Esmaeil Khedmati Morasae, Tanith C Rose, Mark Gabbay, Laura Buckels, Colette Morris, Sharon Poll, Mark Goodall, Rob Barnett, Ben Barr
{"title":"Evaluating the Effectiveness of a Local Primary Care Incentive Scheme: A Difference-in-Differences Study.","authors":"Esmaeil Khedmati Morasae, Tanith C Rose, Mark Gabbay, Laura Buckels, Colette Morris, Sharon Poll, Mark Goodall, Rob Barnett, Ben Barr","doi":"10.1177/10775587211035280","DOIUrl":"https://doi.org/10.1177/10775587211035280","url":null,"abstract":"<p><p>National financial incentive schemes for improving the quality of primary care have come under criticism in the United Kingdom, leading to calls for localized alternatives. This study investigated whether a local general practice incentive-based quality improvement scheme launched in 2011 in a city in the North West of England was associated with a reduction in all-cause emergency hospital admissions. Difference-in-differences analysis was used to compare the change in emergency admission rates in the intervention city, to the change in a matched comparison population. Emergency admissions rates fell by 19 per 1,000 people in the years following the intervention (95% confidence interval [17, 21]) in the intervention city, relative to the comparison population. This effect was greater among more disadvantaged populations, narrowing socioeconomic inequalities in emergency admissions. The findings suggest that similar approaches could be an effective component of strategies to reduce unplanned hospital admissions elsewhere.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"394-403"},"PeriodicalIF":2.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10775587211035280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39255332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ge Bai, Hossein Zare, Matthew D Eisenberg, Daniel Polsky, Gerard F Anderson
{"title":"Comparison of Trends in Nonprofit Hospitals' Charity Care Eligibility Policies Between Medicaid Expansion States and Medicaid Nonexpansion States.","authors":"Ge Bai, Hossein Zare, Matthew D Eisenberg, Daniel Polsky, Gerard F Anderson","doi":"10.1177/10775587211039695","DOIUrl":"https://doi.org/10.1177/10775587211039695","url":null,"abstract":"<p><p>Nonprofit hospitals provide charity care to financially disadvantaged patients according to their self-designed eligibility policies. The Affordable Care Act may have prompted nonprofit hospitals to adopt more generous eligibility policies, but no prior research has examined the longitudinal trend. The expansion of Medicaid coverage in many states has been found to reduce charity care provision, but it is unclear whether the change in charity care eligibility policies differed between Medicaid expansion and nonexpansion states. Using mandatory tax filings, we found that both hospitals in Medicaid expansion states and hospital in nonexpansion states adopted more generous eligibility policies in 2018 than in 2010, but the change was greater in the former for discounted charity care; while the former provided less charity care regardless of their policy changes, the latter provided more when their policies became more generous. This study has implications for policy discussions on the justification of nonprofit hospitals' tax-exempt status.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"458-468"},"PeriodicalIF":2.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39343278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum to Medicaid Expansion and Not-For-Profit Hospitals' Financial Status: National and State-Level Estimates Using IRS and CMS Data, 2011-2016.","authors":"","doi":"10.1177/10775587211029108","DOIUrl":"https://doi.org/10.1177/10775587211029108","url":null,"abstract":"","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"469-470"},"PeriodicalIF":2.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10775587211029108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39251165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michaela Kerrissey, Maike Tietschert, Zhanna Novikov, Hassina Bahadurzada, Anna D Sinaiko, Veronique Martin, Sara J Singer
{"title":"Social Features of Integration in Health Systems and Their Relationship to Provider Experience, Care Quality and Clinical Integration.","authors":"Michaela Kerrissey, Maike Tietschert, Zhanna Novikov, Hassina Bahadurzada, Anna D Sinaiko, Veronique Martin, Sara J Singer","doi":"10.1177/10775587211024796","DOIUrl":"https://doi.org/10.1177/10775587211024796","url":null,"abstract":"<p><p>More is known about the structural features of health system integration than the social features-elements of normative integration (alignment of norms) and interpersonal integration (collaboration among professionals and with patients). We surveyed practice managers and 1,360 staff and physicians at 59 practice sites within 17 health systems (828 responses; 61%). Building on prior theory, we developed and established the psychometric properties of survey measures describing normative and interpersonal integration. Normative and interpersonal integration were both consistently related to better provider experience, perceived care quality, and clinical integration (e.g., a 1-point increase in a practice's normative integration was associated with 0.53-point higher job satisfaction and 0.77-point higher perceived care quality in the practice, measured on 1 to 5 scales, <i>p</i> < .01). Variation in social features of integration may help explain why some health systems better integrate care, pointing to normative and interpersonal integration as potential resources for improvement.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"359-370"},"PeriodicalIF":2.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10775587211024796","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39233580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shoou-Yih D Lee, Bradley Iott, Jane Banaszak-Holl, Shu-Fang Shih, Minakshi Raj, Kimson E Johnson, Karalyn Kiessling, N'dea Moore-Petinak
{"title":"Application of Mixed Methods in Health Services Management Research: A Systematic Review.","authors":"Shoou-Yih D Lee, Bradley Iott, Jane Banaszak-Holl, Shu-Fang Shih, Minakshi Raj, Kimson E Johnson, Karalyn Kiessling, N'dea Moore-Petinak","doi":"10.1177/10775587211030393","DOIUrl":"https://doi.org/10.1177/10775587211030393","url":null,"abstract":"<p><p>Mixed methods research (MMR) is versatile, pragmatic, and adaptable to constraints and opportunities during a research process. Although MMR has gain popularity in health services management research, little is known about how the research approach has been used and the quality of research. We conducted a systematic review of 198 MMR articles published in selected U.S.-based and international health services management journals from 2000 through 2018 to examine the extent of MMR application and scientific rigor. Results showed limited, yet increasing, use of MMR and a high degree of correspondence between MMR designs and study purposes. However, most articles did not clearly justify using MMR designs and the reporting of method details and research integration were inadequate in a significant portion of publications. We propose a checklist to assist the preparation and review of MMR manuscripts. Additional implications and recommendations to improve transparency, rigor, and quality in MMR are discussed.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"331-344"},"PeriodicalIF":2.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10775587211030393","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39177266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sayeh Nikpay, Ezra Golberstein, Hannah T Neprash, Caitlin Carroll, Jean M Abraham
{"title":"Taking the Pulse of Hospitals' Response to the New Price Transparency Rule.","authors":"Sayeh Nikpay, Ezra Golberstein, Hannah T Neprash, Caitlin Carroll, Jean M Abraham","doi":"10.1177/10775587211024786","DOIUrl":"https://doi.org/10.1177/10775587211024786","url":null,"abstract":"<p><p>As of January 1, 2021, most U.S. hospitals are required to publish pricing information on their website to promote more informed decision making by consumers regarding their care. In a nationally representative sample of 470 hospitals, we analyzed whether hospitals met price transparency information reporting requirements and the extent to which complete reporting was associated with ownership status, bed size category, system affiliation, and location in a metropolitan area. Fewer than one quarter of sampled hospitals met the price transparency information requirements of the new rule, which include five types of standard charges in machine-readable form and the consumer-shoppable display of 300 shoppable services. Our analyses of hospital reporting by organizational and market attributes revealed limited differences, with some exceptions for nonprofit and system-member hospitals demonstrating greater responsiveness with respect to the consumer-shoppable aspects of the rule.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"428-434"},"PeriodicalIF":2.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10775587211024786","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39248334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Continuous Eligibility for Medicaid Associated With Improved Child Health Outcomes.","authors":"Erin Brantley, Leighton Ku","doi":"10.1177/10775587211021172","DOIUrl":"https://doi.org/10.1177/10775587211021172","url":null,"abstract":"<p><p>Fluctuating insurance coverage, or churning, is a recognized barrier to health care access. We assessed whether state policies that allow children to remain covered in Medicaid for a 12-month period, regardless of fluctuations in income, are associated with health and health care outcomes, after controlling for individual factors and other Medicaid policies. This cross-sectional study uses a large, nationally representative database of children ages 0 to 17. Continuous eligibility was associated with improved rates of insurance, reductions in gaps in insurance and gaps due to application problems, and lower probability of being in fair or poor health. For children with special health care needs, it was associated with increases in use of medical care and preventive and specialty care access. However, continuous eligibility was not associated with health care utilization outcomes for the full sample. Continuous eligibility may be an effective strategy to reduce gaps in coverage for children and reduce paperwork burden on Medicaid agencies.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"404-413"},"PeriodicalIF":2.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39421713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uduwanage Gayani E Perera, Andrew W Dick, Ashley M Chastain, Patricia W Stone, Jingjing Shang
{"title":"The Effects of Home Health Value-Based Purchasing on Home Health Care Quality in For-Profit and Nonprofit Agencies: A Comparative Interrupted Time-Series Analysis, 2012-2018.","authors":"Uduwanage Gayani E Perera, Andrew W Dick, Ashley M Chastain, Patricia W Stone, Jingjing Shang","doi":"10.1177/10775587211049628","DOIUrl":"https://doi.org/10.1177/10775587211049628","url":null,"abstract":"<p><p>Beginning in 2016, the Home Health Value-Based Purchasing (HHVBP) model incentivized U.S. Medicare-certified home health agencies (HHAs) in nine states to improve quality of patient care and patient experience. Here, we quantified HHVBP effects upon quality over time (2012-2018) by HHA ownership (i.e., for-profit vs. nonprofit) using a comparative interrupted time-series design. Our outcome measures were Care Quality and Patient Experience indices composed of 10 quality of patient care measures and five patient experience measures, respectively. Overall, 17.7% of HHAs participated in the HHVBP model of which 81.4% were for-profit ownership. Each year after implementation, HHVBP was associated with a 1.59 (<i>p</i> < .001) percentage point increase in the Care Quality index among for-profit HHAs and a 0.71 (<i>p</i> = .024) percentage point increase in the Patient Experience index among nonprofits. The differences of quality improvement under the HHVBP model by ownership indicate variations in HHA leadership responses to HHVBP.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"414-427"},"PeriodicalIF":2.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980113/pdf/nihms-1747069.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39486202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient Decision Aid Selection for Shared Decision Making: A Multicase Qualitative Study.","authors":"Cynthia LeRouge, Ann M Nguyen, Deborah J Bowen","doi":"10.1177/10775587211012995","DOIUrl":"https://doi.org/10.1177/10775587211012995","url":null,"abstract":"<p><p>The patient decision aid (PDA) is a promising patient engagement tool for use in shared decision making (SDM). Selecting a PDA is an essential precursor to successful SDM implementation. Little is known regarding the organizational stakeholder process for assessing and selecting a PDA. We conducted a qualitative, multicase study within the context of a maternal health decision to identify the criteria used by stakeholders to select a PDA. We further explored the perceived value of PDA certification on PDA selection. We reported the PDA selection criteria within the domains of (1) Design and Functionality, (2) User Fit, (3) Context and Climate, (4) Support, and (5) Strategic Vision and found that certification was perceived to be a valuable screening mechanism for smaller health organizations. Health organizations and researchers may use our PDA selection criteria and conceptual model to plan future deployments of PDAs and patient engagement tools.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"267-280"},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10775587211012995","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38957117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States.","authors":"Priyanka Anand, Dora Gicheva","doi":"10.1177/10775587211015816","DOIUrl":"https://doi.org/10.1177/10775587211015816","url":null,"abstract":"<p><p>This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions-that is, some students substituted their private and employer-sponsored coverage for Medicaid.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"299-307"},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10775587211015816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38915272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}