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  1. Artikel ; 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  Band 5, Heft 4, Seite(n) e240043

    Sprache Englisch
    Erscheinungsdatum 2024-04-05
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Retraction of Publication
    ISSN 2689-0186
    ISSN (online) 2689-0186
    DOI 10.1001/jamahealthforum.2024.0043
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; 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  Band 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.
    Schlagwörter anuran ; competition ; disruptive selection ; diversification ; fear ; phenotypic plasticity ; Veterinary medicine ; SF600-1100 ; Zoology ; QL1-991
    Thema/Rubrik (Code) 303
    Sprache Englisch
    Erscheinungsdatum 2023-04-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

    Volltext online

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  3. Artikel: 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  Band 13, Heft 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 (
    Sprache Englisch
    Erscheinungsdatum 2023-04-06
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2606558-7
    ISSN 2076-2615
    ISSN 2076-2615
    DOI 10.3390/ani13071264
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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

    Ryan, Andrew M / Markovitz, Adam A

    Publikation ZURÜCKGEZOGEN

    JAMA health forum

    2023  Band 4, Heft 12, Seite(n) 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-Begriff(e) Aged ; United States ; Humans ; Medicare Part C ; Accountable Care Organizations ; Benchmarking ; Budgets ; Cost-Benefit Analysis
    Sprache Englisch
    Erscheinungsdatum 2023-12-01
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Retracted Publication
    ISSN 2689-0186
    ISSN (online) 2689-0186
    DOI 10.1001/jamahealthforum.2023.4449
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; 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.
    Schlagwörter Anostraca ; Pelobatidae ; cannibalism ; carnivores ; detritus ; fearfulness ; phenotype
    Sprache Englisch
    Erscheinungsverlauf 2023-0406
    Erscheinungsort Multidisciplinary Digital Publishing Institute
    Dokumenttyp Artikel ; Online
    ZDB-ID 2606558-7
    ISSN 2076-2615
    ISSN 2076-2615
    DOI 10.3390/ani13071264
    Datenquelle NAL Katalog (AGRICOLA)

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

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

    JAMA

    2024  Band 331, Heft 15, Seite(n) 1271–1272

    Mesh-Begriff(e) 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
    Sprache Englisch
    Erscheinungsdatum 2024-03-19
    Erscheinungsland United States
    Dokumenttyp 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
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Buch ; 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  

    Schlagwörter Personnel & human resources management ; Medicolegal issues ; Psychology ; Management & Organizational Behavior ; Health Sciences
    Sprache Englisch
    Umfang 1 Online-Ressource
    Verlag RAND Corporation
    Dokumenttyp Buch ; Online
    Anmerkung English
    HBZ-ID HT030610840
    ISBN 9780833087294 ; 0833087290
    Datenquelle ZB MED Katalog Medizin, Gesundheit, Ernährung, Umwelt, Agrar

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  8. Artikel ; Online: Heterogeneity within the Oregon Health Insurance Experiment: An application of causal forests.

    Hattab, Zaid / Doherty, Edel / Ryan, Andrew M / O'Neill, Stephen

    PloS one

    2024  Band 19, Heft 1, Seite(n) e0297205

    Abstract: Existing evidence regarding the effects of Medicaid expansion, largely focused on aggregate effects, suggests health insurance impacts some health, healthcare utilization, and financial hardship outcomes. In this study we apply causal forest and ... ...

    Abstract Existing evidence regarding the effects of Medicaid expansion, largely focused on aggregate effects, suggests health insurance impacts some health, healthcare utilization, and financial hardship outcomes. In this study we apply causal forest and instrumental forest methods to data from the Oregon Health Insurance Experiment (OHIE), to explore heterogeneity in the uptake of health insurance, and in the effects of (a) lottery selection and (b) health insurance on a range of health-related outcomes. The findings of this study suggest that the impact of winning the lottery on the health insurance uptake varies among different subgroups based on age and race. In addition, the results generally coincide with findings in the literature regarding the overall effects: lottery selection (and insurance) reduces out-of-pocket spending, increases physician visits and drug prescriptions, with little (short-term) impact on the number of emergency department visits and hospital admissions. Despite this, we detect quite weak evidence of heterogeneity in the effects of the lottery and of health insurance across the outcomes considered.
    Mesh-Begriff(e) United States ; Humans ; Oregon ; Insurance Coverage ; Insurance, Health ; Medicaid ; Health Expenditures
    Sprache Englisch
    Erscheinungsdatum 2024-01-18
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0297205
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel: Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal Study.

    Lin, Sunny C / Adler-Milstein, Julia / Hollingsworth, John M / Ryan, Andrew

    Journal of patient experience

    2024  Band 11, Seite(n) 23743735241240926

    Abstract: Preparing patients for posthospital care may improve readmission risk. Alternative payment models (APMs) incent hospitals to reduce readmissions by tying payment to outcomes. The impact of APMs on preparation for discharge is not well understood. We ... ...

    Abstract Preparing patients for posthospital care may improve readmission risk. Alternative payment models (APMs) incent hospitals to reduce readmissions by tying payment to outcomes. The impact of APMs on preparation for discharge is not well understood. We assessed whether patient-reported preparation for posthospital care was associated with reduced readmissions, and whether APM participation was associated with improved preparation for posthospital care. We used mixed-effects regression on retrospective (2013-2017) observational data for 2685 U.S. hospitals. We measured patient-reported preparation for posthospital care using the 3-Item Care Transition Measure and readmission using 30-day all-cause risk-adjusted readmissions from Hospital Compare. Participation in accountable care organizations (ACOs), Medical Homes, and Medicare's Bundled Payments for Care Improvement program was obtained from Medicare, the American Hospital Association's Annual Survey, and Leavitt Partner's ACO database. We found that APMs are not associated with improved preparation for posthospital care, even though it was associated with reduced readmissions (Marginal Effect: -0.012 percentage points). This may be because hospitals are not investing in patient engagement. This study has limited insight into causality and reduced generalizability among smaller, rural, and non-teaching hospitals.
    Sprache Englisch
    Erscheinungsdatum 2024-03-22
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2857285-3
    ISSN 2374-3743 ; 2374-3735
    ISSN (online) 2374-3743
    ISSN 2374-3735
    DOI 10.1177/23743735241240926
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Buch ; 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  

    Schlagwörter Middle Eastern history ; Terrorism, armed struggle ; Political Science ; History
    Sprache Englisch
    Umfang 1 Online-Ressource
    Verlag RAND Corporation
    Dokumenttyp Buch ; Online
    Anmerkung English
    HBZ-ID HT030612365
    ISBN 9780833078001 ; 0833078003
    Datenquelle ZB MED Katalog Medizin, Gesundheit, Ernährung, Umwelt, Agrar

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