Health and Medical Administration Commons^™

Post-Acute Care Payment Reform Demonstration: Final Report Volume 2 Of 4, Barbara Gage, Melissa Morley, Laura Smith, Melvin Ingber, Anne Deutsch, Tracy Kline, Jill Dever, Judith Abbate, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Kelleher, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Uncertainty about the magnitude and timing of economic returns associated with spending on public health services has contributed to policy debates about the optimal role of the federal government in financing these services.

Recent Proposals To Limit Medigap Coverage And Modify Medicare Cost Sharing, Kathryn Linehan

National Health Policy Forum

As policymakers look for savings from the Medicare program, some have proposed eliminating or discouraging “first-dollar coverage” available through privately purchased Medigap policies. Medigap coverage, which beneficiaries obtain to protect themselves from Medicare’s cost-sharing requirements and its lack of a cap on out-of-pocket spending, may discourage the judicious use of medical services by reducing or eliminating beneficiary cost sharing. It is estimated that eliminating such coverage, which has been shown to be associated with higher Medicare spending, and requiring some cost sharing would encourage beneficiaries to reduce their service use and thus reduce program spending. However, eliminating first-dollar coverage could …

Older Americans Act Of 1965: Programs And Funding, Carol O'Shaughnessy

National Health Policy Forum

This document offers a basic description of the Older Americans Act of 1965. The Act is considered the major vehicle for promoting the delivery of social services to the aging population. The Act's seven titles and multiple programs are described, along with a chart showing fiscal year 2012 federal appropriations.

Public Health Spending, Preventable Outcomes, And Medical Cost Offsets: Questions For Health Reform, Glen P. Mays

Health Management and Policy Presentations

Uncertainty continues to surround the health and economic effects that can be expected from increased federal spending on public health and prevention strategies. Recent research provides some insight into the question of whether spending on public health strategies can offset the need for future spending on medical care.

Agenda Of 02/03/2012 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Minutes Of 02/03/2012 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Notice Of 02/03/2012 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

The Geographic Value Of Patient-Carried Medical Records In Improving Healthcare In The Us, Lauren Edmundson

The Macalester Review

American medical records have typically been maintained in a single location. However, patient-carried medical records (PCMRs) present an opportunity to alter the space in which health records and information operate. While past research has evaluated PCMRs from a largely economic perspective, this research examines potential benefits of PCMRs through a geographic framework. In total, while further work is needed to perfect the PCMR system, they can ultimately serve as a tool to alleviate four specific complaints made by American patients: lack of communication between provider and patient, lack of communication between providers, medical error, and high costs.

Finding The Medicine For Healthcare, Singapore Management University

Perspectives@SMU

Singapore’s healthcare system is lauded internationally as a model that has managed to restrain costs while delivering excellent health outcomes. The country spends below four per cent of its GDP on healthcare and was ranked 6th out of 191 countries on overall health system performance by the World Health Organisation in 2000.

What's Happening: February, 2012, Maine Medical Center

What's Happening

No abstract provided.

Utilization Of Ct Scans And Mris In An Insured Population With Migraine, Neil I. Goldfarb, Valerie Pracilio, Mph, Daisy Ng-Mak, Phd, Joe Couto, Pharmd, Mba, Cary Sennett, Md, Phd, Mary Hopkins, Rn, Jon Bumbaugh, Stephen Silberstein, Md

College of Population Health Lectures, Presentations, Workshops

Background:

• Neuroimaging is a diagnostic tool that may be used to rule out a serious condition when a patient presents with head pain. It is not typically warranted for patients who have a normal neurologic exam, and may be over utilized despite established practice parameters set by the American Academy of Neurology.

•A decision to use neuroimaging should consider the type of headache and presence of any clinical features that suggest a serious condition.

Over-utilization of neuroimaging has cost and safety implications.

The United States Headache Consortium, a panel of experts on migraine, set the guidelines for diagnosis and …

Association Between Triptanuse And Cardiac Contraindications In An Insured Migraine Population, Daisy Ng-Mak, Phd, Valerie P. Pracilio, Mph, Stephen Silberstein, Md, Joseph Couto, Pharmd, Mba, Cary Sennett, Md, Phd, Mary Hopkins, Rn, Jon Bumbaugh, Neil I. Goldfarb

College of Population Health Lectures, Presentations, Workshops

Background

Safety concerns exist when using triptansto treat patients with cardiac contraindications.

–Triptans cause vasoconstriction, a safety concern for migraineurswith cardiovascular (CV) disease or other cardiac risk factors.

–All triptans contain contraindications in their package inserts to avoid use in patients with cardiac conditions.

•Previous research indicates that clinicians are less likely to prescribe triptansin patients with CV disease or CV risk factors.

Limited research has examined the proportion of migraine patients with cardiovascular disease or those individuals who were concurrently treated with triptans.

Accountable Care Organizations In The Affordable Care Act, Frank Pasquale

Faculty Scholarship

No abstract provided.

Purging Healthcare Of Conventional "Wisdom" - An Interview With Liak Teng Lit, Lien Centre For Social Innovation

Social Space

Liak Teng Lit is known for his iconoclastic views and for pushing the envelope on healthcare and other social causes. Social Space visits the maverick in his award-winning Khoo Teck Puat Hospital for some wake-up calls.

Trust In Government And Support For Governmental Regulation: The Case Of Electronic Health Records, Mitchel Herian, Nancy C. Shank, Tarik Abdel-Monem

University of Nebraska Public Policy Center: Publications

Background — This paper presents results from a public engagement effort in Nebraska, USA, which measured public opinions about governmental involvement in encouraging the use of electronic health records (EHRs).

Objective — We examine the role of trust in government in contributing to public support for government involvement in the development of EHR technologies. We hypothesize that trust in government will lead to support for federal and state governmental encouragement of the use of EHRs among doctors and insurance companies. Further, because individual experiences with health-care professionals will reduce perceptions of risk, we expect that support for governmental involvement will …

The Impact Of Physician Job Satisfaction On The Sustained Competitive Advantage Of Health Care Organizations, Olena Mazurenko, Stephen J. O’Connor

School of Public Health Faculty Research

This paper employs the resource-based theory of the firm to explain the influence of human resources on the sustained competitive advantage of an organization. Based on previous conceptual and empirical literature, we posit that the presence of a high potential employee workforce, coupled with adequate human resource management policies, can result in improved profit generating potential. We developed a conceptual framework with several propositions that illustrate the associations between job satisfaction and organizational productivity. We apply this concept in the health care field, suggesting that the satisfaction of physicians’ needs leads to greater organizational productivity and sustained competitive advantage.

The Emergence And Potential Impact Of Medicine 2.0 In The Healthcare Industry, Terra Stump, Sarah Zilch, Alberto Coustasse

Management Faculty Research

Medicine 2.0 has emerged within healthcare information technology to enable more defined relationships among providers and patients. Physicians, hospitals, and patients are using Medicine 2.0 through social networking to maintain their foothold in the evolution of medical technologies. The authors’ purpose was to determine potential improvements that Medicine 2.0 has on communication and collaboration of healthcare information. Research has shown that Medicine 2.0 has integrated into the healthcare industry and is enabling an increase in communication in healthcare matters. The provider-patient relationship is improving through the use of Medicine 2.0 and has positively impacted society so far.

What's Happening: January, 2012, Maine Medical Center

What's Happening

No abstract provided.

Children's Mercy Hospital Annual Report 2011, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

The Patient Protection And Affordable Care Act And Medicaid Expansion: Leadership Strategies For Effective Change Management In Managed Care Organizations, Emily Aurand

Theses and Graduate Projects

As a result of tlie 2010 Patient Protection and Affordable Care Act (ACA), eligibility requirements for the Medicaid program were revised resulting in a greater number of people eligible to enroll in tlie government healthcare program. These circumstances require numerous organizational changes for Medicaid managed care organizations (MCOs) that administer the Medicaid program in order to accommodate the healthcare needs of the growing Medicaid population and comply with applicable regulatory requirements. This case study sought to identify effective leadership strategies employed by Minnesota Medicaid MCO change leaders guiding organizational change processes and seeking quality change outcomes, resulting from the externally …

A Retrospective Analysis Of Sustainability: Chcs That Were Part Of A Consortia When Federal Funding Ended, Latonya B. Dunlow

MUSC Theses and Dissertations

Community health centers (CHCs) serve an important role in addressing gaps in access to care experienced by millions of Americans. There have been programs in the past developed to provide funding support to increase access to care. However, when funding ends some grantees are faced with program sustainability challenges. This study sought to identify factors and advice for sustainability of programs and services once funding ends. The findings of this study are consistent with the literature; however there were two qualities of leadership important to sustainability that were not as pronounced in the literature that were found in this study-perseverance …

"First Impression": Creating An Intake Procedure That Is Welcoming To Clients And Useful To Clinicians, Brandi Embacher

All Graduate Theses, Dissertations, and Other Capstone Projects

Have you ever contacted an agency and felt doubtful about their ability to help you due to the phone interaction or written correspondence you received? The significance of this Capstone project is to create an intake procedure that will leave a positive first impression for individuals seeking services with Mankato Marriage and Family Therapy Center (MMFTC).

Teaching Cultural Humility And Competence: A Multi-Disciplinary Course For Public Health And Health Services Students, Rob Simmons Drph,Mph,Ches, Nancy L. Chernett, Mph, Elaine Yuen, Phd, Susan Toth-Cohen, Phd, Otr/L

College of Population Health Lectures, Presentations, Workshops

Poster on the interdisciplinary Cultural Humility and Competence course taught at the Jefferson School of Population Health for the past several years.

Overall Course Aim:

Why a multi-disciplinary cultural humility competence course?

An in-depth and advanced understanding of cultural diversity, health inequities and cultural competence in inter-professional health and human service delivery and administration. Facilitate development of cultural competence and humility in one's self, colleagues and the work environment and its application to practice.

Electronic Health Records: Eliciting Behavioral Health Providers’ Beliefs [Brief Reports], Nancy C. Shank, Elizabeth Willborn, Lisa M. Pytlik Zillig, Harmonijoie Noel

Nancy Shank Publications

Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

Characterization Of Pasteurella Multocida Strains Isolated From Geese, Zsuzsanna Varga, Dmitriy V. Volokhov, Laszlo Stipkovits, Akos Thuma, Boglarka Sellyei, Tibor Magyar

United States Food and Drug Administration: Publications

Phenotypic and genotypic diversity of forty-two Pasteurella multocida isolates from geese were characterized by analysis of their capsular type, Heddleston serotype, biotype, fimbrial gene allele type, comparative outer membrane protein (OMP) electrophoresis patterns, and were analyzed using PCR for the presence of virulence-associated genes (toxA, tbpA, pfhA, hgbA, hgbB, nanH, nanB, fimA, hsf-1, and pmHAS). A sequence comparison of the thdF and rpoB housekeeping genes of twenty representative P. multocida strains from three different OMP groups demonstrated that seventeen strains were closely related phylogenetically to previously published strains of P. multocida subsp. multocida and P. multocida subsp. gallicida, and only …

The Impact Of Minority And Women Leaders On Health Care Employee Satisfaction, Kinneil Coltman

MUSC Theses and Dissertations

A preponderance of research suggests that the presence of minorities on the front lines of health care can improve access, satisfaction, and quality of care for minority patients, in addition to mitigating health care disparities. Yet, there is little evidence of the utility of diversity efforts focused on the upper echelons of health care. By examining employee satisfaction scores from 58 hospitals across the United States, this study explored the relationship between the presence of women and minority managers and executives and two key indicators-representation of minority employees and employee satisfaction. Quantitative analyses showed that gender and racial diversity in …

Influence Of Oncotype Dx® On Chemotherapy Prescribing In Early Stage Breast Cancer Patients: A Claims-Based Evaluation Of Utilization In The Real World, Kenneth Neil Kennedy

Theses and Dissertations--Pharmacy

The decision for adjuvant therapy in women with early stage breast cancer (ESBC) has historically been guided by the presence or absence of specific biological markers (hormone and HER2 receptors), age, and extent of nodal involvement. Oncotype DX® is a validated assay that quantifies protein expression that can predict the risk of cancer recurrence. This study evaluates if the use of Oncotype DX® impacts chemotherapy prescribing in ESBC. This retrospective, cohort study identified patients with ESBC from a large commercially insured population from January 2007 through June 2009. Patients were identified as having ESBC by utilizing procedure and diagnosis codes …

The Impact Of Blood Center Consolidation In Florida From 1991-2011, James L. Decker

MUSC Theses and Dissertations

Mergers and acquisitions involving various types of healthcare organizations have been well documented in recent years and a number of published studies have evaluated the pros and cons of these transactions. However, while increased consolidation activity within the blood industry has been observed nationally, there are no published studies that have empirically analyzed the impact of this activity. Due to the number of finalized transactions during the past two decades, this study focuses on blood center consolidation in Florida and explores the driving forces behind such activity. By employing a blended qualitative and quantitative approach, a better understanding of the …

Association Between Hospitals Caring For A Disproportionately High Percentage Of Minority Trauma Patients And Increased Mortality: A Nationwide Analysis Of 434 Hospitals., Adil H. Haider, Sharon Ong'uti, David T. Efron, Tolulope A. Oyetunji, Marie L. Crandall, Valerie K. Scott, Elliott R. Haut, Eric B. Schneider, Neil R. Powe, Lisa A. Cooper, Edward E. Cornwell

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To determine whether there is an increased odds of mortality among trauma patients treated at hospitals with higher proportions of minority patients (ie, black and Hispanic patients combined).

DESIGN: Hospitals were categorized on the basis of the percentage of minority patients admitted with trauma. The adjusted odds of in-hospital mortality were compared between hospitals with less than 25% of patients who were minorities (the reference group) and hospitals with 25% to 50% of patients who were minorities and hospitals with more than 50% of patients who were minorities. Multivariate logistic regression (with generalized linear modeling and a cluster-correlated robust …