{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T20:46:14Z","timestamp":1781210774764,"version":"3.54.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Due to the high cost of left ventricular assist device (LVAD) therapy, payer type may be an important factor in determining eligibility. How payer type influences outcomes after LVAD implantation is unclear. We, therefore, aimed to study the association of health insurance payer type with outcomes after durable LVAD implantation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Using STS-INTERMACS (Society of Thoracic Surgeons-Interagency Registry for Mechanically Assisted Circulatory Support), we studied nonelderly adults receiving a durable LVAD from 2016 to 2018 and compared all-cause mortality and postindex hospitalization adverse event episode rate by payer type. Multivariable Fine-Gray and generalized linear models were used to compare the outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Of the 3251 patients included, 26.0% had Medicaid, 24.9% had Medicare alone, and 49.1% had commercial insurance. Compared with commercially insured patients, mortality did not differ for patients with Medicaid (subdistribution hazard ratio, 1.00 [95% CI, 0.75\u20131.34],\n              <jats:italic>P<\/jats:italic>\n              =0.99) or Medicare (subdistribution hazard ratio, 1.09 [95% CI, 0.84\u20131.41],\n              <jats:italic>P<\/jats:italic>\n              =0.52). Medicaid was associated with a significantly lower adjusted incidence rate (incidence rate ratio, 0.88 [95% CI, 0.78\u20130.99],\n              <jats:italic>P<\/jats:italic>\n              =0.041), and Medicare was associated with a significantly higher adjusted incidence rate (incidence rate ratio, 1.16 [95% CI, 1.03\u20131.30],\n              <jats:italic>P<\/jats:italic>\n              =0.011) of adverse event episodes compared with commercially insured patients.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>All-cause mortality after durable LVAD implantation did not differ significantly by payer type. Payer type was associated with the rate of adverse events, with Medicaid associated with a significantly lower rate, and Medicare with a significantly higher rate of adverse event episodes compared with commercially insured patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.120.008277","type":"journal-article","created":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T16:00:13Z","timestamp":1621094413000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Association of Health Insurance Payer Type and Outcomes After Durable Left Ventricular Assist Device Implantation: An Analysis of the STS-INTERMACS Registry"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1345-3004","authenticated-orcid":true,"given":"Sameed Ahmed M.","family":"Khatana","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"Penn Cardiovascular Outcomes, Quality, &amp; Evaluative Research Center (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"The Leonard Davis Institute of Health Economics (S.A.M.K., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3096-1227","authenticated-orcid":true,"given":"Thomas C.","family":"Hanff","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"Penn Cardiovascular Outcomes, Quality, &amp; Evaluative Research Center (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-6423","authenticated-orcid":true,"given":"Ashwin S.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"Penn Cardiovascular Outcomes, Quality, &amp; Evaluative Research Center (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"The Leonard Davis Institute of Health Economics (S.A.M.K., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias J.","family":"Dayoub","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"Penn Cardiovascular Outcomes, Quality, &amp; Evaluative Research Center (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"The Leonard Davis Institute of Health Economics (S.A.M.K., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Wilson","family":"Grandin","sequence":"additional","affiliation":[{"name":"Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology (E.W.G.), Beth Israel Deaconess Medical Center, Boston, MA."},{"name":"Division of Cardiology (E.W.G.), Beth Israel Deaconess Medical Center, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Eduardo","family":"Rame","sequence":"additional","affiliation":[{"name":"Jefferson Heart Institute, Thomas Jefferson University Hospital, Pennsylvania, PA (J.E.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9060-5307","authenticated-orcid":true,"given":"Alexander C.","family":"Fanaroff","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"Penn Cardiovascular Outcomes, Quality, &amp; Evaluative Research Center (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"The Leonard Davis Institute of Health Economics (S.A.M.K., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8076-0098","authenticated-orcid":true,"given":"Jay","family":"Giri","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"Penn Cardiovascular Outcomes, Quality, &amp; Evaluative Research Center (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"The Leonard Davis Institute of Health Economics (S.A.M.K., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7374-4292","authenticated-orcid":true,"given":"Peter W.","family":"Groeneveld","sequence":"additional","affiliation":[{"name":"Penn Cardiovascular Outcomes, Quality, &amp; Evaluative Research Center (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"The Leonard Davis Institute of Health Economics (S.A.M.K., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"Division of General Internal Medicine, Perelman School of Medicine (P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA."},{"name":"Center for Health Equity Research and Promotion, Michael J. 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The Uninsured and the ACA: A Primer-Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act. Washington DC: Kaiser Family Foundation. January 2019. Accessed October 1 2020. https:\/\/www.kff.org\/uninsured\/report\/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act\/"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.03.005"},{"key":"e_1_3_5_27_2","volume-title":"Medicaid physician fees after the ACA primary care fee bump","author":"Zuckerman S","year":"2017","unstructured":"Zuckerman, S, Skopec, L, Epstein, M. Medicaid physician fees after the ACA primary care fee bump. Washington, DC: Urban Institute. 2017. 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