Medicine and Health Sciences Commons^™

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

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

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medicine recommended in 2012 that the federal government undertake work to identify the components and costs of a "minimum package" of public health programs, services, and capabilities that should be available in every American community. This presentation summarizes work that is currently underway through the Robert Wood Johnson Foundation-supported Public Health Practice-Based Research Networks (PBRN) Program to estimate the costs of public health delivery.

New Health Delivery Networks: Merging Public Health And Health Care Systems, Glen P. Mays

Health Management and Policy Presentations

Incomplete coordination between medical care and public health delivery systems can result in significant missed opportunities for improving population health and constraining overall resource use. This lecture uses insight from the field of public health services and systems research (PHSSR) to examine: (1) why medical care and public health systems often fail to connect; (2) what are the potential health and economic consequences of these failures; and (3) what are the opportunities for connecting medical care and public health delivery to improve population health.

Who Benefits From Public Health Spending And How Long Does It Take: Estimating Community-Specific Spending Effects, Glen P. Mays

Health Management and Policy Presentations

Objectives: Spending on public health and prevention strategies varies widely across states and communities. The Patient Protection and Affordable Care Act of 2010 (ACA) authorized the largest expansion in federal public health spending in decades, with the goals of improving population health and helping to moderate growth in medical care spending. To produce evidence needed to inform these investments, this study (1) estimates the effects of public health spending patterns within communities on preventable mortality and subsequent medical care spending; and (2) uses the methods of local instrumental variables developed by Heckman and Vytlacil and Basu to estimate how the …

Recessions, Risks And Reforms: Changes In Inter-Organizational Activities To Improve Public Health, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new incentives for hospitals, insurers, employers, public health agencies, and others to contribute to activities designed to promote health and prevent disease an injury. At the same time, the economic recession has constrained government and private sector spending on health and health care, necessitating changes in the scope and scale of public health delivery. This study uses data from the 1998-2012 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, with a focus on hospitals, insurers, employers, and primary …

Update On Public Health Financing & Economic Studies From The Phssr And Pbrn Programs, Glen P. Mays

Health Management and Policy Presentations

As part of the Public Health Financing Roundtable at APHA, this session provides an update on public health financing and economics studies underway through the Public Health Services and Systems Research (PHSSR) Program and the Public Health Practice-Based Research Networks (PBRN) Program, supported by the Robert Wood Johnson Foundation.

Public Health Services & Systems Research: Building The Science Of Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

The extreme heterogeneity in how public health activities are organized, financed, and implemented across U.S. states and communities provides compelling opportunities for research on the comparative effectiveness and efficiency of public health delivery. This talk highlights some of the most compelling and policy-relevant opportunities for research on public health organization and financing issues, and examines some of the ongoing studies in the field.

Cost Estimation Methods And Foundational Public Health Capabilities, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medine recently recommended that the federal government identify the components and costs of a "minimum package of public health services" and "foundational public health capabilities" that should be universally available across the U.S. This presentation reviews costing methods that can be used for identifying the costs required to establish "foundational public health capabilities" at state and local levels within the U.S. public health system.

Building The Science Of Delivery: Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Studying variation and innovation in public health delivery can identify pathways for improving the organization, financing, and implementation of programs and policies that protect and promote health.

Accreditation And Standardization In Local Public Health, Glen P. Mays

Health Management and Policy Presentations

Reducing harmful, wasteful, and inequitable variation in public health delivery is a central objective for administrative and policy decision-makers in public health, and is embedded in the national accreditation movement. The challenge lies in accomplishing this objective while preserving the benefits of customization in public health delivery that accrue through tailoring and targeting of resources to unique community needs and risks. Public health services and systems research (PHSSR) can help determine the optimal balance between standardization and customization in public health delivery.

Strengthening The Evidence Base For Accreditation: Progress In Phssr And Pbrns, Glen P. Mays

Health Management and Policy Presentations

With the launch of a voluntary national accreditation program for public health agencies, the field requires an expanding evidence base concerning which public health strategies work best, for which populations, and under what circumstances. The field of public health services and systems research (PHSSR) and practice-based research networks (PBRNs) are producing applied studies that can inform the future development and implementation of accreditation standards, and evaluate the impact of accreditation on the field of practice.

Public Health Services & Systems Research: Concepts, Methods, And Emerging Findings, Glen P. Mays

Health Management and Policy Presentations

The field of public health services & systems research (PHSSR) increasingly is addressing the question of how to assess the value of investments in public health programs, infrastructure, and delivery systems. Progress in quasi-experimental research designs, measurement, estimation techniques, and data sources are yielding important insight.

Health System Contributions To Public Health Activities Amid Policy And Economic Change: Estimating Complementarities, Substitutions, And Network Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new incentives for hospitals, insurers, employers, public health agencies, and others to contribute to activities designed to promote health and prevent disease an injury, potentially changing the structure of public health delivery systems and expanding the delivery of strategies that improve population health. At the same time, the economic recession has constrained government and private sector spending on health and health care, necessitating changes in the scope and scale of public health delivery. This study uses data from the 1998-2012 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and …

Hospital Contributions To Public Health Activities Before And After Aca: Incentives, Constraints & Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created enhanced IRS requirements for not-for-profit hospitals regarding the provision of community benefits, potentially stimulating new approaches to community health needs assessment, priority setting, and engagement with public health agencies and other community stakeholders. Yet the economic downturn has constrained hospital earnings and increased demand for uncompensated care, potentially crowding out hospital contributions to public health activities. This study uses data from 1998-2012 on a national cohort of communities to examine: (1) the extent and nature of change in hospital contributions to public health activities; and (2) the economic, institutional, and policy-related factors that …

Frontiers In Public Health Services And Systems Research: Accelerating And Expanding Knowledge Transfer In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

As part of the "Meet the Editors" panel on publishing health services research, this presentation discusses the new open-access journal Frontiers in Public Health Services and Systems Research. This journal serves as a vehicle for rapidly disseminating newly emerging and preliminary findings from studies that examine the organization, financing, and delivery of public health services. The goal is to stimulate research collaboration and accelerate knowledge transfer from research projects to policy and administrative decision-makers within the public health system.

Analyzing Return On Investment In Public Health: Implications And Future Directions, Glen P. Mays

Health Management and Policy Presentations

Return on investment (ROI) analyses of public health programs, policies, and services are being undertaken with increasing frequency to provide assessments of the value of these activities. This presentation reviews current initiatives and future directions for improving the quality of ROI studies and their application to real-world public health policy and administrative decisions.

Harnessing The Power Of Public Health Systems For Injury Prevention & Control, Glen P. Mays

Health Management and Policy Presentations

Efforts to improve population health hinge on a vast yet diffuse constellation of government agencies, health care providers, and community organizations that assume responsibilities in implementing prevention programs and policies across the U.S. Realizing the full health and economic benefits of injury prevention and control initiatives requires mobilizing and managing these complex and heterogeneous public health delivery systems. This session will explore the emerging science of public health delivery systems and what it tells us about improving injury prevention and control amid policy and economic change.

Estimating Return On Investment: Approaches And Methods, Glen P. Mays

Health Management and Policy Presentations

Continuing fiscal constraints in the public sector and large-scale policy changes associated with health reform implementation in the U.S. are giving heightened attention to questions about the health and economic value of public health programs, services, and policies -- strategies designed to protect health and prevent disease and injury on a population-wide basis. This session provides an overview of approaches for conducting return-on-investment (ROI) analyses and related economic evaluation studies in public health settings in order to inform policy and administrative decision-making. New opportunities and resources created through CDC's National Public Health Improvement Initiative (NPHII) and RWJF's Public Health Practice-based …

Optimizing The Value Of Public Health Services: Lessons From Research & Practice, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health programs and policies holds considerable potential for improving population health and constraining the growth in health care spending. Achieving such expansions efficiently, particularly in low-resource settings, requires careful attention to interorganizational and intergovernmental relationships in public health delivery.

Next Generation Public Health Delivery: Optimizing Health And Economic Impact, Glen P. Mays

Health Management and Policy Presentations

Improving population health in the context of significant policy and economic change will require governmental public health agencies to rethink their roles within the U.S. health and social services systems, giving much greater attention to "catalytic" functions intended to mobilize, direct, and coordinate the actions of others. A growing body of evidence and experience suggests that such changes are likely to be feasible, effective, and efficient.

The Value Of Public Health Financial Data, Glen P. Mays

Health Management and Policy Presentations

Effective policy and administrative decision-making in public health requires reliable information on the amount of resources invested in governmental public health programs and how these resouces are allocated and used across the U.S. public health system. This session examines current and potential uses of public health financial data in the U.S., and considers expanded roles for research in informing policy and administrative decisions.

Public Health Roi: Evidence, Experience And Remaining Questions, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health and prevention strategies holds considerable potential for improving health outcomes and constraining costs across the U.S. health system. Unfortunately, lingering certainties about the costs required to expand public health delivery systems and about the health and economic effects of such expansions has muted private and public support for increased public health expenditures. This lecture examines recent evidence from public health services and systems research studies that examine the health and economic value of public health delivery, and identifies remaining research needs for the field.

Cost Estimation Methods: Strategies And Examples For Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

This webinar reviews methods for conducting cost studies in public health settings, including strategies for estimating the financial and ecnomic costs of delivering public health services, and analytic approaches to identifying factors that influence delivery costs. These types of studies are of increasing importance to policy and practice stakeholders given the need for evidence about the return-on-investment (ROI) generated through public health delivery.

Building The Science Of Public Health Delivery: Advances In Public Health Services And Systems Research, Glen P. Mays

Health Management and Policy Presentations

Efforts to improve the health and economic performance of the U.S. health system require evidence about how best to deliver public health strategies that protect health and prevent disease and injury on a population-wide basis. The field of public health services and systems research is building a "science of delivery" in public health that complements the evidence-based practice movement in medical care.

Public Health Delivery Systems And Population Health: What We Know And Need To Learn, Glen P. Mays

Health Management and Policy Presentations

Despite high overall health expenditures, the U.S. continues to fall behind other high-income countries on many measures of population health. While health care delivery systems are now studied intensively for solutions to U.S. cost and quality problems, the nation's delivery systems for public health programs and policies are only now becoming the subject of rigorous empirical study. This presentation examines recent studies of public health delivery systems and important directions for future inquiry.

Estimating The Health And Economic Effects Of Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Preventable health conditions account for more than 75% of the $2.7 trillion spent annually on health care in the U.S., yet less than 5% of these expenditures are devoted to public health programs and services that are designed to prevent and control disease and injury rather than to treat the downstream consequences of these conditions. Such limited expenditures in public health may contribute to the higher rates of preventable morbidity, mortality and excess medical costs experienced in the U.S. compared to other high-income countries. In this presentation, I update previous estimates of the health effects and medical cost offsets associated …

Public Health Expenditures, Public Health Delivery Systems, And Population Health, Glen P. Mays

Health Management and Policy Presentations

This seminar examines a series of approaches for estimating the health and economic effects attributable to public health expenditures in the U.S., along with a novel method for estimating economies of scale and scope in the delivery of public health services. The use of instrumental-variables techniques and network analytic methods are described in these research approaches.

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Health Management and Policy Presentations

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 …