Zirui Song, MD, PhD
Zirui Song is the Center for Primary Care faculty director of research and is an HMS associate professor of health care policy and medicine. He is a general internist at Massachusetts General Hospital, where he practices primary care and attends on the inpatient medicine teaching service.
Dr. Song’s research focuses on efforts to improve the value of health care spending. This includes studies of payment reform, pricing of medical services, financing of health insurance, and quality or appropriateness of care. Related work aims to understand other policies or factors that affect spending or health outcomes, including employer efforts, peer influences, and individual- or population-level interventions.
Dr. Song directs the Health Policy concentration in the MGH Internal Medicine Residency Program. He also co-directs the Essentials of the Profession–Health Policy course for first-year Harvard medical and dental students. In addition, Dr. Song has co-led HMS Executive Education courses for employers and global health care leaders, as well as the Mass General Brigham Health Policy Course for residents and fellows. He guest lectures at Harvard College, School of Public Health, Kennedy School, and Mass General Brigham. Dr. Song has received several Certificates of Distinction in Teaching from Harvard University and tutorial teaching awards from HMS. Along with teaching, he advises postdoctoral fellows, Ph.D. students, and medical trainees.
Dr. Song has worked on Medicare payment policy at the U.S. Department of Health and Human Services and was a guest at the Brookings Institution. Locally, he has served as a Visiting Fellow in the Massachusetts Health Policy Commission and on the Massachusetts Medical Society Task Force on Health Care Reform. Dr. Song is an incoming Associate Editor of JAMA Health Forum and Editorial Board member of Health Services Research. He previously served in editorial roles at PLOS Medicine and Healthcare.
Dr. Song is a recipient of the AcademyHealth Article-of-the-Year award, NIHCM Foundation Health Care Research Award, and Society of General Internal Medicine Outstanding Junior Investigator of the Year Award. His research has also been recognized by Johns Hopkins, the American College of Physicians, American Journal of Managed Care, and International Society for Pharmacoeconomics and Outcomes Research. For clinical work, he received the Morton N. Swartz, M.D. Humanism in Medicine Award at Massachusetts General Hospital.
Dr. Song trained in internal medicine (primary care track) at Massachusetts General Hospital. He received his M.D. from Harvard Medical School, magna cum laude, and Ph.D. in Health Policy (Economics track) from Harvard University, where he was a fellow in Aging and Health Economics at the National Bureau of Economic Research. He received his B.A. in Public Health Studies with honors from Johns Hopkins University.
Working Papers
After years of growth, federal payments to Medicare Advantage plans began to decline after the Affordable Care Act (ACA). We exploit variation in those payments caused by the ACA to assess whether insurers respond symmetrically to payment increases and decreases pre- and post-ACA. We find that plans changed their pricing and pass-through to beneficiaries symmetrically, with plans passing through roughly 60 cents for each dollar of payment increases or decreases. However, plans reduced less salient benefits post-ACA by more than they had increased them pre-ACA, even though they left premiums virtually unchanged. Partial pass-through suggests that plans likely operate above cost; plans in more competitive markets responded less to payment changes than plans in less competitive markets. Partial pass-through of payment cuts, combined with quality bonuses and growth in risk scores, may explain the continued growth in Medicare Advantage enrollment post-ACA.
CV
2009–2011
Certificates of Distinction in Teaching
Harvard University
2010–2011
Excellence in Tutorial Facilitation Award
Harvard Medical School
2012
Joan P. Curhan Citizenship Award
Harvard University
2013
Article-of-the-Year Award
AcademyHealth
2014
30 Under 30 in Science and Healthcare
Forbes Magazine
2014
Daniel Ford Award (“Achievement in health services and outcomes research”)
Johns Hopkins Medicine
2015
Morton N. Swartz, M.D. Humanism in Medicine Award
Massachusetts General Hospital
2015
Hospital-Wide Individual Research Award
Massachusetts General Hospital
2016
Mack Lipkin Sr. Associate Member Scientific Presentation Award
Society of General Internal Medicine
2016
Seema S. Sonnad Emerging Leader in Managed Care Research Award
The American Journal of Managed Care
2017
Award for Excellence in Clinician Investigation
Society of General Internal Medicine, New England Region
2017
NIH Director’s Early Independence Award
National Institutes of Health
2019
Milton W. Hamolsky Jr. Faculty Scientific Presentation Award
Society of General Internal Medicine
2019
Bernie J. O'Brien New Investigator Award
International Society for Pharmacoeconomics and Outcomes Research
2020
Outstanding Reviewer in 2019
Health Services Research
2020
Outstanding Junior Investigator of the Year
Society of General Internal Medicine
2020
NIHCM Foundation Health Care Research Award
National Institute for Health Care Management Foundation
Primary Care and Financial Risk - Navigating the Crossroads
Authors: Song Z, Chokshi DA, Press MJ
New England Journal of Medicine 2022-07-28
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Measuring Changes in Disparity Gaps: An Application to Health Insurance
Authors: Goldsmith-Pinkham P, Jiang K, Song Z, Wallace J
American Economic Association Papers and Proceedings 2022-05-01
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Geographic Variation in Private Equity Penetration Across Select Office-Based Physician Specialties in the US
Authors: Singh Y, Zhu JM, Polsky D, Song Z
JAMA Health Forum 2022-04-29
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Surprise Billing and the No Surprises Act: Considerations for Oral-Maxillofacial Surgery
Authors: Wang TT, Lee CC, Song Z, Hajibandeh J
Journal of Oral and Maxillofacial Surgery 2022-04-09
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Changes in Health Care Spending, Use, and Clinical Outcomes After Nonfatal Firearm Injuries Among Survivors and Family Members: A Cohort Study
Authors: Song Z, Zubizarreta JR, Giuriato M, Paulos E, Koh KA
Annals of Internal Medicine 2022-04-05
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Physician Practice Pattern Variations in Common Clinical Scenarios Within 5 US Metropolitan Areas
Authors: Song Z, Kannan S, Gambrel RJ, Marino M, Vaduganathan M, Clapp MA, Seiglie JA, Bloom PP, Malik AN, Resnick MJ
JAMA Health Forum 2022-01-28
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Racial and Ethnic Disparities in Hospitalization Outcomes Among Medicare Beneficiaries During the COVID-19 Pandemic
Authors: Song Z, Zhang X, Patterson LJ, Barnes CL, Haas DA
JAMA Health Forum 2021-12-23
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Prevalence, Costs, and Consequences of Low-Value Preprocedural Urinalyses in the US
Authors: Shenoy ES, Giuriato MA, Song Z
JAMA Internal Medicine 2021-11-01
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Changes in Patient Experiences and Assessment of Gaming Among Large Clinician Practices in Precursors of the Merit-Based Incentive Payment System
Authors: Roberts ET, Song Z, Ding L, McWilliams JM
JAMA Health Forum 2021-10-08
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Use of private management consultants in public health
Authors: Bruch JD, Feldman J, Song Z
British Medical Journal 2021-09-07
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Changes in Racial and Ethnic Disparities in Access to Care and Health Among US Adults at Age 65 Years
Authors: Wallace J, Jiang K, Goldsmith-Pinkham P, Song Z
JAMA Internal Medicine 2021-09-01
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Mortality Before and After Border Wall Construction Along the US-Mexico Border, 1990-2017
Authors: Bruch JD, Barin O, Venkataramani AS, Song Z
American Journal of Public Health 2021-09-01
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Health And Economic Outcomes Up To Three Years After A Workplace Wellness Program: A Randomized Controlled Trial
Authors: Song Z, Baicker K
Health Affairs 2021-06-01
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Making the Affordable Care Act Marketplace More Affordable
Authors: Song Z
JAMA Health Forum 2021-05-21
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Navigating Hospital Price Transparency—A Cautionary Tale
Authors: Shah SA, Song Z
Journal of General Internal Medicine 2021-05-04
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Out-of-Network Laboratory Test Spending, Utilization, and Prices in the US
Authors: Song Z, Lillehaugen T, Wallace J
Journal of the American Medical Association 2021-04-01
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Implications of Changes in Medicare Payment and Documentation for Primary Care Spending and Time Use
Authors: Basu S, Song Z, Phillips RS, Bitton A, Landon BE
Journal of General Internal Medicine 2021-03-01
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Characteristics of Private Equity-Owned Hospitals in 2018
Authors: Bruch J, Zeltzer D, Song Z
Annals of Internal Medicine 2021-02-01
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Out-of-Network Spending on Behavioral Health, 2008–2016
Authors: Song Z, Lillehaugen T, Busch SH, Benson NM, Wallace J.
Journal of General Internal Medicine 2021-01-01
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Changes in Hospital Income, Use, and Quality Associated with Private Equity Acquisition
Authors: Bruch JD, Gondi S, Song Z
JAMA Internal Medicine 2020-08-24
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Expansion of Private Equity Involvement in Women's Health Care
Authors: Bruch JD, Borsa A, Song Z, Richardson SS
JAMA Internal Medicine 2020-08-24
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Prices And Cost Sharing For Psychotherapy In Network Versus Out Of Network In The United States
Authors: Benson NM, Song Z
Health Affairs 2020-07-06
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Implications of Changes in Medicare Payment and Documentation for Primary Care Spending and Time Use
Authors: Basu S, Song Z, Phillips RS, Bitton A, Landon BE
Journal of General Internal Medicine 2020-06-03
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Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016
Authors: Song Z, Johnson W, Kennedy K, Biniek JF, Wallace J
Health Affairs 2020-06-01
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Potential Implications of Lowering the Medicare Eligibility Age to 60
Authors: Song Z
Journal of the American Medical Association 2020-05-29
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Differences in the Complexity of Office Visits by Physician Specialty: NAMCS 2013-2016
Authors: Goodson JD, Shahbazi S, Rao K, Song Z
Journal of General Internal Medicine 2020-03-10
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Health Care Spending And Use Among People Experiencing Unstable Housing In The Era Of Accountable Care Organizations
Authors: Koh KA, Racine M, Gaeta JM, Goldie J, Martin DP, Bock B, Takach M, O'Connell JJ, Song Z
Health Affairs 2020-02-03
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Out-of-Network Spending on Behavioral Health, 2008–2016
Authors: Song Z, Lillehaugen T, Busch SH, Benson NM, Wallace J
Journal of General Internal Medicine 2020-01-28
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Physician-initiated payment reform: a new path toward value
Authors: Gondi S, Ferris TG, Patel KK, Song Z
American Journal of Managed Care 2019-09-01
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Will Increasing Primary Care Spending Alone Save Money?
Authors: Song Z, Gondi S
Journal of the American Medical Association 2019-08-15
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Physician Payment Disparities and Access to Services—a Look Across Specialties
Authors: Goodson JD, Shahbazi S, Song Z
Journal of General Internal Medicine 2019-08-05
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Health Care Spending, Utilization, and Quality 8 Years into Global Payment
Authors: Song Z, Ji Y, Safran DG, Chernew ME
New England Journal of Medicine 2019-07-18
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The Pricing of Care Under Medicare for All: Implicattions and Policy Choices
Authors: Song Z
Journal of the American Medical Association 2019-06-28
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Changes in Economic and Clinical Outcomes Under CMS Mandatory Bundled Payments for Joint Replacements
Authors: Haas DA, Zhang X, Kaplan RS, Song Z
JAMA Internal Medicine 2019-06-03
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Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes: A Randomized Clinical Trial
Authors: Song Z, Baicker K
JAMA 2019-04-16
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Potential Implications of Private Equity Investments in Health Care Delivery
Authors: Gondi S, Song Z.
Journal of the American Medical Association 2019-02-28
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The US Affordable Care Act: Reflections and Directions at the Close of a Decade
Authors: McIntyre A, Song Z
PLos Med 2019-02-26
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Health Care Spending Slowed After Rhode Island Applied Affordability Standards To Commercial Insurers.
Authors: Baum A, Song Z, Landon BE, Phillips RS, Bitton A, Basu S.
Health Affairs 2019-02-01
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Improving Affordability and Equity in Medicare Advantage
Authors: Song Z, Basu S
Inquiry 2019-01-01
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Gatekeeping and patterns of outpatient care post healthcare reform.
Authors: Barnett ML, Song Z, Bitton A, Rose S, Landon BE.
American Journal of Managed Care 2018-10-01
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Gatekeeping and Patterns of Outpatient Care Post Healthcare Reform
Authors: Michael L. Barnett, MD, MS; Zirui Song, MD, PhD; Asaf Bitton, MD, MPH; Sherri Rose, PhD; and Bruce E. Landon, MD, MBA, MSc
The American Journal of Managed Care 2018-10-01
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The CMS Proposal to Reform Office-Visit Payments
Authors: Song Z, Goodson JD
New England Journal of Medicine 2018-09-20
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Type 2 Myocardial Infarction and the Hospital Readmission Reduction Program
Authors: McCarthy CP, Vaduganathan M, Singh A, Song Z, Blankstein R, Gaggin HK, Wasfy JH, Januzzi JL Jr.
Journal of the American College of Cardiology 2018-09-04
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“Finance and Time Use Implications of Team Documentation for Primary Care: A Microsimulation
Authors: Basu S, Phillips RS, Bitton A, Song Z, Landon BE
Annals of Family Medicine 2018-07-03
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Incorporating value into physician payment and patient cost-sharing
Authors: Song Z, Navathe AS, Emanuel EJ, Volpp KG
American Journal of Managed Care 2018-07-03
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Finance and Time Use Implications of Team Documentation for Primary Care: A Microsimulation.
Authors: Basu S, Phillips RS, Bitton A, Song Z, Landon BE.
Annals of Family Medicine 2018-07-01
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Effects of global payment and accountable care on medication treatment for alcohol and opioid use disorders.
Authors: Donohue JM, Barry CL, Stuart EA, Greenfield SF, Song Z, Chernew ME, Huskamp HA.
Journal of Addiction Medicine 2018-01-01
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Health reform and utilization of high-volume hospitals for complex cancer operations.
Authors: Andrew P. Loehrer, David C. Chang, Zirui Song, and George J. Chang
Journal of Oncology Practice 2018-01-01
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Baby boomers and beds: a demographic challenge for the ages
Authors: Song Z, Ferris TG
Journal of General Internal Medicine 2017-12-22
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Using Medicare prices—Toward equity and affordability in the ACA marketplace
Authors: Song Z
New England Journal of Medicine 2017-12-14
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Mortality quadrupled among opioid-driven hospitalizations, notably within lower-income and disabled white populations
Authors: Song Z
Health Affairs 2017-12-01
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Behavioral health integration into primary care: a microsimulation of financial implications for practices.
Authors: Basu S, Landon BE, Williams JW Jr, Bitton A, Song Z, Phillips RS
Journal of General Internal Medicine 2017-12-01
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Effects of global payment and accountable care on medication treatment for alcohol and opioid use disorders.” Journal of Addiction Medicin
Authors: Donohue JM, Barry CL, Stuart EA, Greenfield SF, Song Z, Chernew ME, Huskamp HA
Journal of Addiction Medicine 2017-11-20
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Health reform and utilization of high-volume hospitals for complex cancer operations
Authors: Loehrer AP, Chang DC, Song Z, Chang GJ
Journal of Oncology Practice 2017-11-20
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Insurance transitions and changes in physician and emergency department utilization: An observational study
Authors: Barnett ML, Song Z, Rose S, Bitton A, Chernew ME, Landon BE.
Journal of General Internal Medicine 2017-10-01
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High Levels of Capitation Payments Needed to Shift Primary Care Toward Proactive Team and Nonvisit Care
Authors: Basu S, Phillips RS, Song Z, Bitton A, Landon BE
Health Affairs 2017-09-01
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Association of Insurance Expansion With Surgical Management of Thyroid Cancer.
Authors: Loehrer AP, Murthy SS, Song Z, Lubitz CC, James BC
JAMA Surgery 2017-08-01
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The next generation of episode-based payments
Authors: Navathe AS, Song Z, Emanuel EJ
Journal of the American Medical Association 2017-06-20
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Drivers of the variation in prosthetic implant purchase prices for total knee and total hip arthroplasties
Authors: Haas DA, Bozic KJ, DiGioia AM, Song Z, Kaplan RS.
Journal of Arthroplasty 2017-02-01
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Effects of accountable care and payment reform on substance use disorder treatment: evidence from the initial 3 years of the Alternative Quality Contract.
Authors: Stuart EA, Barry CL, Donohue JM, Greenfield SF, Duckworth K, Song Z, Kouri EM, Ebnesajjad C, Mechanic R, Chernew ME, Huskamp HA
Addiction 2017-01-01
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Lower- Versus Higher-Income Populations in the Alternative Quality Contract: Improved Quality and Similar Spending
Authors: Song Z, Rose S, Chernew ME, Safran DG
Health Affairs 2017-01-01
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The impact of health insurance expansion on the treatment of colorectal cancer
Authors: Loehrer AP, Song Z, Haynes AB, Chang DC, Hutter MW, Mullen JT
Journal of Clinical Oncology 2016-12-01
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Expanding payment reform in Medicare: The cardiology episode-based payment model
Authors: Song Z, Blumenthal DM
Journal of the American Medical Association 2016-11-15
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“Effects of global payment and accountable care on tobacco cessation service use: an observational study
Authors: Huskamp HA, Greenfield SF, Stuart EA, Donohue JM, Duckworth K, Kouri EM, Song Z, Chernew ME, Barry CL
Journal of General Internal Medicine 2016-10-01
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Physician incentives and behavioral economics in the Medicare Access and CHIP Reauthorization Act
Authors: Song Z
Healthcare 2016-09-01
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Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model
Authors: Basu S, Phillips RS, Song Z, Landon BE, Bitton A
Annals of Family Medicine 2016-09-01
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The ACO experiment in infancy—Looking back and looking forward
Authors: Song Z, Fisher ES
Journal of the American Medical Association 2016-08-16
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New and unexpected potentially-disruptive life events: what are the immediate impacts on medication-taking behavior? A case-crossover analysis
Authors: Lauffenburger JC, Gagne JJ, Song Z, Brill G, Choudhry NK
BMJ Open 2016-08-04
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Specialty-based global payment: A new phase in payment reform
Authors: Song Z, Colla CH
Journal of the American Medical Association 2016-06-07
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Traditional Medicare versus private insurance: How spending, volume, and price change at age sixty-five
Authors: Wallace J, Song Z
Health Affairs 2016-05-01
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Impact of expanded insurance coverage on racial disparities in vascular disease: insights from Massachusetts
Authors: Loehrer AP, Hawkins AT, Auchincloss HG, Song Z, Hutter MM, Patel VI
Annals of Surgery 2016-04-01
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The Early Impact of the 'Alternative Quality Contract' on Mental Health Service Use and Spending in Massachusetts
Authors: Barry CL, Stuart EA, Donohue JM, Greenfield SF, Kouri E, Duckworth K, et al
Health Affairs 2015-12-21
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Health insurance expansion and treatment of pancreatic cancer: Does increased access lead to improved care?
Authors: Loehrer AP, Chang DC, Hutter MM, Song Z, Lillemoe KD, Warshaw AL, Ferrone CR
Journal of the American College of Surgeons 2015-12-01
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Medicare chronic care management payments and financial returns to primary care practices: A modeling study
Authors: Basu S, Phillips RS, Bitton A, Song Z, Landon BE
Annals of Internal Medicine 2015-10-20
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Racial and regional disparities in the effect of the Affordable Care Act's dependent coverage provision on young adult trauma patients
Authors: Scott JW, Salim A, Sommers BD, Tsai TC, Scott KW, Song Z
Journal of the American College of Surgeons 2015-08-01
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Addressing the primary care workforce crisis
Authors: Song Z, Chopra V, McMahon LF
American Journal of Managed Care 2015-08-01
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Influence of health insurance expansion on disparities in the treatment of acute cholecystitis
Authors: Loehrer AP, Song Z, Auchincloss HG, Hutter MM
Annals of Surgery 2015-07-01
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Medicare fee cuts and cardiologist-hospital integration
Authors: Song Z, Wallace J, Neprash HT, McKellar MR, Chernew ME, McWilliams JM
JAMA Internal Medicine 2015-07-01
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Implications of Workforce and Financing Changes for Primary Care Practice Utilization, Revenue, and Cost: A Generalizable Mathematical Model for Practice Management
Authors: Basu S, Landon BE, Song Z, Bitton A, Phillips RS
Medical Care 2015-02-20
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Rethinking physician payment
Authors: Song Z, McMahon LF Jr
Journal of General Internal Medicine 2015-02-01
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The role of private payers in payment reform
Authors: Song Z, Chokshi DA
Journal of the American Medical Association 2015-01-06
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Dependent coverage provision led to uneven insurance gains and unchanged mortality rates in young adult trauma patients
Authors: Scott JW, Sommers BD, Tsai TC, Scott KW, Schwartz AL, Song Z.
Health Affairs 2015-01-01
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Using Propensity Scores in Difference-in-Differences Models to Estimate the Effects of a Policy Change
Authors: Stuart EA, Huskamp HA, Duckworth K, Simmons J, Song Z, Chernew M et al
Health Services & Outcomes Research Methodology 2014-12-01
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Changes in Health Care Spending and Quality 4 years into Global Payment
Authors: Song Z, Rose S, Safran DG, Landon BE, Day MP, Chernew ME
The New England Journal of Medicine 2014-10-30
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Patient referrals: a linchpin for increasing the value of care
Authors: Song Z, Sequist TD, Barnett ML
Journal of the American Medical Association 2014-08-13
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Accountable care organizations in the U.S. health care system
Authors: Song Z
Journal of Clinical Outcomes Management 2014-08-01
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The impact of global budgets on pharmaceutical spending and utilization: early experience from the Alternative Quality Contract
Authors: Afendulis CC, Fendrick AM, Song Z, Landon BE, Safran DG, Mechanic RE, Chernew ME
Inquiry 2014-01-01
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Two-year Impact of the Alternative Quality Contract on Pediatric Healthcare Quality and Spending
Authors: Chien AT, Song Z, Chernew ME, Landon BE, McNeil BJ, Safran DG, Schuster MA
Pediatrics 2014-01-01
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Competitive bidding in Medicare Advantage: Effect of benchmark changes on plan bids
Authors: Song Z, Landrum MB, Chernew ME
Journal of Health Economics 2013-12-02
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Massachusetts health care reform and reduced racial disparities in minimally invasive surgery
Authors: Loehrer AP, Song Z, Auchincloss HG, Hutter MM
JAMA Surgery 2013-12-01
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Becoming a physician in the age of payment reform
Authors: Song Z
Healthcare 2013-09-01
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The effect of bundled payment on emergency department use: Alternative Quality Contract effects after year one
Authors: Sharp AL, Song Z, Safran DG et al
Academic Emergency Medicine 2013-09-01
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Global budgets and technology-intensive medical services
Authors: Song Z, Fendrick AM, Safran DG, Landon B, Chernew ME
Healthcare 2013-06-01
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Guidance for structuring team-based incentives in healthcare
Authors: Blumenthal DM, Song Z, Jena AB, Ferris TG
American Journal of Managed Care 2013-02-01
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Unintended consequences of eliminating Medicare payments for consultations.
Authors: Song Z, Ayanian JZ, Wallace J, et al.
Archives of Internal Medicine 2013-01-14
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The era of delivery system reform begins
Authors: Song Z, Lee TH
Journal of the American Medical Association 2013-01-02
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Mobile clinic in Massachusetts associated with cost savings from lowering blood pressure and emergency department use
Authors: Song Z, Hill C, Bennet J, Vavasis A, Oriol NE
Health Affairs 2013-01-01
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Competitive Bidding in Medicare: Who Benefits from Competition?
Authors: Song Z, Landrum MB and Chernew ME
American Journal of Managed Care 2012-09-01
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Potential consequences of reforming Medicare into a competitive bidding system
Authors: Song Z, Cutler DM, Chernew ME
Journal of the American Medical Association 2012-08-01
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The ‘Alternative Quality Contract,’ Based on a Global Budget, Lowering Medical Spending and Improved Quality.
Authors: Song A, Safran DG, Landon BE, et al.
Health Affairs 2012-08-01
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Implications for ACOs of variations in spending growth.
Authors: McWilliams JM and Song Z
New England Journal of Medicine 2012-05-10
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Controlling Health Care Spending – The Massachusetts Experiment.
Authors: Song Z and Landon BE
New England Journal of Medicine 2012-04-26
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Trends in Physician Referrals in the United States, 1999-2009.
Authors: Barnett ML, Song Z and Landon BE
Archives of Internal Medicine 2012-01-23
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Health Care Spending and Quality in Year 1 of the Alternative Quality Contract
Authors: Song Z, Safran DG, Landon BE, et al.
New England Journal of Medicine 2011-07-01
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Workplace wellness programs can generate savings
Authors: Baicker K, Cutler D, Song Z
Health Affairs 2010-02-01
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