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
Rahman, Momotazur; Foster, Andrew D (2015) Racial segregation and quality of care disparity in US nursing homes. J Health Econ 39:16-Jan
Rahman, Momotazur; Tyler, Denise; Thomas, Kali S et al. (2015) Higher Medicare SNF care utilization by dual-eligible beneficiaries: can Medicaid long-term care policies be the answer? Health Serv Res 50:161-79
Teno, Joan; Meltzer, David O; Mitchell, Susan L et al. (2014) Type of attending physician influenced feeding tube insertions for hospitalized elderly people with severe dementia. Health Aff (Millwood) 33:675-82
Clark, Melissa A; Roman, Anthony; Rogers, Michelle L et al. (2014) Surveying multiple health professional team members within institutional settings: an example from the nursing home industry. Eval Health Prof 37:287-313
Miller, Susan C; Lepore, Michael; Lima, Julie C et al. (2014) Does the introduction of nursing home culture change practices improve quality? J Am Geriatr Soc 62:1675-82
Rahman, Momotazur; Grabowski, David C; Gozalo, Pedro L et al. (2014) Are dual eligibles admitted to poorer quality skilled nursing facilities? Health Serv Res 49:798-817
Thomas, Kali S; Wysocki, Andrea; Intrator, Orna et al. (2014) Finding Gertrude: The resident's voice in Minimum Data Set 3.0. J Am Med Dir Assoc 15:802-6
Schneider, Julie M; McMahon, Catherine M; Gopinath, Bamini et al. (2014) Dual sensory impairment and hearing aid use among clients attending low-vision services in Australia: the vision-hearing project. J Aging Health 26:231-49
Thomas, Kali S (2014) The relationship between older Americans act in-home services and low-care residents in nursing homes. J Aging Health 26:250-60
Fulton, Ana Tuya; Gozalo, Pedro; Mitchell, Susan L et al. (2014) Intensive care utilization among nursing home residents with advanced cognitive and severe functional impairment. J Palliat Med 17:313-7

Showing the most recent 10 out of 65 publications