Daniel Polsky
Dados Biográficos
| ID | 953382 |
|---|---|
| NOME | Daniel Polsky |
| PRENOMES | Daniel |
| SOBRENOME | Polsky |
| ASSINATURA | POLSKY D |
| AFILIAÇÕES | Johns Hopkins University |
| ORCID | 0000-0001-8403-9612 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 34 |
| TOTAL DE CITAÇÕES | 33 |
| TOTAL COMO AUTOR | 34 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1998 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 4 |
Variation in Annual Wellness Visit Use and Risk Scores Across Medicare Advantage Insurers
This cross-sectional study assesses the use of Medicare’s Annual Wellness Visits among older patients with Medicare Advantage and traditional Medicare coverage
Inertia, Market Power, and Adverse Selection in Health Insurance
We study how inertia interacts with market power and adverse selection in health insurance. We incorporate inertia into a model of plan selection and price competition, and estimate it using data from the California ACA exchange. We estimate inertia costs equaling 26% of average premiums. Our simulations indicate that inertia exacerbates market power, but has minimal interaction with selection. Eliminating inertia reduces average premiums by 6.6%…
Medicare-Covered Services Near the End of Life in Medicare Advantage vs Traditional Medicare
MA enrollment was associated with lower rates of potentially burdensome and facility-based care near the EOL. Greater use of home-based care may improve quality of care but may also leave patients without adequate assistance after hospitalization
Macular Degeneration Drug Prescribing Patterns After Step Therapy Introduction in Medicare Advantage
The findings of this retrospective encounter-based analysis indicate that step therapy is associated with a greater probability of prescribing the plan-preferred drug for the first administration. The analysis failed to find a statistically significant greater rate of medication switching within a treatment episode. Step therapy changed macular degeneration prescribing patterns, but step therapy alone did not transition all administrations to the…
Role of Patient Sorting in Avoidable Hospital Stays in Medicare Advantage vs Traditional Medicare
In this cross-sectional study of MA and TM beneficiaries, the lower rate of avoidable hospital stays among MA beneficiaries than TM beneficiaries was attributable to MA beneficiaries visiting clinicians with lower rates of avoidable hospital stays. The patient sorting that occurs in MA plays a critical role in the lower rates of avoidable hospital stays compared with TM
New Opportunities to Strengthen Medicaid Managed Care Network Adequacy Standards
This Viewpoint discusses new standards proposed by the Centers for Medicare & Medicaid Services for ensuring that Medicare managed care networks meet enrollees’ needs
MD EJSCREEN v2.0
Geographic information system tools analyze the environmental hazards and injustice throughout the United States. This article highlights the updated Maryland Environmental Justice Screening Tool (MD EJSCREEN v2.0), a state-specific resource for visualizing local environmental justice and health disparities in Maryland. Four new functions for screening and visualizing environmental justice indicators are described and demonstrated: the Select Fea…
Association of Private Equity Acquisition of Physician Practices With Changes in Health Care Spending and Utilization
In this difference-in-differences study, private equity acquisition of physician practices in dermatology, gastroenterology, and ophthalmology were associated with differential increases in allowed amount and charges per claim, volume of encounters, and new patients seen, as well as some changes in billing and coding
Geographic Variation in Private Equity Penetration Across Select Office-Based Physician Specialties in the US
This cross-sectional study examines geographic variations in private equity firm acquisitions of US physician practices across 6 specialties
The Growing Role of Chief Medical Officers in Major Corporations
This Viewpoint discusses the growing role of chief medical officers in major corporations and the need for medical schools and professional societies to develop educational programs that train physicians to fill this role
Physician Network Breadth and Plan Quality Ratings in Medicare Advantage
This cross-sectional study examines the extent of narrow networks across Medicare Advantage, types of counties where they are common, enrollment in narrow network plans, and how networks are associated with star ratings
Environmental Justice and the Mississippi Poultry Farming Industry
Mississippi's growing poultry business, including industrialized farms and meatpacking plants, raises a number of concerns regarding public health and environmental justice. Using hot spot analysis, we analyzed the totality of Mississippi's industrial poultry farms and meatpacking plants to assess whether these types of facilities were disproportionately sited in communities of color and/or low socioeconomic status communities at the census tract…
Acuity-based Scheduling in Primary Care
OBJECTIVES: Triage algorithms are ubiquitous in emergency care settings, but the extent of their use in primary care is unknown. This study asks whether primary care practices prioritize patients with more acute service needs. METHODS: We used an audit study in which simulated patients were randomized to 2 clinical scenarios-a new patient seeking a routine check-up or a new patient seeking treatment for newly diagnosed hypertension-and attempted …
Primary Care Appointment Availability for Medicaid Patients
BACKGROUND: Arkansas and Iowa received waivers from the federal government in 2014 to use federal Medicaid expansion funding to enroll beneficiaries in commercial insurance plans on the Marketplaces. One key hypothesis of these "private option" or "premium assistance" programs was that Medicaid beneficiaries would experience increased access to care. In this study, we compare new patient primary care appointment availability and wait-times for be…
Real-World Data
As real-world data (RWD) in health care begin to cross over to the Big Data realms, a panel of health economists was gathered to establish how well the current US policy environment further the goals of RWD and, if not, what can be done to improve matters. This report summarizes these discussions spanning the current US landscape of RWD availability and usefulness, private versus public development of RWD assets, the current inherent bias in term…
Real-World Data
Basu, Anirban PhD*; Axelsen, Kirsten MS†; Grabowski, David C. PhD‡; Meltzer, David O. MD, PhD§; Polsky, Daniel PhD∥; Ridley, David B. PhD¶; Wiederkehr, Daniel MPh†; Philipson, Tomas J. PhD# Author Information
High deductible health plans
OBJECTIVE: To determine whether increased cost sharing in health insurance plans induces higher levels of consumer sophistication in a non-elderly population. STUDY DESIGN: This analysis is based on the collection of survey and demographic data collected from enrollees in the RAND health insurance experiment (HIE). During the RAND HIE, enrollees were randomly assigned to different levels of cost sharing (0, 25, 50 and 95%). METHODS: The study pop…
Patient-centered Medical Homes and Access to Services for New Primary Care Patients
BACKGROUND: Recent efforts to revitalize primary care have centered on the patient-centered medical home (PCMH). Although enhanced access is an integral component of the PCMH model, the effect of PCMHs on access to primary care services is understudied. OBJECTIVE: To determine whether PCMH practices are associated with better access to new appointments for nonelderly adults by direct measurement. RESEARCH DESIGN: We estimated the relationship bet…
Prevalence and patterns of cooking dinner at home in the USA
Objective To measure the prevalence of cooking dinner at home in the USA and test whether home dinner preparation habits are associated with socio-economic status, race/ethnicity, country of birth and family structure. Design Cross-sectional analysis. The primary outcome, self-reported frequency of cooking dinner at home, was divided into three categories: 0–1 dinners cooked per week (‘never’), 2–5 (‘sometimes’) and 6–7 (‘always’). We used bivari…
Access Points for the Underserved
BACKGROUND: Federally Qualified Health Centers (FQHCs) are a vital source of primary care for underserved populations, such as Medicaid enrollees and the uninsured. Their role in delivering care may increase through new funding allocations in the Affordable Care Act and expanded Medicaid programs across many states. OBJECTIVE: Examine differences in appointment availability and wait-times for new patient visits between FQHCs and other providers. …
Geographic Variation in Implantable Cardioverter-Defibrillator Use and Heart Failure Survival
BACKGROUND: Implantable cardioverter-defibrillators and cardiac resynchronization therapy-defibrillators (ICD/CRT-Ds) are evidence-based preventative treatments for many patients with heart failure (HF), yet large numbers of eligible patients remain untreated. It is uncertain if localities with more frequent ICD/CRT-D use have had better rates of HF survival. OBJECTIVES: To determine if US Hospital Referral Regions (HRRs) with larger increases in…
Racial Differences in Surgeons and Hospitals for Endometrial Cancer Treatment
PURPOSE: To determine whether (1) black and white women with endometrial cancer were treated by different surgical specialties and in different types of hospitals and (2) differences in specialty and hospital type contributed to racial differences in survival. METHODS: Retrospective cohort study of 12,307 women aged 65 years and older who underwent surgical treatment of endometrial cancer between 1991 and 1999 in the 11 Surveillance Epidemiology …
Malpractice Premiums and the Supply of Obstetricians
Using longitudinal data on practicing obstetricians from 1998 to 2004 derived from Pennsylvania, Florida, and New York hospital discharge data, this study finds that rising malpractice premiums are associated with an increased rate of exit and a reduced rate of entry for obstetricians. In Pennsylvania and Florida, where premiums rose by an average of 20% per year for four years, the combined effect of more exits and fewer entries was associated w…
Polsky and Sochalski Respond
Trends in Characteristics and Country of Origin Among Foreign-Trained Nurses in the United States, 1990 and 2000
Objectives. We describe long-term trends in the characteristics of foreign-trained new entrants to the registered nurse (RN) workforce in the United States. Methods. Using the 1990 and 2000 US Census 5% Public Use Microdata Sample files, we compared trends in characteristics of US- and foreign-trained new entrants to the RN labor force (n=40827) and identified trends in the country of origin of the foreign-trained new entrants. Results. Foreign-t…
Factors affecting decisions to seek treatment for sick children in Kerala, India
Changing Consequences of Job Separation in the United States
Using the Panel Study of Income Dynamics, the author examines the consequences of job loss between the periods 1976-81 and 1986-91. He finds stability in the overall incidence of job separation, but a statistically significant increase in the incidence of involuntary job loss, relative to quits, for older workers. He also finds that the consequences of involuntary job loss worsened: the reemployment rate of workers who experienced involuntary job…
Trends in Characteristics and Country of Origin Among Foreign-Trained Nurses in the United States, 1990 and 2000
Objectives. We describe long-term trends in the characteristics of foreign-trained new entrants to the registered nurse (RN) workforce in the United States. Methods. Using the 1990 and 2000 US Census 5% Public Use Microdata Sample files, we compared trends in characteristics of US- and foreign-trained new entrants to the RN labor force (n=40827) and identified trends in the country of origin of the foreign-trained new entrants. Results. Foreign-t…
Changes in Veterans’ Use of Outpatient Care From 1992 to 2000
Objectives. During the mid-1990s, the Veterans Health Administration (VHA) reorganized and placed greater emphasis on high-quality primary care. To determine whether the reorganization was associated with changes in patterns of out-patient VHA use, we sought to evaluate changes in characteristics of veterans who use VHA outpatient services between 1992 and 2000. Methods. We merged 2 waves of the National Survey of Veterans to determine changes in…
Accounting for Apparent “Reverse” Racial Disparities in Department of Veterans Affairs (VA)–Based Medical Care
Conclusions regarding racial differences in care following a newly elevated prostate-specific antigen (PSA) test at the Department of Veterans Affairs (VA) may differ depending on whether follow-up care outside the VA is considered. Consecutive Philadelphia, Pa, VA patients with newly elevated PSA tests (n = 183) were interviewed 1 year after baseline. Among exclusive VA users, Blacks had higher rates of urology referrals and prostate biopsies co…
Health Maintenance Organization Penetration and the Practice Location Choices of New Physicians
Objectives. The rapid growth of health maintenance organizations is reshaping the practice opportunities available to physicians. The practice location decisions of new physicians provide a sensitive bellwether of these changes. This study assessed the effect of health maintenance organization penetration on practice location for physicians completing graduate medical education (GME). Methods. Conditional logit regression analysis was used to det…
Self-Reported Physician Specialties and the Primary Care Content of Medical Practice
BACKGROUND: Many internal medicine physicians report both primary and secondary specialties in the American Medical Association (AMA) Physician Masterfile. Usually, those represent combinations of general internal medicine and medical subspecialty practice. Whether reported specialty combinations can be used to assess the contribution of specialists to primary care is unknown. OBJECTIVES: To examine whether internists' primary and secondary speci…
Changing Consequences of Job Separation in the United States
Using the Panel Study of Income Dynamics, the author examines the consequences of job loss between the periods 1976-81 and 1986-91. He finds stability in the overall incidence of job separation, but a statistically significant increase in the incidence of involuntary job loss, relative to quits, for older workers. He also finds that the consequences of involuntary job loss worsened: the reemployment rate of workers who experienced involuntary job…
Patient Choice of Breast Cancer Treatment
BACKGROUND: Multiple treatment options exist for many medical conditions. The extent to which physicians should involve the patient in the choice the treatment to be delivered is not well understood. OBJECTIVE: To test the impact of breast cancer treatment choice on patients' health state preferences. DESIGN AND SETTING: A cohort from 29 hospitals (primarily referral centers) in Massachusetts, Texas, Washington DC, and New York. Subjects were sur…
Factors affecting decisions to seek treatment for sick children in Kerala, India
Accounting for Apparent “Reverse” Racial Disparities in Department of Veterans Affairs (VA)–Based Medical Care
Conclusions regarding racial differences in care following a newly elevated prostate-specific antigen (PSA) test at the Department of Veterans Affairs (VA) may differ depending on whether follow-up care outside the VA is considered. Consecutive Philadelphia, Pa, VA patients with newly elevated PSA tests (n = 183) were interviewed 1 year after baseline. Among exclusive VA users, Blacks had higher rates of urology referrals and prostate biopsies co…
Changes in Veterans’ Use of Outpatient Care From 1992 to 2000
Objectives. During the mid-1990s, the Veterans Health Administration (VHA) reorganized and placed greater emphasis on high-quality primary care. To determine whether the reorganization was associated with changes in patterns of out-patient VHA use, we sought to evaluate changes in characteristics of veterans who use VHA outpatient services between 1992 and 2000. Methods. We merged 2 waves of the National Survey of Veterans to determine changes in…
Polsky and Sochalski Respond
Trends in Characteristics and Country of Origin Among Foreign-Trained Nurses in the United States, 1990 and 2000
Objectives. We describe long-term trends in the characteristics of foreign-trained new entrants to the registered nurse (RN) workforce in the United States. Methods. Using the 1990 and 2000 US Census 5% Public Use Microdata Sample files, we compared trends in characteristics of US- and foreign-trained new entrants to the RN labor force (n=40827) and identified trends in the country of origin of the foreign-trained new entrants. Results. Foreign-t…
Polsky and Sochalski Respond
We appreciate the letter from Betlehem et al. and the information on the growth of educational opportunities for Hungarian nurses and the consequences of those efforts. The experience in Hungary confirms our analysis of nurses working in the United States: the skill level among nurses educated abroad is comparable to that of nurses educated in the United States. As the demand for university-trained nurses grows globally, countries like Hungary th…
Is Lower 30-Day Mortality Posthospital Admission Among Blacks Unique to the Veterans Affairs Health Care System
BACKGROUND: Several studies have reported lower risk-adjusted mortality for blacks than whites within the Veterans Affairs (VA) health care system, particularly for those age 65 and older. This finding may be a result of the VA's integrated health care system, which reduces barriers to care through subsidized comprehensive health care services. However, no studies have directly compared racial differences in mortality within 30 days of hospitaliz…
Malpractice Premiums and the Supply of Obstetricians
Using longitudinal data on practicing obstetricians from 1998 to 2004 derived from Pennsylvania, Florida, and New York hospital discharge data, this study finds that rising malpractice premiums are associated with an increased rate of exit and a reduced rate of entry for obstetricians. In Pennsylvania and Florida, where premiums rose by an average of 20% per year for four years, the combined effect of more exits and fewer entries was associated w…
Racial Differences in Surgeons and Hospitals for Endometrial Cancer Treatment
PURPOSE: To determine whether (1) black and white women with endometrial cancer were treated by different surgical specialties and in different types of hospitals and (2) differences in specialty and hospital type contributed to racial differences in survival. METHODS: Retrospective cohort study of 12,307 women aged 65 years and older who underwent surgical treatment of endometrial cancer between 1991 and 1999 in the 11 Surveillance Epidemiology …
Geographic Variation in Implantable Cardioverter-Defibrillator Use and Heart Failure Survival
BACKGROUND: Implantable cardioverter-defibrillators and cardiac resynchronization therapy-defibrillators (ICD/CRT-Ds) are evidence-based preventative treatments for many patients with heart failure (HF), yet large numbers of eligible patients remain untreated. It is uncertain if localities with more frequent ICD/CRT-D use have had better rates of HF survival. OBJECTIVES: To determine if US Hospital Referral Regions (HRRs) with larger increases in…
Prevalence and patterns of cooking dinner at home in the USA
Objective To measure the prevalence of cooking dinner at home in the USA and test whether home dinner preparation habits are associated with socio-economic status, race/ethnicity, country of birth and family structure. Design Cross-sectional analysis. The primary outcome, self-reported frequency of cooking dinner at home, was divided into three categories: 0–1 dinners cooked per week (‘never’), 2–5 (‘sometimes’) and 6–7 (‘always’). We used bivari…
Access Points for the Underserved
BACKGROUND: Federally Qualified Health Centers (FQHCs) are a vital source of primary care for underserved populations, such as Medicaid enrollees and the uninsured. Their role in delivering care may increase through new funding allocations in the Affordable Care Act and expanded Medicaid programs across many states. OBJECTIVE: Examine differences in appointment availability and wait-times for new patient visits between FQHCs and other providers. …
High deductible health plans
OBJECTIVE: To determine whether increased cost sharing in health insurance plans induces higher levels of consumer sophistication in a non-elderly population. STUDY DESIGN: This analysis is based on the collection of survey and demographic data collected from enrollees in the RAND health insurance experiment (HIE). During the RAND HIE, enrollees were randomly assigned to different levels of cost sharing (0, 25, 50 and 95%). METHODS: The study pop…
Patient-centered Medical Homes and Access to Services for New Primary Care Patients
BACKGROUND: Recent efforts to revitalize primary care have centered on the patient-centered medical home (PCMH). Although enhanced access is an integral component of the PCMH model, the effect of PCMHs on access to primary care services is understudied. OBJECTIVE: To determine whether PCMH practices are associated with better access to new appointments for nonelderly adults by direct measurement. RESEARCH DESIGN: We estimated the relationship bet…
Primary Care Appointment Availability for Medicaid Patients
BACKGROUND: Arkansas and Iowa received waivers from the federal government in 2014 to use federal Medicaid expansion funding to enroll beneficiaries in commercial insurance plans on the Marketplaces. One key hypothesis of these "private option" or "premium assistance" programs was that Medicaid beneficiaries would experience increased access to care. In this study, we compare new patient primary care appointment availability and wait-times for be…
Real-World Data
As real-world data (RWD) in health care begin to cross over to the Big Data realms, a panel of health economists was gathered to establish how well the current US policy environment further the goals of RWD and, if not, what can be done to improve matters. This report summarizes these discussions spanning the current US landscape of RWD availability and usefulness, private versus public development of RWD assets, the current inherent bias in term…
Real-World Data
Basu, Anirban PhD*; Axelsen, Kirsten MS†; Grabowski, David C. PhD‡; Meltzer, David O. MD, PhD§; Polsky, Daniel PhD∥; Ridley, David B. PhD¶; Wiederkehr, Daniel MPh†; Philipson, Tomas J. PhD# Author Information
Acuity-based Scheduling in Primary Care
OBJECTIVES: Triage algorithms are ubiquitous in emergency care settings, but the extent of their use in primary care is unknown. This study asks whether primary care practices prioritize patients with more acute service needs. METHODS: We used an audit study in which simulated patients were randomized to 2 clinical scenarios-a new patient seeking a routine check-up or a new patient seeking treatment for newly diagnosed hypertension-and attempted …
Physician Network Breadth and Plan Quality Ratings in Medicare Advantage
This cross-sectional study examines the extent of narrow networks across Medicare Advantage, types of counties where they are common, enrollment in narrow network plans, and how networks are associated with star ratings
Environmental Justice and the Mississippi Poultry Farming Industry
Mississippi's growing poultry business, including industrialized farms and meatpacking plants, raises a number of concerns regarding public health and environmental justice. Using hot spot analysis, we analyzed the totality of Mississippi's industrial poultry farms and meatpacking plants to assess whether these types of facilities were disproportionately sited in communities of color and/or low socioeconomic status communities at the census tract…
MD EJSCREEN v2.0
Geographic information system tools analyze the environmental hazards and injustice throughout the United States. This article highlights the updated Maryland Environmental Justice Screening Tool (MD EJSCREEN v2.0), a state-specific resource for visualizing local environmental justice and health disparities in Maryland. Four new functions for screening and visualizing environmental justice indicators are described and demonstrated: the Select Fea…
Medicine (27 obras) · Family medicine (17 obras) · Healthcare Policy and Management (16 obras) · Health care (14 obras) · Political science (13 obras) · Business (12 obras) · Environmental health (12 obras) · Economics (11 obras) · Primary Care and Health Outcomes (11 obras) · Population (10 obras)