So Limpa-Amara - Academia.edu (original) (raw)

Papers by So Limpa-Amara

Research paper thumbnail of Results from the 2003 and 2004 Targeted Beneficiary Surveys on Access to Physician Services Among Medicare Beneficiaries

Mathematica Policy Research Reports, 2005

Research paper thumbnail of Societal cost of nine selected maternal morbidities in the United States

PLOS ONE

Objective To estimate the cost of maternal morbidity for all 2019 pregnancies and births in the U... more Objective To estimate the cost of maternal morbidity for all 2019 pregnancies and births in the United States. Methods Using data from 2010 to 2020, we developed a cost analysis model that calculated the excess cases of outcomes attributed to nine maternal morbidity conditions with evidence of outcomes in the literature. We then modeled the associated medical and nonmedical costs of each outcome incurred by birthing people and their children in 2019, projected through five years postpartum. Results We estimated that the total cost of nine maternal morbidity conditions for all pregnancies and births in 2019 was 32.3billionfromconceptiontofiveyearspostpartum,amountingto32.3 billion from conception to five years postpartum, amounting to 32.3billionfromconceptiontofiveyearspostpartum,amountingto8,624 in societal costs per birthing person. Conclusion We found only nine maternal morbidity conditions with sufficient supporting evidence of linkages to outcomes and costs. The lack of comprehensive data for other conditions suggests that maternal morbidity exacts a higher toll on society than we found. P...

Research paper thumbnail of The High Costs of Maternal Morbidity Show Why We Need Greater Investment in Maternal Health

Policy and system reforms could reduce costs of maternal morbidity and shape the social factors a... more Policy and system reforms could reduce costs of maternal morbidity and shape the social factors affecting quality of life for birthing people and their children.

Research paper thumbnail of Results from the 2003 Targeted Beneficiary Survey on Access to Physician Services Among Medicare Beneficiaries

Research Papers in Economics, Jun 17, 2004

Research paper thumbnail of The PHS 340B Drug Pricing Program: Results of a Survey of Eligible Entities

Mathematica Policy Research Reports, 2004

Research paper thumbnail of The Demand for Dialysis Care in Vermont: 2005-2014

Mathematica Policy Research Reports, 2005

Analyzing the demand for dialysis care in Vermont over the next 10 years, Mathematica’s researc... more Analyzing the demand for dialysis care in Vermont over the next 10 years, Mathematica’s researchers found that demand will grow between 75 and 136 percent; most state dialysis centers will be oversubscribed by 2014 even with the addition of a new center in Newport; the addition of a Newport center aids in reducing travel time in some counties, but travel time would still exceed 60 minutes for a couple of counties (the standard specified in Vermont’s certificate of need guideline); and the number and proportion of patients projected to receive dialysis treatment out of state will increase steadily over time. Consequently, Vermont may have to consider further expansion of capacity to meet potential growth in demand.

Research paper thumbnail of Diabetes Prevalence, Outcomes, and Preventive Services Among Maryland Medicare Beneficiaries

This study was a joint effort of the MHCC and the DHMH, Center for Preventive Health Services. Fu... more This study was a joint effort of the MHCC and the DHMH, Center for Preventive Health Services. Funding came from MHCC and from DHMH's diabetes prevention and control cooperative agreement with the Centers for Disease Control and Prevention (CDC). The ...

Research paper thumbnail of Results from the 2003 Targeted Beneficiary Survey on Access to Physician Services Among Medicare Beneficiaries. Cambridge, MA: Mathematica Policy Research

Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in ... more Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in some areas may have problems obtaining needed care in a timely manner. This report suggests that these reductions have not led to marked restrictions in access to care, even though the study examined geographic areas thought most likely to be experiencing difficulties. However, access problems are more common for certain subgroups that may be especially vulnerable to change, including those who had recently moved or changed insurance coverage.

Research paper thumbnail of Racial Disparities in Hospitalizations for Ambulatory Care–Sensitive Conditions

American Journal of Preventive Medicine, 2010

Background: Variation in the quality of ambulatory care may be a key factor in explaining dispari... more Background: Variation in the quality of ambulatory care may be a key factor in explaining disparities in health, and these disparities have large cost implications. Purpose: This study identifıed differences in hospitalization rates for elderly African-American and white Marylanders for eight ambulatory care-sensitive conditions (ACSCs). It assessed the relative contribution of race to disparities in preventable hospitalizations after controlling for demographic and socioeconomic factors as well as underlying prevalence. It also estimated the excess cost associated with these disparities. Methods: Using prevention quality indicator specifıcations from the Agency for Healthcare and Research Quality applied to 2006 Medicare claims data, eight ACSC hospitalization measures were developed for 569,896 Maryland Medicare benefıciaries. The analysis was conducted in 2008. A Poisson regression model identifıed race, age, gender, and income as factors associated with differences in ACSC hospitalization rates. Excess costs were estimated from excess hospitalizations of African Americans and the median cost per admission. Results: African Americans had signifıcantly higher rates of ACSC hospitalizations than whites for fıve of eight conditions after controlling for demographic, socioeconomic, and geographic factors. Excess costs from disparities in quality ranged from 8million(heartfailure)to8 million (heart failure) to 8million(heartfailure)to38,000 (urinary tract infection). Conclusions: Race may be a key predictor of preventable hospitalizations for some ACSCs. Racial disparities in these hospitalizations represent excess costs to Medicare. Because ACSC admissions are potentially preventable with optimal ambulatory care, improving care for minority populations may reduce disparities and lower hospital costs.

Research paper thumbnail of The Demand for Dialysis Care in Vermont: 2005-2014. Cambridge, MA: Mathematica Policy Research

Analyzing the demand for dialysis care in Vermont over the next 10 years, Mathematica’s researc... more Analyzing the demand for dialysis care in Vermont over the next 10 years, Mathematica’s researchers found that demand will grow between 75 and 136 percent; most state dialysis centers will be oversubscribed by 2014 even with the addition of a new center in Newport; the addition of a Newport center aids in reducing travel time in some counties, but travel

Research paper thumbnail of SCHIP at 10: A Synthesis of the Evidence on Substitution of SCHIP for Other Coverage

Final report submitted …, 2007

Executive Summary Purpose. As the State Children's Health Insurance Program (SCHIP) faces re... more Executive Summary Purpose. As the State Children's Health Insurance Program (SCHIP) faces reauthorization in 2007, it is timely to review evidence from the past decade on the extent of substitution of SCHIP for private coverage. This report synthesizes and assesses ...

Research paper thumbnail of National Evaluation of the State Children's Health Insurance Program: A Decade of Expanding Coverage and Improving Access

… , MA: Mathematica Policy …, 2007

This project would not have been possible without the contributions of many MPR staff, both past ... more This project would not have been possible without the contributions of many MPR staff, both past and present, at various points in the project. Marilyn Ellwood led the early analyses on SCHIP enrollment and, more recently, contributed her insights as an internal reviewer. We value her guidance and consultation immensely. Judith Wooldridge reviewed drafts of many reports produced under this project, and we are grateful for her time, effort, and wisdom. Over the course of this project, many researchers, programmers, analysts, and research assistants have helped with different aspects of the evaluation. We thank each of them for their support over the years:

Research paper thumbnail of The PHS 340B Drug Pricing Program: Results of a Survey of Eligible Entities. Cambridge, MA: Mathematica Policy Research

Escalating drug prices have affected safety net providers in serious ways. This report studies pr... more Escalating drug prices have affected safety net providers in serious ways. This report studies providers eligible to purchase prescription drugs at a discount under the 340B program, which requires manufacturers that receive reimbursement from Medicaid to provide reduced prices to more than 10,000 qualified health care clinics, centers, and hospitals in the U.S. These providers in turn serve more than 10 million people in all 50 states. The findings suggest that the program has led to significant savings and a high level of satisfaction for providers enrolled in it. In its absence, providers would probably serve fewer patients, charge higher prices for prescription drugs, and incur greater losses.

Research paper thumbnail of Results from the 2003 Targeted Beneficiary Survey on Access to Physician Services Among Medicare Beneficiaries. Cambridge, MA: Mathematica Policy Research

Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in ... more Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in some areas may have problems obtaining needed care in a timely manner. This report suggests that these reductions have not led to marked restrictions in access to care, even though the study examined geographic areas thought most likely to be experiencing difficulties. However, access problems are more common for certain subgroups that may be especially vulnerable to change, including those who had recently moved or changed insurance coverage.

Research paper thumbnail of Results from the 2003 and 2004 Targeted Beneficiary Surveys on Access to Physician Services Among Medicare Beneficiaries

Mathematica Policy Research Reports, 2005

Research paper thumbnail of Societal cost of nine selected maternal morbidities in the United States

PLOS ONE

Objective To estimate the cost of maternal morbidity for all 2019 pregnancies and births in the U... more Objective To estimate the cost of maternal morbidity for all 2019 pregnancies and births in the United States. Methods Using data from 2010 to 2020, we developed a cost analysis model that calculated the excess cases of outcomes attributed to nine maternal morbidity conditions with evidence of outcomes in the literature. We then modeled the associated medical and nonmedical costs of each outcome incurred by birthing people and their children in 2019, projected through five years postpartum. Results We estimated that the total cost of nine maternal morbidity conditions for all pregnancies and births in 2019 was 32.3billionfromconceptiontofiveyearspostpartum,amountingto32.3 billion from conception to five years postpartum, amounting to 32.3billionfromconceptiontofiveyearspostpartum,amountingto8,624 in societal costs per birthing person. Conclusion We found only nine maternal morbidity conditions with sufficient supporting evidence of linkages to outcomes and costs. The lack of comprehensive data for other conditions suggests that maternal morbidity exacts a higher toll on society than we found. P...

Research paper thumbnail of The High Costs of Maternal Morbidity Show Why We Need Greater Investment in Maternal Health

Policy and system reforms could reduce costs of maternal morbidity and shape the social factors a... more Policy and system reforms could reduce costs of maternal morbidity and shape the social factors affecting quality of life for birthing people and their children.

Research paper thumbnail of Results from the 2003 Targeted Beneficiary Survey on Access to Physician Services Among Medicare Beneficiaries

Research Papers in Economics, Jun 17, 2004

Research paper thumbnail of The PHS 340B Drug Pricing Program: Results of a Survey of Eligible Entities

Mathematica Policy Research Reports, 2004

Research paper thumbnail of The Demand for Dialysis Care in Vermont: 2005-2014

Mathematica Policy Research Reports, 2005

Analyzing the demand for dialysis care in Vermont over the next 10 years, Mathematica’s researc... more Analyzing the demand for dialysis care in Vermont over the next 10 years, Mathematica’s researchers found that demand will grow between 75 and 136 percent; most state dialysis centers will be oversubscribed by 2014 even with the addition of a new center in Newport; the addition of a Newport center aids in reducing travel time in some counties, but travel time would still exceed 60 minutes for a couple of counties (the standard specified in Vermont’s certificate of need guideline); and the number and proportion of patients projected to receive dialysis treatment out of state will increase steadily over time. Consequently, Vermont may have to consider further expansion of capacity to meet potential growth in demand.

Research paper thumbnail of Diabetes Prevalence, Outcomes, and Preventive Services Among Maryland Medicare Beneficiaries

This study was a joint effort of the MHCC and the DHMH, Center for Preventive Health Services. Fu... more This study was a joint effort of the MHCC and the DHMH, Center for Preventive Health Services. Funding came from MHCC and from DHMH's diabetes prevention and control cooperative agreement with the Centers for Disease Control and Prevention (CDC). The ...

Research paper thumbnail of Results from the 2003 Targeted Beneficiary Survey on Access to Physician Services Among Medicare Beneficiaries. Cambridge, MA: Mathematica Policy Research

Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in ... more Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in some areas may have problems obtaining needed care in a timely manner. This report suggests that these reductions have not led to marked restrictions in access to care, even though the study examined geographic areas thought most likely to be experiencing difficulties. However, access problems are more common for certain subgroups that may be especially vulnerable to change, including those who had recently moved or changed insurance coverage.

Research paper thumbnail of Racial Disparities in Hospitalizations for Ambulatory Care–Sensitive Conditions

American Journal of Preventive Medicine, 2010

Background: Variation in the quality of ambulatory care may be a key factor in explaining dispari... more Background: Variation in the quality of ambulatory care may be a key factor in explaining disparities in health, and these disparities have large cost implications. Purpose: This study identifıed differences in hospitalization rates for elderly African-American and white Marylanders for eight ambulatory care-sensitive conditions (ACSCs). It assessed the relative contribution of race to disparities in preventable hospitalizations after controlling for demographic and socioeconomic factors as well as underlying prevalence. It also estimated the excess cost associated with these disparities. Methods: Using prevention quality indicator specifıcations from the Agency for Healthcare and Research Quality applied to 2006 Medicare claims data, eight ACSC hospitalization measures were developed for 569,896 Maryland Medicare benefıciaries. The analysis was conducted in 2008. A Poisson regression model identifıed race, age, gender, and income as factors associated with differences in ACSC hospitalization rates. Excess costs were estimated from excess hospitalizations of African Americans and the median cost per admission. Results: African Americans had signifıcantly higher rates of ACSC hospitalizations than whites for fıve of eight conditions after controlling for demographic, socioeconomic, and geographic factors. Excess costs from disparities in quality ranged from 8million(heartfailure)to8 million (heart failure) to 8million(heartfailure)to38,000 (urinary tract infection). Conclusions: Race may be a key predictor of preventable hospitalizations for some ACSCs. Racial disparities in these hospitalizations represent excess costs to Medicare. Because ACSC admissions are potentially preventable with optimal ambulatory care, improving care for minority populations may reduce disparities and lower hospital costs.

Research paper thumbnail of The Demand for Dialysis Care in Vermont: 2005-2014. Cambridge, MA: Mathematica Policy Research

Analyzing the demand for dialysis care in Vermont over the next 10 years, Mathematica’s researc... more Analyzing the demand for dialysis care in Vermont over the next 10 years, Mathematica’s researchers found that demand will grow between 75 and 136 percent; most state dialysis centers will be oversubscribed by 2014 even with the addition of a new center in Newport; the addition of a Newport center aids in reducing travel time in some counties, but travel

Research paper thumbnail of SCHIP at 10: A Synthesis of the Evidence on Substitution of SCHIP for Other Coverage

Final report submitted …, 2007

Executive Summary Purpose. As the State Children's Health Insurance Program (SCHIP) faces re... more Executive Summary Purpose. As the State Children's Health Insurance Program (SCHIP) faces reauthorization in 2007, it is timely to review evidence from the past decade on the extent of substitution of SCHIP for private coverage. This report synthesizes and assesses ...

Research paper thumbnail of National Evaluation of the State Children's Health Insurance Program: A Decade of Expanding Coverage and Improving Access

… , MA: Mathematica Policy …, 2007

This project would not have been possible without the contributions of many MPR staff, both past ... more This project would not have been possible without the contributions of many MPR staff, both past and present, at various points in the project. Marilyn Ellwood led the early analyses on SCHIP enrollment and, more recently, contributed her insights as an internal reviewer. We value her guidance and consultation immensely. Judith Wooldridge reviewed drafts of many reports produced under this project, and we are grateful for her time, effort, and wisdom. Over the course of this project, many researchers, programmers, analysts, and research assistants have helped with different aspects of the evaluation. We thank each of them for their support over the years:

Research paper thumbnail of The PHS 340B Drug Pricing Program: Results of a Survey of Eligible Entities. Cambridge, MA: Mathematica Policy Research

Escalating drug prices have affected safety net providers in serious ways. This report studies pr... more Escalating drug prices have affected safety net providers in serious ways. This report studies providers eligible to purchase prescription drugs at a discount under the 340B program, which requires manufacturers that receive reimbursement from Medicaid to provide reduced prices to more than 10,000 qualified health care clinics, centers, and hospitals in the U.S. These providers in turn serve more than 10 million people in all 50 states. The findings suggest that the program has led to significant savings and a high level of satisfaction for providers enrolled in it. In its absence, providers would probably serve fewer patients, charge higher prices for prescription drugs, and incur greater losses.

Research paper thumbnail of Results from the 2003 Targeted Beneficiary Survey on Access to Physician Services Among Medicare Beneficiaries. Cambridge, MA: Mathematica Policy Research

Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in ... more Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in some areas may have problems obtaining needed care in a timely manner. This report suggests that these reductions have not led to marked restrictions in access to care, even though the study examined geographic areas thought most likely to be experiencing difficulties. However, access problems are more common for certain subgroups that may be especially vulnerable to change, including those who had recently moved or changed insurance coverage.