LDI at 2018 AcademyHealth Annual Research Meeting Poster Displays
SUMR 2018 Attends AHRQ National Research Service Awards Conference
Amol Navathe Wins AcademyHealth 'Best Abstract' Award
Modernizing Medicare Funding for Nurse Education
With policies rooted in the 1960s, it’s time to change how Medicare pays for nurse education. In a New England Journal of Medicine Perspective, LDI Senior Fellow Linda Aiken and colleagues present a compelling case for funding a new consortium model that trains nurse practitioners (NPs) in the community settings where they are a crucial source of primary care.
LDI Awarded Grant to Study Payment Policies for Opioid Use Disorder
Chart of the Day: Nurse Practitioners in Primary Care
A new study in Health Affairs by Hilary Barnes, Matthew McHugh, and colleagues, demonstrates the increasingly important role nurse practitioners (NPs) have in primary care in the United States.
Integrated Behavioral Health Care in Family Medicine Residencies: A CERA Survey
Christine Jacobs, Jay A. Brieler, Joanne Salas, Renée M. Betancourt, Peter F. Cronholm
ABSTRACT [FROM JOURNAL]
Background and Objectives: Behavioral health integration (BHI) in primary care settings is critical to mental health care in the United States. Family medicine resident experience in BHI in family medicine residency (FMR) continuity clinics is essential preparation for practice. We surveyed FMR program directors to characterize the status of BHI in FMR training.
Methods: Using the Council of Academic Family Medicine Educational Research Alliance (CERA) 2017 survey, FMR program directors...
Incidence Trends and Risk Factor Variation in Severe Intraventricular Hemorrhage across a Population Based Cohort
Sara C. Handley, Molly Passarella, Henry C. Lee, Scott A.Lorch
ABSTRACT [FROM JOURNAL]
Objective: To quantify the current burden of severe intraventricular hemorrhage (IVH), describe time trends in severe IVH, identify IVH-associated risk factors, and determine the contribution of mediating factors.
Study design: The
...Balancing Affordability And Access: Lessons From New Cholesterol-Lowering Drugs
[Reposted: Jalpa A. Doshi, Justin Puckett, Michael S. Parmacek, and Daniel J. Rader.
Comparison Of Hospitals Participating In Medicare’s Voluntary And Mandatory Orthopedic Bundle Programs
Amol S. Navathe, Joshua M. Liao, Daniel Polsky, Yash...
Abstract [from journal]
We analyzed data from Medicare and the American Hospital Association Annual Survey to compare characteristics and baseline performance among hospitals in Medicare’s voluntary (Bundled Payments for Care Improvement initiative, or BPCI) and mandatory (Comprehensive Care for Joint Replacement Model, or CJR) joint replacement bundled payment programs. BPCI hospitals had higher mean patient volume and were larger and more teaching intensive than were CJR hospitals, but the two groups had similar risk exposure and baseline episode quality and cost. BPCI hospitals...
The Effect of Workforce Assignment on Performance: Evidence from Home Health Care
In this study of more than 43,000 home health episodes following a hospitalization, handoffs between skilled nursing providers—a marker of discontinuity of care—substantially increased hospital readmissions, and were more detrimental for sicker patients. The estimates imply that a single handoff increases the likelihood of 30-day hospital readmission by 16% and that one in four hospitalizations during home health care could be avoided if handoffs were eliminated.
Trends in hospital-SNF relationships in the care of Medicare beneficiaries
Joshua M. Liao, R. Tamara Konetzka, Rachel M. Werner
Abstract [from journal]
Improving the value of post-acute care at skilled nursing facilities (SNFs) has become a Medicare policy priority. Anecdotally, hospitals have responded by formally acquiring or pursuing tighter informal connections with SNFs. We evaluated the trend in connections between US acute care hospitals and Medicare-certified SNFs between 2000 and 2013 using vertical integration and two novel network-based measures (number of SNF partners, and...
Preventable Hospitalizations, Barriers to Care, and Disability
Liliana E. Pezzin, Hillary R. Bogner, Jibby E. Kurichi, Pui L. Kwong, Joel E. Streim, Dawei Xie, Ling Na, Sean Hennessy
Abstract [from journal]
The AHRQ's Prevention Quality Indicators assume inpatient hospitalizations for certain conditions, referred as ambulatory-care sensitive (ACS) conditions, are potentially preventable and may indicate reduced access to and a lower quality of ambulatory care. Using a cohort drawn from the Medicare Current Beneficiary Survey (MCBS) linked to Medicare claims, we examined the extent to which barriers to healthcare are associated with ACS hospitalizations and related costs, and whether these associations differ by beneficiaries' disability status. Our results...
Outcomes of Care for Ischemic Heart Disease and Chronic Heart Failure in the Veterans Health Administration
Peter W. Groeneveld, Elina L. Medvedeva, Lorrie Walker, Andrea G. Segal, Diane M. Richardson, Andrew J. Epstein
Abstract [from journal]
Importance: The Department of Veterans Affairs (VA) operates a nationwide system of hospitals and hospital-affiliated clinics, providing health care to more than 2 million veterans with cardiovascular disease. While data permitting hospital comparisons of the outcomes of acute cardiovascular care (eg, myocardial infarction) are publicly available, little is known about variation across VA medical centers (VAMCs) in outcomes of care for populations of patients with chronic, high-risk cardiovascular conditions.
Objective: ...
Organizational Processes and Patient Experiences in the Patient-Centered Medical Home
Jaya Aysola, Marilyn M. Schapira, Hairong Huo, Rachel M....
Abstract [from journal]
Background: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences.
Objective: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care.
Research Design: We analyzed visit data from patients (n=8356) at adult primary care practices...