L. Kurth, M. Casey, P. Schleiff, Cara N Halldin, J. Mazurek, D. Blackley
{"title":"联邦黑肺福利计划支付的医疗保险索赔:1999-2016年美国医疗保险受益人。","authors":"L. Kurth, M. Casey, P. Schleiff, Cara N Halldin, J. Mazurek, D. Blackley","doi":"10.1097/JOM.0000000000001745","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\nTo establish the burden of totally disabling respiratory impairment among coal miners, we identified the healthcare utilization and cost for Medicare claims where the Federal Black Lung Program (FBLP) was the primary payer.\n\n\nMETHODS\nWe extracted FBLP claims from 1999-2016 institutional Medicare data along with beneficiary, comorbidity, and claim cost information. Healthcare utilization was evaluated and compared to the 2016 Medicare population.\n\n\nRESULTS\nThe FBLP was the primary payer on 75,690 claims from 19,700 beneficiaries and paid an increasing percentage of the total paid to providers annually. Claims decreased from 1999-2016 but cost per claim increased. Beneficiaries were hospitalized and visited the ER for respiratory and cardiovascular conditions.\n\n\nCONCLUSIONS\nMedicare beneficiaries with FBLP primary payer claims have higher healthcare utilization and comorbidities compared to Medicare enrollees, indicative of increased financial and healthcare burden.","PeriodicalId":46545,"journal":{"name":"International Journal of Occupational and Environmental Medicine","volume":"71 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Medicare claims paid by the Federal Black Lung Benefits Program: U.S. Medicare Beneficiaries, 1999-2016.\",\"authors\":\"L. Kurth, M. Casey, P. Schleiff, Cara N Halldin, J. Mazurek, D. Blackley\",\"doi\":\"10.1097/JOM.0000000000001745\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\nTo establish the burden of totally disabling respiratory impairment among coal miners, we identified the healthcare utilization and cost for Medicare claims where the Federal Black Lung Program (FBLP) was the primary payer.\\n\\n\\nMETHODS\\nWe extracted FBLP claims from 1999-2016 institutional Medicare data along with beneficiary, comorbidity, and claim cost information. Healthcare utilization was evaluated and compared to the 2016 Medicare population.\\n\\n\\nRESULTS\\nThe FBLP was the primary payer on 75,690 claims from 19,700 beneficiaries and paid an increasing percentage of the total paid to providers annually. Claims decreased from 1999-2016 but cost per claim increased. Beneficiaries were hospitalized and visited the ER for respiratory and cardiovascular conditions.\\n\\n\\nCONCLUSIONS\\nMedicare beneficiaries with FBLP primary payer claims have higher healthcare utilization and comorbidities compared to Medicare enrollees, indicative of increased financial and healthcare burden.\",\"PeriodicalId\":46545,\"journal\":{\"name\":\"International Journal of Occupational and Environmental Medicine\",\"volume\":\"71 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Occupational and Environmental Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/JOM.0000000000001745\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Occupational and Environmental Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/JOM.0000000000001745","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
Medicare claims paid by the Federal Black Lung Benefits Program: U.S. Medicare Beneficiaries, 1999-2016.
OBJECTIVE
To establish the burden of totally disabling respiratory impairment among coal miners, we identified the healthcare utilization and cost for Medicare claims where the Federal Black Lung Program (FBLP) was the primary payer.
METHODS
We extracted FBLP claims from 1999-2016 institutional Medicare data along with beneficiary, comorbidity, and claim cost information. Healthcare utilization was evaluated and compared to the 2016 Medicare population.
RESULTS
The FBLP was the primary payer on 75,690 claims from 19,700 beneficiaries and paid an increasing percentage of the total paid to providers annually. Claims decreased from 1999-2016 but cost per claim increased. Beneficiaries were hospitalized and visited the ER for respiratory and cardiovascular conditions.
CONCLUSIONS
Medicare beneficiaries with FBLP primary payer claims have higher healthcare utilization and comorbidities compared to Medicare enrollees, indicative of increased financial and healthcare burden.