Health and Medical Administration Commons^™

Valuing And Financing Multi-Sector Population Health Initiatives, Glen P. Mays

Health Management and Policy Presentations

Large-scale multi-sector health improvement initiatives can be difficult to initiate and sustain over time due to uncertainties about their health and economic impact. This presentation reviews research on multi-sector population health initiatives, and examines several alternative approaches for sustainable financing.

Multi-Sector Contributions To Public Health Delivery Systems: Economic, Institutional & Policy Determinants, Glen P. Mays

Health Management and Policy Presentations

The United States faces growing public and policy demands to improve health status on a population-wide basis. This session reviews new research from the Robert Wood Johnson Foundation's Systems for Action research program about the implementation of population health activities in communities across the U.S. Using 16 years of data on a national cohort of metropolitan communities, we show that substantial growth has occurred in the array of organizations and sectors that contribute to population health activities, especially in the years following Affordable Care Act implementation. We also show that this growth has not occurred evenly across the U.S., with …

Aligning Delivery & Financing Systems To Build A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Systems for Action research program uses strong social science methods to discover ways of aligning medical, public health, and social service systems in ways that improve health and wellbeing. This session profiles several of the studies now underway through this new program.

Health Care, Employers And Population Health, Glen P. Mays

Health Management and Policy Presentations

Data from the National Longitudinal Survey of Public Health Systems show that hospital and employer contributions to population health activities vary widely across U.S. communities. As peripheral participants in the organizational networks that support population health activities, these stakeholders bring novel information and resources to multi-sector work. This fact may explain the tendency for population health improvement activities to be more effective when hospitals and employers are involved.

Transforming Public Health Delivery Systems For Population Health Improvement, Glen P. Mays

Health Management and Policy Presentations

A growing body of empirical research documents the health and economic benefits of multi-sector health improvement initiatives. In this session we share research that points to the delivery system features --including institutions, infrastructure, and incentives -- that lead to effective population health improvement strategies.

National Health Security Preparedness Index Joint Workgroup Meeting On Model Design And Analytic Methodology, Glen P. Mays

Health Management and Policy Presentations

This workgroup meeting of the National Health Security Preparedness Index reviews results from the 2016 release of the Index and examines opportunities for enhancing the Index measures and analytic methodologies for subsequent releases.

Comprehensive Public Health Delivery Systems: Using Foundational Capabilities To Achieve Health Impact And Equity, Glen P. Mays

Health Management and Policy Presentations

Achieving health equity requires building more comprehensive systems. Using data from a nationally representative cohort of U.S. communities, this session will explore the characteristics of Comprehensive Public Health Delivery Systems, the structures and processes needed to build such systems, and the health and economic benefits attributable to these systems.

Learning Objectives:

• Compare innovative ways to structure local health departments that maximize resources to enhance service delivery to the community.
• Discuss ways local health departments can build strategic alliances to implement successful collaborations that address health threats in the community.

Affordable Care Act Implementation And Multi-Sector Contributions To Population Health, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act established new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the degree and nature of change in multi-sectoral contributions to public health activities; and (2) the extent to which these system changes are attributable to key ACA provisions including coverage expansions, Prevention and Public Health funding, …

Integrating Delivery And Financing Systems Across Sectors To Build A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

The delivery and financing systems for medical care, public health, and social and community services are powerful determinants of health and wellbeing for families and communities across the U.S. Unfortunately, these systems interact in complex and often poorly understood ways through fragmented funding streams, organizational relationships, information flows, and governance and decision-making structures. This session will feature new studies underway through the Robert Wood Johnson Foundation’s Systems for Action (S4A) Research Program to test multi-sector strategies for integrating delivery and financing systems to improve population health.

Featured speakers:

David Meltzer, MD, PhD, University of Chicago Urban Labs. Expanding a Comprehensive …

New Directions In Public Health Systems Research: The U.S. Context, Glen P. Mays

Health Management and Policy Presentations

Public health services and delivery systems have the potential to improve population health and reduce health inequities by intervening on pathways that connect social and economic determinants to health outcomes. This session profiles the developing field of public health services and systems research (PHSSR) in the United States and new research directions to better understand the current and potential impact of public health delivery systems on social and economic drivers of health. We discuss emerging opportunities for cross-national comparative research on public health delivery systems in the U.S. and Canada.

Public Health Spending And Its Contributions To The Total Spend On Health, Glen P. Mays

Health Management and Policy Presentations

This presentation provides an overview of recent research on governmental public health expenditures and their interaction with medical spending, carried out through the Robert Wood Johnson Foundation supported initiatives on Public Health Services and Systems Research (PHSSR) and the new Systems for Action research program. This work illustrates the value of tracking resource use across multiple sectors that influence health and well-being in American communities. As such, this work can inform the ongoing dialogue about methodologies for summarizing total health spending for the U.S. and for state and local areas.

Learning From Geographic Variation And Change In Preparedness: The 2016 National Health Security Preparedness Index, Glen P. Mays

Health Management and Policy Presentations

The 2016 release of the National Health Security Preparedness Index tracks the nation's progress in preparing for disasters and other emergencies that create health risks for large groups of people. Recent improvements in the Index computational methodologies and measures allow results to be compared validly across states and over time. The Index aggregates more than 130 individual measures from nearly 60 data sources into valid composite measures for 6 domains and 19 subdomains that reflect core functional areas of emergency preparedness and response. Improvements in normalization, weighting, imputation, and confidence interval construction enhance the validity and reliability of Index estimates …

Measuring Progress To Comprehensive Public Health Systems, National Preparedness, And A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

This update describes recent progress on two national health measurement initiatives: The National Health Security Preparedness Index and the National Longitudinal Survey of Public Health Systems. These longitudinal data sources offer valuable perspectives on how health security practices and public health delivery systems are changing across the U.S.

Learning From Variation And Change: The 2016 Release Of The National Health Security Preparedness Index, Glen P. Mays

Health Management and Policy Presentations

The 2016 release of the National Health Security Preparedness Index uses an improved computational methodology and validated set of measures to more accurately track national and state progress in protecting the public from the health effects of disasters, outbreaks and other large-scale emergencies. This presentation provides a preview of the new methodology and results.

Understanding The Value Of Multi-Sector Partnerships To Improve Population Health, Glen P. Mays

Health Management and Policy Presentations

We review recent research concerning multi-sectoral partnerships aimed at improving health status on a population-wide basis, with a particular focus on implementation strategies and on health and economic impact. While still preliminary and emerging, research indicates that large health benefits are possible through collective actions that engage the medical, public health, and social sectors. Mechanisms for aligning incentives, dividing responsibilities equitably, and measuring progress regularly appear critical to success.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays, Rick Ingram

Health Management and Policy Presentations

We review methods for measuring the structure of public health delivery systems using data from the National Longitudinal Survey of Public Health Systems. A growing body of research using these measures demonstrates how multiple sectors contribute to core public health functions, and how these functions influence community health status over time. We end with a summary of how the Comprehensive Public Health System measure will be used in monitoring the impact of the 21st Century Public Health System initiative.

Aligning Delivery & Financing Systems To Advance A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Systems for Action Research Program supports research on how best to organize, finance, and deliver the constellation of services and supports that promote health and well-being in American communities, including but extending beyond the medical care and public health sectors. This session describes work underway through the S4A program and future research priorities, building on a strong scientific foundation in the fields of health services research (HSR) and public health services & systems research (PHSSR).

Integrating Health Services & Systems: What We Know, Think We Know, And Need To Learn, Glen P. Mays

Health Management and Policy Presentations

The delivery and financing systems for medical care, public health, and social and community services pursue many common goals and serve overlapping groups of families and communities. Unfortunately, in most American communities these systems interact in complex and often poorly understood ways through fragmented funding vehicles, information flows, governance and decision-making structures, institutional relationships, implementation rules and strategies, and professional and interpersonal connections. New research approaches are required to untangle these interactions and expose novel pathways of influence that can support equitable improvements in service delivery, resource use, health impact, and wellbeing. This presentation will summarize evidence from recent studies …

Measuring Multi-Sector Contributions To Public Health Delivery Systems & Population Health, Glen P. Mays

Health Management and Policy Presentations

The National Longitudinal Survey of Public Health Systems has followed a nationally-representative cohort of U.S. communities since 1998 to measure the scope of public health activities implemented in each community and the range of organizations and sectors that contribute to each activity. With 16 years of follow-up observations, this survey allows us to study the effects of demographic, economic, and policy shocks on public health delivery systems, and estimate the health effects attributable to delivery system change.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays

Health Management and Policy Presentations

Delivery and financing systems for public health services vary widely across U.S. communities, raising questions about the comparative effectiveness and efficiency of alternative structures. We summarize recent approaches for measuring alternative system configurations and estimating their health and economic effects.

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

Estimating Health & Economic Gains From Public Health Delivery System Transformation, Glen P. Mays

Health Management and Policy Presentations

Objectives: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health system change; and (2) the effects of these changes on preventable mortality and resource use. Methods: …

Understanding The Value Of Multi-Sector Health System Interactions, Glen P. Mays

Health Management and Policy Presentations

Recent research examines the health and economic value of multi-organizational and multi-sectoral approaches for the delivery of public health services. This presentation examines how data on these multi-organizational delivery systems and their impact can be used to solve collective action problems and stimulate collaborative solutions in public health.

Kentucky’S Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays

Health Management and Policy Presentations

This session examines recent progress toward the 2012 Institute of Medicine recommendation to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be available across the U.S. Research about the health and economic benefits of Foundational Public Health Services has begun to shape Kentucky's strategic plan for transforming the public health system.

Analytic Approaches For Causal Inference With Complex Multi-Component Interventions, Glen P. Mays, Arnold J. Stromberg, Jing Li, Mark V. Williams

Health Management and Policy Presentations

Estimating the causal effects of complex, multi-component health interventions is a task with many challenges in measurement and methodology. This presentation profiles the methods being used as part of the PCORI-funded Project Achieve, a national study to estimate the comparative effectiveness of heterogeneous care transition programs designed to help hospitalized patients and their caregivers navigate care delivery systems effectively and return back to the community with optimal health and wellbeing.

Trends In Health Care Delivery Systems: Implications For Cancer Prevention And Control, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act and larger economic forces are leading both health care providers and public health agencies to renegotiate their roles and responsibilities within the U.S. health system. This session reviews major changes occurring in both health care and public health delivery systems, with a focus on the implications for cancer prevention and control. The information infrastructure created by cancer registries and other health information systems are increasingly important for enabling greater coordination, alignment and accountability within the nation's changing delivery systems.

The National Health Security Preparedness Index: Proposed Updates For 2015-16, Glen P. Mays

Health Management and Policy Presentations

The U.S. Centers for Disease Control and Prevention (CDC) initiated development of the National Health Security Preparedness Index in 2012 to create a platform for measuring the nation’s progress in preparing for, responding to, and recovering from disasters and other large-scale emergencies that pose risks to health and well-being in the United States. As a measurement tool, the Index is designed to summarize levels of preparedness achieved within individual states and for the nation as a whole. This session summarizes proposed updates to the Index for 2015-16 that are designed to improve the validity and reliability of Index measures and …

Using Research And Roi To Drive Partnerships In Public Health Delivery Systems, Glen P. Mays

Health Management and Policy Presentations

Stimulating public-private partnerships (PPP) for health and economic development initiatives requires research that can answer key questions: (1) what are the health and economic returns likely to be realized; (2) over what time frames and with what certainty; (3) what investments are required to achieve results; and (4) what are the implementation strategies most likely to succeed. This presentation reviews ongoing research on the PPPs used to deliver public health services in the U.S., and explores the lessons this research offers PPPs in low and middle income countries. We examine how scientific evidence on public health delivery systems and their …

Estimating Patient-Centered And Community-Centered Treatment Effects: Examples From Medical Care And Public Health, Glen P. Mays

Health Management and Policy Presentations

Health services researchers face growing clinical and policy imperatives for estimating how the effectiveness of medical and public health interventions vary across patients, population groups, and community settings. Recent advances in local instrumental variables estimation techniques allow for the estimation of person-specific and community-specific treatment effects in the presence of unobserved heterogeneity. This presentation explores examples from both medicine and public health following the local IV methods developed by Basu et al. (2013).

Foundational Public Health Services And Health System Reform, Glen P. Mays

Health Management and Policy Presentations

The Institute of Medicine's 2012 report on public health financing recommended a national initiative to identify the components and costs of a "minimum package" of public health programs and infrastructure that should be available in every U.S. community. In response, efforts are now underway to reach consensus on a set of "Foundational Public Health Services" for the nation, and to identify resource requirements for implementing these services. This presentation reviews existing research on the current availability of Foundational Public Health Services across the U.S. and the health and economic effects attributable to these services. We also review progress on ongoing …