Core B will centrally unify primary data collection activities of the renewal P01 and serve all three proposed research projects. This will be done by developing and implementing a series of case studies that will collect data utilized by all of the projects. In addition. Core B will lead efforts to gather and update other relevant federal and state policy data related to health care reform, such as collecting lists of CMS acknowledged Accountable Care Organizations (ACO) and lists of bundled payment demonstration projects participating providers and lists of hospitals fined under CMS's re-hospitalization penalty system. These data will then be transferred to Core C for integration into the overall program project hierarchical data base. The primary purpose of Core B is to qualitatively explore how multiple players in a market affect the choice, use and outcomes of post-acute care (PAC). A total of 8 case studies will be conducted with markets selected based upon Medicare Managed Care penetration (Project #3). In each site two hospitals will be selected based upon their re-hospitalization rate (Project #2) and for every hospital we'll select two skilled nursing facilities based upon whether they appear to be the hospital's preferred referral source or not (Project #1). In order to meet the needs of the three proposed projects, several key informants will be interviewed at each organization selected for each of the case study sites. We will interview approximately 26 individuals at each case study site (6 by telephone and 20 in-person), including five individuals at each of the two hospitals selected at each site, three individuals at each of the four SNFs selected at each site, and one case manager and one medical director from each of the top two MCOs in the market (based on market share). This will result in more than 200 interviews, with each site analyzed as a separate case study. However, consistency will be sought across sites by organization and respondent type and organizations differing in important ways (e.g. 30-day re-hospitalizations rates) will be compared and contrasted.

Public Health Relevance

Core B will serve the three interrelated renewal P01 projects. These projects build upon the same conceptual framework for understanding how policies and market forces affect provider behavior and strategies and ultimately the outcomes experienced by patients. The work of Core B will allow the 3 projects to answer key policy questions about how to best structure incentives and regulations to insure that frail older hospitalized patients receive cost effective and coordinated care

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Program Projects (P01)
Project #
2P01AG027296-06A1
Application #
8618216
Study Section
Special Emphasis Panel (ZAG1-ZIJ-3 (01))
Project Start
Project End
Budget Start
2014-02-15
Budget End
2015-01-31
Support Year
6
Fiscal Year
2014
Total Cost
$213,932
Indirect Cost
$82,282
Name
Brown University
Department
Type
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
Rivera-Hernandez, Maricruz; Leyva, Bryan; Keohane, Laura M et al. (2016) Quality of Care for White and Hispanic Medicare Advantage Enrollees in the United States and Puerto Rico. JAMA Intern Med 176:787-94
Berridge, Clara; Tyler, Denise A; Miller, Susan C (2016) Staff Empowerment Practices and CNA Retention: Findings From a Nationally Representative Nursing Home Culture Change Survey. J Appl Gerontol :
Mor, Vincent; Rahman, Momotazur; McHugh, John (2016) Accountability of Hospitals for Medicare Beneficiaries' Postacute Care Discharge Disposition. JAMA Intern Med 176:119-21
Rahman, Momotazur; Grabowski, David C; Mor, Vincent et al. (2016) Is a Skilled Nursing Facility's Rehospitalization Rate a Valid Quality Measure? Health Serv Res 51:2158-2175
Schoenfeld, Andrew J; Zhang, Xuan; Grabowski, David C et al. (2016) Hospital-skilled nursing facility referral linkage reduces readmission rates among Medicare patients receiving major surgery. Surgery 159:1461-8
Teno, Joan M; Gozalo, Pedro; Khandelwal, Nita et al. (2016) Association of Increasing Use of Mechanical Ventilation Among Nursing Home Residents With Advanced Dementia and Intensive Care Unit Beds. JAMA Intern Med 176:1809-1816
Rahman, Momotazur; Norton, Edward C; Grabowski, David C (2016) Do hospital-owned skilled nursing facilities provide better post-acute care quality? J Health Econ 50:36-46
Baier, Rosa R; Trivedi, Amal N (2016) For Hospital Readmissions, Hindsight is Not 20/20. J Gen Intern Med 31:1270-1271
Rahman, Momotazur; McHugh, John; Gozalo, Pedro L et al. (2016) The Contribution of Skilled Nursing Facilities to Hospitals' Readmission Rate. Health Serv Res :
Jung, Hye-Young; Trivedi, Amal N; Grabowski, David C et al. (2016) Does More Therapy in Skilled Nursing Facilities Lead to Better Outcomes in Patients With Hip Fracture? Phys Ther 96:81-9

Showing the most recent 10 out of 118 publications