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  1. Article ; Online: Notice of Retraction and Replacement. Ryan and Markovitz. Estimated Savings From the Medicare Shared Savings Program. JAMA Health Forum. 2023;4(12):e234449.

    Ryan, Andrew M

    JAMA health forum

    2024  Volume 5, Issue 4, Page(s) e240043

    Language English
    Publishing date 2024-04-05
    Publishing country United States
    Document type Journal Article
    ISSN 2689-0186
    ISSN (online) 2689-0186
    DOI 10.1001/jamahealthforum.2024.0043
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Factor in Fear

    Alexandru Strugariu / Ryan Andrew Martin

    Animals, Vol 13, Iss 1264, p

    Interference Competition in Polymorphic Spadefoot Toad Tadpoles and Its Potential Role in Disruptive Selection

    2023  Volume 1264

    Abstract: Disruptive selection arises when extreme phenotypes have a fitness advantage compared to more-intermediate phenotypes. Theory and evidence suggest that intraspecific resource competition is a key driver of disruptive selection. However, while competition ...

    Abstract Disruptive selection arises when extreme phenotypes have a fitness advantage compared to more-intermediate phenotypes. Theory and evidence suggest that intraspecific resource competition is a key driver of disruptive selection. However, while competition can be indirect (exploitative) or direct (interference), the role of interference competition in disruptive selection has not been tested, and most models of disruptive selection assume exploitative competition. We experimentally investigated whether the type of competition affects the outcome of competitive interactions using a system where disruptive selection is common: Mexican spadefoot toads ( Spea multiplicata ). Spea tadpoles develop into alternative resource-use phenotypes: carnivores, which consume fairy shrimp and other tadpoles, and omnivores, which feed on algae and detritus. Tadpoles intermediate in phenotype have low fitness when competition is intense, as they are outcompeted by the specialized tadpoles. Our experiments revealed that the presence of carnivores significantly decreased foraging behavior in intermediate tadpoles, and that intermediate tadpoles had significantly lower growth rates in interference competition treatments with carnivores but not with omnivores. Interference competition may therefore be important in driving disruptive selection. As carnivore tadpoles are also cannibalistic, the ‘fear’ effect may have a greater impact on intermediate tadpoles than exploitative competition alone, similarly to non-consumptive effects in predator–prey or intraguild relationships.
    Keywords anuran ; competition ; disruptive selection ; diversification ; fear ; phenotypic plasticity ; Veterinary medicine ; SF600-1100 ; Zoology ; QL1-991
    Subject code 303
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: Factor in Fear: Interference Competition in Polymorphic Spadefoot Toad Tadpoles and Its Potential Role in Disruptive Selection.

    Strugariu, Alexandru / Martin, Ryan Andrew

    Animals : an open access journal from MDPI

    2023  Volume 13, Issue 7

    Abstract: Disruptive selection arises when extreme phenotypes have a fitness advantage compared to more-intermediate phenotypes. Theory and evidence suggest that intraspecific resource competition is a key driver of disruptive selection. However, while competition ...

    Abstract Disruptive selection arises when extreme phenotypes have a fitness advantage compared to more-intermediate phenotypes. Theory and evidence suggest that intraspecific resource competition is a key driver of disruptive selection. However, while competition can be indirect (exploitative) or direct (interference), the role of interference competition in disruptive selection has not been tested, and most models of disruptive selection assume exploitative competition. We experimentally investigated whether the type of competition affects the outcome of competitive interactions using a system where disruptive selection is common: Mexican spadefoot toads (
    Language English
    Publishing date 2023-04-06
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2606558-7
    ISSN 2076-2615
    ISSN 2076-2615
    DOI 10.3390/ani13071264
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Estimated Savings From the Medicare Shared Savings Program.

    Ryan, Andrew M / Markovitz, Adam A

    JAMA health forum

    2023  Volume 4, Issue 12, Page(s) e234449

    Abstract: Importance: The Medicare Shared Savings Program (MSSP) is the largest and most important alternative payment model that has been implemented by the Centers for Medicare & Medicaid Services (CMS). Its budgetary impact to CMS is not well understood.: ... ...

    Abstract Importance: The Medicare Shared Savings Program (MSSP) is the largest and most important alternative payment model that has been implemented by the Centers for Medicare & Medicaid Services (CMS). Its budgetary impact to CMS is not well understood.
    Objective: To evaluate the association between the MSSP and net savings to CMS for performance years 2013 to 2021.
    Design, setting, and participants: The economic evaluation used publicly reported data on the MSSP from April 1, 2012, to December 31, 2021, and estimates extracted from 2 prior studies.
    Main outcomes and measures: Net savings to CMS, calculated as the difference between incentive payments to MSSP accountable care organizations and gross spending reductions. Incentive payments were calculated using the publicly reported data. The association of the MSSP with gross medical spending in traditional Medicare was extracted from 2 prior studies. Spillovers of the MSSP to Medicare Advantage (MA) were estimated by evaluating how gross spending reductions from the MSSP impacted benchmark payments to MA plans. Savings from traditional Medicare and MA were then combined.
    Results: The MSSP was associated with net losses to traditional Medicare of between $584 million and $1.423 billion over the study period. Savings from MSSP-related reductions to MA benchmarks totaled between $4.480 billion and $4.923 billion. Across traditional Medicare and MA, the MSSP was associated with savings of between $3.057 billion and $4.339 billion. This represents approximately 0.075% of combined spending for traditional Medicare and MA over the study period.
    Conclusions and relevance: This economic evaluation found that the MSSP was associated with net losses to traditional Medicare, net savings to MA, and overall net savings to CMS. The total budget impact of the MSSP to CMS was small and continues to be uncertain due to challenges in estimating the effects of the MSSP on gross spending, particularly in recent years.
    MeSH term(s) Aged ; United States ; Humans ; Medicare Part C ; Accountable Care Organizations ; Benchmarking ; Budgets ; Cost-Benefit Analysis
    Language English
    Publishing date 2023-12-01
    Publishing country United States
    Document type Journal Article
    ISSN 2689-0186
    ISSN (online) 2689-0186
    DOI 10.1001/jamahealthforum.2023.4449
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Factor in Fear: Interference Competition in Polymorphic Spadefoot Toad Tadpoles and Its Potential Role in Disruptive Selection

    Strugariu, Alexandru / Martin, Ryan Andrew

    Animals. 2023 Apr. 06, v. 13, no. 7

    2023  

    Abstract: Disruptive selection arises when extreme phenotypes have a fitness advantage compared to more-intermediate phenotypes. Theory and evidence suggest that intraspecific resource competition is a key driver of disruptive selection. However, while competition ...

    Abstract Disruptive selection arises when extreme phenotypes have a fitness advantage compared to more-intermediate phenotypes. Theory and evidence suggest that intraspecific resource competition is a key driver of disruptive selection. However, while competition can be indirect (exploitative) or direct (interference), the role of interference competition in disruptive selection has not been tested, and most models of disruptive selection assume exploitative competition. We experimentally investigated whether the type of competition affects the outcome of competitive interactions using a system where disruptive selection is common: Mexican spadefoot toads (Spea multiplicata). Spea tadpoles develop into alternative resource-use phenotypes: carnivores, which consume fairy shrimp and other tadpoles, and omnivores, which feed on algae and detritus. Tadpoles intermediate in phenotype have low fitness when competition is intense, as they are outcompeted by the specialized tadpoles. Our experiments revealed that the presence of carnivores significantly decreased foraging behavior in intermediate tadpoles, and that intermediate tadpoles had significantly lower growth rates in interference competition treatments with carnivores but not with omnivores. Interference competition may therefore be important in driving disruptive selection. As carnivore tadpoles are also cannibalistic, the ‘fear’ effect may have a greater impact on intermediate tadpoles than exploitative competition alone, similarly to non-consumptive effects in predator–prey or intraguild relationships.
    Keywords Anostraca ; Pelobatidae ; cannibalism ; carnivores ; detritus ; fearfulness ; phenotype
    Language English
    Dates of publication 2023-0406
    Publishing place Multidisciplinary Digital Publishing Institute
    Document type Article ; Online
    ZDB-ID 2606558-7
    ISSN 2076-2615
    ISSN 2076-2615
    DOI 10.3390/ani13071264
    Database NAL-Catalogue (AGRICOLA)

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  6. Article ; Online: The Rise and Risks of Medicare Advantage "Affinity Plans".

    Beckman, Adam L / Ryan, Andrew M / Figueroa, Jose F

    JAMA

    2024  Volume 331, Issue 15, Page(s) 1271–1272

    MeSH term(s) Fee-for-Service Plans ; Medicare Part C/economics ; Medicare Part C/statistics & numerical data ; Medicare Part C/trends ; Quality Indicators, Health Care ; Quality of Health Care/economics ; Quality of Health Care/standards ; United States/epidemiology ; Insurance Coverage/economics ; Insurance Coverage/statistics & numerical data ; Insurance Coverage/trends ; Insurance Benefits/economics ; Insurance Benefits/statistics & numerical data ; Insurance Benefits/trends
    Language English
    Publishing date 2024-03-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2024.1703
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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    Order via subito

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  7. Book ; Online: Access to Behavioral Health Care for Geographically Remote Service Members and Dependents in the U.S

    Brown, Ryan Andrew / Marshall, Grant N / Breslau, Joshua / Farris, Coreen / Osilla, Karen Chan

    2014  

    Keywords Personnel & human resources management ; Medicolegal issues ; Psychology ; Management & Organizational Behavior ; Health Sciences
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030610840
    ISBN 9780833087294 ; 0833087290
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  8. Book ; Online: Predicting Suicide Attacks

    Perry, Walter L / Berrebi, Claude / Brown, Ryan Andrew / Hollywood, John S / Jaycocks, Amber

    Integrating Spatial, Temporal, and Social Features of Terrorist Attack Targets

    2013  

    Keywords Middle Eastern history ; Terrorism, armed struggle ; Political Science ; History
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030612365
    ISBN 9780833078001 ; 0833078003
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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  9. Book ; Online: Improving the U.S. Military's Understanding of Unstable Environments Vulnerable to Violent Extremist Groups

    Thaler, David E / Brown, Ryan Andrew / Gonzalez, Gabriella C / Mobley, Blake W / Roshan, Parisa

    Insights from Social Science

    2013  

    Keywords Warfare & defence ; Espionage & secret services ; Terrorism, armed struggle ; Political Science ; History
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030612266
    ISBN 9780833081643 ; 0833081640
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  10. Book ; Online: Using Behavioral Indicators to Help Detect Potential Violent Acts

    Davis, Paul K / Perry, Walter L / Brown, Ryan Andrew / Yeung, Douglas / Roshan, Parisa

    A Review of the Science Base

    2013  

    Keywords Crime & criminology ; Technology: general issues ; Sociology ; Technology
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030611798
    ISBN 9780833080929 ; 083308092X
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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