Bruce Kinosian, MD is a general internist/geriatrician with involvement among a broad group of researchers. He has produced influential cost-effectiveness analyses of interventions for cardiovascular disease in work spanning a decade, developed sophisticated, pioneering models for Alzheimer’s Disease using Grade of Membership techniques, and has been involved in economic evaluations of a range of VA HSRD-funded clinical trials. He’s evaluated models of integrated, community-based LTC in Philadelphia, and most recently has been involved in the design and implementation of CMMI’s Independence at Home (IAH) demonstration. He has performed a number of effectiveness studies using VA data for home-based primary care, and has applied the HCC model, with VA-appropriate modifications, to evaluate demonstration programs in the VA, looking at both VA specific costs as well as total federal spending (VA, Medicare, and Medicaid). He previously led a Health Services Research & Development (HSR&D) decision-modeling study in conjunction with the Office of Policy and is planning to produce a new Long Term Care Planning Model for the VA that ties together VA and CMS data with national surveys spanning 20 years.
His current role as Associate Director of the Geriatrics and Extended Care Data and Analysis Center (GEC DAC) stemmed from earlier VA HSR&D research, which established rigorous methods to use VA and other data to meet VA operational needs. As part of the Geriatric and Extended Care Data Analysis Center, he has developed cost and utilization projection methods calibrated to frail elderly populations with superior levels of explanatory power for costs utilization. He has validated and refined a frailty index (the JEN frailty index) for use in the VA, and has incorporated the Independence at Home qualifying criteria into the planning process for sizing Home Based Primary Care (HBPC) programs. Along with collaborators in Canandaigua and Palo Alto, he has an HSR&D funded study to replicate the CMS evaluation of IAH in the VA for the home-based primary care population.