Medicaid program. Six key program attributes are identified for use in examining similarities and differences among these programs. Several alternative arrangements for each attribute are described from among the more than 60 different programs attempted. The typology is illustrated with five…
The Health Care Survival Curve: Competition and Cooperation in the Marketplace
The Interferon Crusade
Orphan Drugs: Medical vs. Market Value
Medicaid Reform: Four Studies of Case Management
Preferred Provider Organizations: Planning Structure and Operations
Health Care Cost Management: Private Sector Initiatives
Hospital Capital Formation in the 1980's
An evaluation of subsidized rural primary care programs: IV. Impact of the rural hospital on clinic self-sufficiency
Subsidized rural clinics and providers have long depended on the rural hospital for the care of some of their patients; the hospital has also been a source of revenue for these providers and programs. We studied a representative national sample of 116 subsidized rural clinics, focusing on the impact on rural clinic costs and revenues of the use of the hospital by the clinics' providers. Both clinic costs and revenue are reduced by the use of the …
Factors Affecting Physicians?? Choice to Practice in a Fee-for- Service Setting Versus an Individual Practice Association
Individual Practice Associations (IPAs) must be able to recruit physicians from the community to compete in the future. This article reports the results of a study to assess the factors that influenced physicians in the Research Triangle area of North Carolina to join a primary care network type of IPA. Results indicate that physicians with lower incomes and fewer physician visits and those who were newly established in the community were more li…
Health Care Economics
1Assistant Professor, Department of Health Administration, University of North Carolina at Chapel Hill 2Assistant Professor, Departments of Health Services and Economics, University of Washington
Emergency room use and primary care case management: Evidence from four Medicaid demonstration programs
Claims-based utilization data collected in four Medicaid demonstration programs are used to examine the impact of primary care case management on patterns of reliance on the emergency room as a source of services. The experience of stratified random samples of AFDC (Aid to Families with Dependent Children) adults and children in the demonstration programs is compared with that of equivalent samples from comparison groups in traditional Medicaid p…
Managed Care for Children and Pregnant Women: Promises and Pitfalls
The Interferon Crusade
Hospital Capital Formation in the 1980's
An evaluation of subsidized rural primary care programs: IV. Impact of the rural hospital on clinic self-sufficiency
Subsidized rural clinics and providers have long depended on the rural hospital for the care of some of their patients; the hospital has also been a source of revenue for these providers and programs. We studied a representative national sample of 116 subsidized rural clinics, focusing on the impact on rural clinic costs and revenues of the use of the hospital by the clinics' providers. Both clinic costs and revenue are reduced by the use of the …
Health Care Economics
1Assistant Professor, Department of Health Administration, University of North Carolina at Chapel Hill 2Assistant Professor, Departments of Health Services and Economics, University of Washington
The Health Care Survival Curve: Competition and Cooperation in the Marketplace
The Interferon Crusade
Orphan Drugs: Medical vs. Market Value
Medicaid Reform: Four Studies of Case Management
Preferred Provider Organizations: Planning Structure and Operations
Health Care Cost Management: Private Sector Initiatives
Hospital Capital Formation in the 1980's
An evaluation of subsidized rural primary care programs: IV. Impact of the rural hospital on clinic self-sufficiency
Subsidized rural clinics and providers have long depended on the rural hospital for the care of some of their patients; the hospital has also been a source of revenue for these providers and programs. We studied a representative national sample of 116 subsidized rural clinics, focusing on the impact on rural clinic costs and revenues of the use of the hospital by the clinics' providers. Both clinic costs and revenue are reduced by the use of the …
Factors Affecting Physicians?? Choice to Practice in a Fee-for- Service Setting Versus an Individual Practice Association
Individual Practice Associations (IPAs) must be able to recruit physicians from the community to compete in the future. This article reports the results of a study to assess the factors that influenced physicians in the Research Triangle area of North Carolina to join a primary care network type of IPA. Results indicate that physicians with lower incomes and fewer physician visits and those who were newly established in the community were more li…
A Typology of Medicaid Managed Care
This article presents a typology for use in classifying and interpreting the findings of the growing empirical literature on managed care initiatives in the Medicaid program. Six key program attributes are identified for use in examining similarities and differences among these programs. Several alternative arrangements for each attribute are described from among the more than 60 different programs attempted. The typology is illustrated with five…
Emergency room use and primary care case management: Evidence from four Medicaid demonstration programs
Claims-based utilization data collected in four Medicaid demonstration programs are used to examine the impact of primary care case management on patterns of reliance on the emergency room as a source of services. The experience of stratified random samples of AFDC (Aid to Families with Dependent Children) adults and children in the demonstration programs is compared with that of equivalent samples from comparison groups in traditional Medicaid p…
The Treatment of Patients with Asthma by Specialists and Generalists
The authors investigated possible differences between specialists and generalists in the intensity with which they treat patients with asthma by studying the care of 283 patients between the ages of six and 40 provided by 13 allergists and 40 randomly selected physicians in two primary care specialties: pediatrics and family practice. After excluding patients with more than one physician, allergists' patients were nearly identical to primary care…
Managed Care for Children and Pregnant Women: Promises and Pitfalls
VB. Influence of Organizational Components on the Delivery of Asthma Care
The documented growing morbidity, mortality, and disability from asthma indicate a failure in effective delivery of appropriate care. This article reviews how different components of organizational technology in hospitals, free-standing emergency centers, physician practices, prepaid groups, and schools may be linked to asthma care and asthma outcomes. A framework to address how practice patterns, risk factors, and outcomes relate to organization…
Costing Medical Care: Using Medicare Administrative Data
This paper describes how the PORTS are using data from the Medicare administrative records systems to study the medical care costs of specific conditions. The general strengths and weaknesses of the Medicare databases for studying cost related issues are discussed, and the relevant data elements are examined in detail. Changes in the nature of the data collected over time are noted. Information is provided on how the PORTS are using these data to…
Revision Rates After Knee Replacement in the United States
OBJECTIVES: Each year approximately 100,000 Medicare patients undergo knee replacement surgery. Patients, referring physicians, and surgeons must consider a variety of factors when deciding if knee replacement is indicated. One factor in this decision process is the likelihood of revision knee replacement after the initial surgery. This study determined the chance that a revision knee replacement will occur and which factors were associated with …
Physician Enthusiasm As an Explanation for Area Variation in the Utilization of Knee Replacement Surgery
BACKGROUND: Explanations for regional variation in the use of many medical and surgical treatments is controversial. OBJECTIVES: To identify factors that might be amenable to intervention, we investigated the determinants of regional variation in the use of knee replacement surgery. RESEARCH DESIGN: We examined the effect of the following factors: characteristics and opinions of surgeons; family physicians and rheumatologists; patients' severity …
A Longitudinal Evaluation of the Effect of Medi-Cal Managed Care on Supplemental Security Income and Aid to Families With Dependent Children Enrollees in Two California Counties
OBJECTIVE: We examined the differential effect of Medicaid managed care (MMC) among Aid to Families With Dependent Children (AFDC) and Supplemental Security Income (SSI) enrollees over time by comparing the experiences of adult nonelderly enrollees in the Health Plan of San Mateo in California versus Ventura County's fee-for-service (FFS) enrollees. RESEARCH DESIGN: Four years of administrative claims data were used to construct a longitudinal da…
Racial Disparities in Service Use among Medicaid Beneficiaries after Mandatory Enrollment in Managed Care: A Difference-in-Differences Approach
Managed care may improve access to health care to previously underserved populations when providers need plan enrollees. However, capitation and utilization management often give providers the incentive to withhold care. Managed care organizations have yet to demonstrate that racial disparities in treatment are not exacerbated. Using Medicaid eligibility, claims, and managed care encounter data, we examine racial disparities in service use among …
Medical Practice Consolidation and Physician Shared Patient Network Size, Strength, and Stability
BACKGROUND: Properties of social networks and shared patient networks of physicians are associated with important outcomes, including costs, quality, information exchange, and organizational effectiveness. OBJECTIVES: To determine whether practice consolidation affects size, strength, and stability of US practice-based physician shared patient networks. RESEARCH DESIGN: We used a dynamic difference-in-differences (event study) design to determine…
Business (13 works) · Healthcare Policy and Management (13 works) · Medicine (13 works) · Family medicine (10 works) · Health care (10 works) · Economics (7 works) · Computer Science (5 works) · Economic growth (5 works) · Medicaid (5 works) · Primary Care and Health Outcomes (5 works)