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Geographic Variation In The Implementation Of Public Health Services: Organizational, Economic, And Network Determinants, Glen P. Mays Dec 2015

Geographic Variation In The Implementation Of Public Health Services: Organizational, Economic, And Network Determinants, Glen P. Mays

Glen Mays

An expanding body of research-tested public health interventions exist to prevent disease and injury and promote health on a population-wide basis, such as those profiled in the CDC’s Guide to Community Prevention Services, but adoption and implementation of these strategies vary widely across states and communities. Public health services are delivered through diffuse constellations of governmental agencies and their private-sector and community-based counterparts using implementation mechanisms that are poorly understood. The studies in this panel examine how organizational, economic, and inter-organizational network characteristics influence the implementation of public health services across states and communities.


Inter-Organizational Network Effects On Public Health Service Implementation, Outcomes, And Disparities Across U.S. Communities, Glen P. Mays Dec 2015

Inter-Organizational Network Effects On Public Health Service Implementation, Outcomes, And Disparities Across U.S. Communities, Glen P. Mays

Glen Mays

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 360 …


Estimating Health And Economic Gains From Public Health Delivery System Transformation, Glen Mays Nov 2015

Estimating Health And Economic Gains From Public Health Delivery System Transformation, Glen Mays

Glen Mays

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 Oct 2015

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

Glen Mays

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 Oct 2015

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

Glen Mays

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 Inferences With Complex Multi-Component Interventions: Project Achieve's Study Of Managing Care Transitions, Glen P. Mays Oct 2015

Analytic Approaches For Causal Inferences With Complex Multi-Component Interventions: Project Achieve's Study Of Managing Care Transitions, Glen P. Mays

Glen Mays

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.


Using Research And Roi To Drive Partnerships In Public Health Delivery Systems, Glen P. Mays Aug 2015

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

Glen Mays

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 …


Foundational Public Health Services And Health System Reform: Evidence, Economics, And Implementation, Glen P. Mays Aug 2015

Foundational Public Health Services And Health System Reform: Evidence, Economics, And Implementation, Glen P. Mays

Glen Mays

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 …


Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays Aug 2015

Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays

Glen Mays

This workshop provides an overview of the design and implementation of economic evaluation studies of public health programs and policies. Strategies for integrating economic evaluation principles, measurement strategies, analytic approaches, and results into the routine operations of public health agencies are examined.


Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays Jun 2015

Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays

Glen Mays

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This session highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This methods workshop examines the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures. This paper profiles examples of using SNA principles and methods to study the implementation …


Learning From Network Analysis: Care Transitions, Market Competition, And Community Interventions, Glen P. Mays Jun 2015

Learning From Network Analysis: Care Transitions, Market Competition, And Community Interventions, Glen P. Mays

Glen Mays

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This methods workshop highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This session will examine the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures.


Cost Estimation In Public Health Services & Systems Research, Glen P. Mays Jun 2015

Cost Estimation In Public Health Services & Systems Research, Glen P. Mays

Glen Mays

Considerable uncertainty persists about the resources required to implement public health programs and policies, and about the factors that drive variation in resource needs and utilization across community and institutional settings. This paper reviews several alternative approaches to cost estimation that we have used in the field of public health services & systems research (PHSSR). This review was prepared for an expert panel meeting convened as part of a study commissioned by the U.S. Assistant Secretary for Planning and Evaluation (ASPE) to estimate the costs associated with public health emergency preparedness capabilities.


Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays Apr 2015

Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays

Glen Mays

The implementation and reach of evidence-based prevention and public health programs varies widely across the U.S., as does the availability of cross-cutting infrastructure and foundational capabilities required to support these interventions. This talk profiles ongoing research to uncover the causes and consequences of variation in public health delivery. This research points to policy and administrative strategies that can reduce inequities and inefficiencies in public health protections.


Using Practice-Based Research Networks For Next-Generation Public Health, Glen P. Mays Mar 2015

Using Practice-Based Research Networks For Next-Generation Public Health, Glen P. Mays

Glen Mays

U.S. public health agencies face an existential imperative to transform their work from a collection of discrete programs and policies into a coherent enterprise for population-wide health improvement. Practice-based research networks (PBRNs) and the advancing science of public health delivery systems can help to achieve this transformation.


Estimating The Costs Of Foundational Public Health Services, Glen P. Mays Feb 2015

Estimating The Costs Of Foundational Public Health Services, Glen P. Mays

Glen Mays

The Institute of Medicine’s 2012 report on public health financing called for the convening of expert panels to identify the components of a “minimum package” of public health services and cross-cutting capabilities that should be available in every U.S. community to protect and improve population health. This report also called for studies to identify the resources required to make these services universally available across the country. This research brief describes the research methodology in use to generate first-generation estimates of current resource use and estimated resource needs for implementing foundational public health services and capabilities.


Improving Measures Of Public Health Activity At Local And State Levels: The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays Feb 2015

Improving Measures Of Public Health Activity At Local And State Levels: The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays

Glen Mays

Implementation of high-value public health strategies for chronic disease prevention, communicable disease control, and environmental health protection vary widely across U.S. states and communities. The Multi-Network Practice and Outcome Variation Examination Study (MPROVE) supported by the Robert Wood Johnson Foundation creates the measurement and analytic foundation for investigating the causes and consequences of practice variation in public health.


The Economics Of Implementing Population Health Strategies, Glen P. Mays Dec 2014

The Economics Of Implementing Population Health Strategies, Glen P. Mays

Glen Mays

Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …


Geographic Variation In The Delivery Of High-Value Public Health Services:Exploring Causes & Consequences, Glen P. Mays Nov 2014

Geographic Variation In The Delivery Of High-Value Public Health Services:Exploring Causes & Consequences, Glen P. Mays

Glen Mays

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …


Cost Estimates Of Foundational Public Health Services:Results From Piloting An Expert Consensus Methodology, Cezar B. Mamaril, Glen P. Mays Nov 2014

Cost Estimates Of Foundational Public Health Services:Results From Piloting An Expert Consensus Methodology, Cezar B. Mamaril, Glen P. Mays

Glen Mays

We review preliminary estimates from pilot testing a cost estimation methodology developed to identify the resources required to implement a set of Foundational Public Health Services as recommended by the Institute of Medicine and defined by the Public Health Leadership Forum.


Estimating The Costs Of Foundational Public Health Services: Pilot Results Of An Expert Consensus Methodology, Cezar B. Mamaril, Glen P. Mays Nov 2014

Estimating The Costs Of Foundational Public Health Services: Pilot Results Of An Expert Consensus Methodology, Cezar B. Mamaril, Glen P. Mays

Glen Mays

We developed a methodology for estimating the resources required to deliver a set of foundational public health capabilities as recommended in the 2012 Institute of Medicine report on public health financing. The capabilities are based on IOM recommendations and defined by a national expert panel convened as part of the Public Health Leadership Forum. This paper presents preliminary estimates from a pilot test of the cost estimation methodology in Kentucky, and outlines plans for the national estimation strategy.


Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays Nov 2014

Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays

Glen Mays

This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .


Comparative Report Of Results From The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays, Lava Timsina Nov 2014

Comparative Report Of Results From The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays, Lava Timsina

Glen Mays

This comparative report displays results from the Multi-Network Practice and Outcome Variation Examination (MPROVE) Study. Funded by the Robert Wood Jonhson Foundation and conducted through Public Health Practice-Based Research Networks (PBRNs) in 6 states, this study profiles geographic variation in the implementation of public health activities for chronic disease prevention, communicable disease control, and environmental health protection. The report shown here was customized for each local public health setting participating in the study.


Annual Bibliography Of The National Coordinating Center For Public Health Services & Systems Resesarch, Year Four, Glen P. Mays, Anna G. Hoover, Lizeth Fowler, Ann Kelly Oct 2014

Annual Bibliography Of The National Coordinating Center For Public Health Services & Systems Resesarch, Year Four, Glen P. Mays, Anna G. Hoover, Lizeth Fowler, Ann Kelly

Glen Mays

The National Coordinating Center for Public Health Services and Systems Research (PHSSR), together with the Public Health Practice-Based Research Networks (PBRN) Program, works to expand the production and application of evidence on how best to organize, finance and deliver public health strategies that improve population health. The Center designs and conducts research studies, provides technical assistance and direction for other researchers across the U.S., develops methodological advances in measurement and analysis, and accelerates the translation and dissemination of research findings for policy and practice stakeholders. This report inventories the research products produced during the Center's fourth program year of funding …


Annual Report Of The National Coordinating Center For Public Health Services & Systems Research, Year Four, Glen P. Mays, Anna G. Hoover, Lizeth Fowler, Ann Kelly Oct 2014

Annual Report Of The National Coordinating Center For Public Health Services & Systems Research, Year Four, Glen P. Mays, Anna G. Hoover, Lizeth Fowler, Ann Kelly

Glen Mays

The National Coordinating Center for Public Health Services and Systems Research (PHSSR), together with the Public Health Practice-Based Research Networks (PBRN) Program, works to expand the production and application of evidence on how best to organize, finance and deliver public health strategies that improve population health. The Center designs and conducts research studies, provides technical assistance and direction for other researchers across the U.S., develops methodological advances in measurement and analysis, and accelerates the translation and dissemination of research findings for policy and practice stakeholders. This report summarizes activities completed during the Center's fourth program year of funding from the …


Cost Estimates Of Foundational Public Health Capabilities: Pilot Test Results Of An Expert Consensus Methodology, Cezar B. Mamaril, Glen Mays Oct 2014

Cost Estimates Of Foundational Public Health Capabilities: Pilot Test Results Of An Expert Consensus Methodology, Cezar B. Mamaril, Glen Mays

Glen Mays

The Institute of Medicine's 2012 report on U.S. public health financing recommended research to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be made available in every U.S. community. We present results from pilot testing of a proposed methodology for estimating the costs and resource requirements for a set of foundational public health capabilities identified by the Public Health Leadership Forum. Using pilot data from Kentucky public health settings, we estimate both current and projected costs under a range of assumptions about the resources required to fully implement the capabilities at …


Ending Failures, Showing Results, Improving Population Health:Insights From Research & Reform In The U.S., Glen P. Mays Oct 2014

Ending Failures, Showing Results, Improving Population Health:Insights From Research & Reform In The U.S., Glen P. Mays

Glen Mays

A growing body of empirical research supports the value of aligning the delivery systems for public health, medical care, and social services for populations with shared needs and risk factors. This presentation reviews selected studies from the field of public health services & systems research (PHSSR) in the U.S. that suggest pathways for achieving greater system alignment in the Canadian context.


How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays Oct 2014

How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays

Glen Mays

Research on the health and economic impact of public health strategies can help newly evolving health care delivery systems focus on upstream health determinants and make evidence-informed decisions about resource allocation across the prevention-treatment spectrum. Examples from research underway in the U.S. have particular relevance for Canada's evolving regional health authorities and their integrated approaches to medical care and public health delivery.


Tougher Than Rocket Science, Or Just Messier? Using Research To Improveu.S. Public Health Delivery, Glen P. Mays Oct 2014

Tougher Than Rocket Science, Or Just Messier? Using Research To Improveu.S. Public Health Delivery, Glen P. Mays

Glen Mays

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.


Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays Oct 2014

Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays

Glen Mays

Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.


Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays Oct 2014

Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays

Glen Mays

Public health laboratories are the information engines for public health agencies and delivery systems. Measuring the value stream that flows from this information can support objective assessments of the health and economic benefits attributable to laboratory infrastructure and information.