National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedYeung K, Richards J, Goemer E
Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system.
The purpose of this study was to describe the cost of using evidence-based implementation strategies for sustained behavioral health integration (BHI) involving population-based screening, assessment, and identification at 25 primary care sites of Kaiser Permanente Washington (2015-2018). The investigators concluded that when spread across patients screened in a single year, BHI implementation costs were well within the range for commonly used diagnostic assessments in primary care (eg, laboratory tests).
AHRQ-funded; HS023173.
Citation: Yeung K, Richards J, Goemer E .
Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system.
Health Serv Res 2020 Dec;55(6):913-23. doi: 10.1111/1475-6773.13592..
Keywords: Healthcare Costs, Evidence-Based Practice, Implementation, Behavioral Health, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare
da Graca B, Ogola GO, Fullerton C
Offsetting patient-centered medical homes investment costs through per-member-per-month or Medicare merit-based incentive payment system incentive payments.
The purpose of this study was to examine potential offsets through commercial payer per-member-per-month (PMPM) payments and the Medicare Merit-based Incentive Payment System (MIPS). The researchers found that with PMPM, breaking even required that 2.4% to 6.4% of commercially insured patients per physician to be covered; with MIPS incentive payments, they would exceed PCMH costs by 2022.
AHRQ-funded; HS022621.
Citation: da Graca B, Ogola GO, Fullerton C .
Offsetting patient-centered medical homes investment costs through per-member-per-month or Medicare merit-based incentive payment system incentive payments.
J Ambul Care Manage 2018 Apr/Jun;41(2):105-13. doi: 10.1097/jac.0000000000000224..
Keywords: Healthcare Costs, Medicare, Patient-Centered Healthcare, Payment, Primary Care
Nguyen OK, Higashi RT, Makam AN
The influence of financial strain on health decision-making.
This study sought to explore which unmet social needs are most influential and how these needs affect individuals’ decisions regarding medical treatment and self-management of health needs among community-dwelling low-income adults. It found that financial strain, rather than any single social need, was the most important factor in health decisionmaking among the underserved adults we studied, and may result in non-adherence to medical recommendations.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Higashi RT, Makam AN .
The influence of financial strain on health decision-making.
J Gen Intern Med 2018 Apr;33(4):406-08. doi: 10.1007/s11606-017-4296-3.
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Keywords: Shared Decision Making, Healthcare Costs, Patient Adherence/Compliance, Patient-Centered Healthcare, Vulnerable Populations
Lieberthal RD, Payton C, Sarfaty M
Measuring the cost of the patient-centered medical home: a cost-accounting approach.
To explore the cost for individual practices to become more patient-centered, this study inventoried and calculated costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance.
AHRQ-funded; HS022630.
Citation: Lieberthal RD, Payton C, Sarfaty M .
Measuring the cost of the patient-centered medical home: a cost-accounting approach.
J Ambul Care Manage 2017 Oct/Dec;40(4):327-38. doi: 10.1097/jac.0000000000000196..
Keywords: Healthcare Delivery, Healthcare Costs, Patient-Centered Healthcare
Flieger SP
Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness.
This study evaluated the impact of a patient-centered medical home (PCMH) pilot on utilization, costs, and quality and assessed variation in PCMH components. There were no statistically significant findings for utilization, cost, or quality in the expected direction. Medical Home Index (MHI) scores suggest variation in type and level of implemented features.
AHRQ-funded; HS021385.
Citation: Flieger SP .
Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness.
J Ambul Care Manage 2017 Jul/Sep;40(3):228-37. doi: 10.1097/jac.0000000000000162.
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Keywords: Patient-Centered Healthcare, Quality of Care, Primary Care, Healthcare Costs, Healthcare Utilization
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Sinaiko AD, Landrum MB, Meyers DJ
Synthesis of research on patient-centered medical homes brings systematic differences into relief.
This study evaluated the impact of patient-centered medical home (PCMH) initiatives on utilization, cost, and quality, by conducting a meta-analysis of methodologically standardized findings from evaluations of eleven major PCMH initiatives. There was significant heterogeneity across individual evaluations in many outcomes. Across evaluations, PCMH initiatives were not associated with changes in the majority of outcomes studied, including primary care, emergency department, and inpatient visits and four quality measures.
AHRQ-funded; HS021385.
Citation: Sinaiko AD, Landrum MB, Meyers DJ .
Synthesis of research on patient-centered medical homes brings systematic differences into relief.
Health Aff 2017 Mar;36(3):500-08. doi: 10.1377/hlthaff.2016.1235.
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Keywords: Patient-Centered Healthcare, Patient-Centered Outcomes Research, Health Services Research (HSR), Healthcare Costs
Shao H, Brown L, Diana ML
Estimating the costs of supporting safety-net transformation into patient-centered medical homes in post-Katrina New Orleans.
The authors aimed to understand the characteristics of clinics that transformed into patient-centered medical homes and the incremental cost for transformation. The estimated incremental cost for clinics that underwent transformation was $37.61 per visit per 6 months, and overall it cost $24.86 per visit per 6 months in grant funds to support a clinic's transformation.
AHRQ-funded; HS022624.
Citation: Shao H, Brown L, Diana ML .
Estimating the costs of supporting safety-net transformation into patient-centered medical homes in post-Katrina New Orleans.
Medicine 2016 Sep;95(39):e4990. doi: 10.1097/md.0000000000004990.
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Keywords: Patient-Centered Healthcare, Healthcare Costs, Access to Care, Organizational Change
Halladay JR, Mottus K, Reiter K
The cost to successfully apply for level 3 medical home recognition.
The National Committee for Quality Assurance patient-centered medical home recognition program provides practices an opportunity to implement medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. This study found variation in the distribution of costs by activity by practice, but the costs to apply were remarkably similar.
AHRQ-funded; HS022629.
Citation: Halladay JR, Mottus K, Reiter K .
The cost to successfully apply for level 3 medical home recognition.
J Am Board Fam Med 2016 Jan-Feb;29(1):69-77. doi: 10.3122/jabfm.2016.01.150211.
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Keywords: Patient-Centered Healthcare, Healthcare Costs, Care Coordination, Quality of Care
Anderson GF, Ballreich J, Bleich S
Attributes common to programs that successfully treat high-need, high-cost individuals.
The authors identified 8 attributes common to programs that successfully treat high-need, high-cost individuals. They then illustrated these attributes with specific examples.
AHRQ-funded; HS000029.
Citation: Anderson GF, Ballreich J, Bleich S .
Attributes common to programs that successfully treat high-need, high-cost individuals.
Am J Manag Care 2015 Nov;21(11):e597-600.
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Keywords: Healthcare Costs, Patient-Centered Healthcare
Magill MK, Ehrenberger D, Scammon DL
The cost of sustaining a patient-centered medical home: experience from 2 states.
This study’s objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. It found that costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices.
AHRQ-funded; HS022620.
Citation: Magill MK, Ehrenberger D, Scammon DL .
The cost of sustaining a patient-centered medical home: experience from 2 states.
Ann Fam Med 2015 Sep;13(5):429-35. doi: 10.1370/afm.1851..
Keywords: Patient-Centered Healthcare, Healthcare Costs, Quality of Care, Primary Care
van Hasselt M, McCall N, Keyes V
Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.
The authors compared health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. They found that, relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices.
AHRQ-funded; HS000029.
Citation: van Hasselt M, McCall N, Keyes V .
Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.
Health Serv Res 2015 Feb;50(1):253-72. doi: 10.1111/1475-6773.12217.
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Keywords: Healthcare Costs, Medicare, Nursing Homes, Patient-Centered Healthcare
Liss DT, Fishman PA, Rutter CM
Outcomes among chronically ill adults in a medical home prototype.
The researchers compared quality, utilization, and cost outcomes for patients with selected chronic illnesses at a patient-centered medical home (PCMH) prototype site with outcomes for patients with the same chronic illnesses at 19 nonintervention control sites. They concluded that a clinic-level population-based PCMH redesign can decrease downstream utilization and reduce total healthcare costs in a subpopulation of patients with common chronic illnesses.
AHRQ-funded; HS019129.
Citation: Liss DT, Fishman PA, Rutter CM .
Outcomes among chronically ill adults in a medical home prototype.
Am J Manag Care 2013 Oct;19(10):e348-58.
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Keywords: Chronic Conditions, Healthcare Costs, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research