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Sunday, June 26
Presentations slides are available in PDF  and PPT  formats.
7:15 a.m. - 8:15 a.m.
International Breakfast Briefing
Room 312- Third Level
Update on Pharmaceutical Policy in Australia, the U.K., & Five European Countries
Chair: Robin Osborn, The Commonwealth Fund
Panelists:
Elizabeth Roughead, University of South Australia
PowerPoint Slides | PDF Handout of Slides
Panos Kanavos, London School of Economics
PowerPoint Slides | PDF Handout of Slides
As prescription drugs continue to consume a greater proportion of health care systems' budgets, governments and other purchasers are pursuing innovative avenues for controlling drug costs. The panel will review recent policy developments in pharmaceutical pricing and regulation in several countries, the use of cost-effectiveness analysis, and further efforts to encourage more evidence-based pharmaceutical policy.
Sponsored by The Commonwealth Fund
8:30 a.m. - 10:00 a.m.
Concurrent Sessions
M Shaping Medicare's Future: An Evidence-Based Approach
Room 200 - Second Level
Chair: Erin Fries Taylor, Mathematica Policy Research, Inc.
Panelists:
Michael Furukawa, Arizona State University
"Medicare Drug Coverage and Declining Disability Among the Elderly: Is There a Link?"
PowerPoint Slides | PDF Handout of Slides
Ronald Ozminkowski, Medstat
"Predictors of Preventive Screening among Medicare Beneficiaries"
PowerPoint Slides | PDF Handout of Slides
James Reschovsky, Center for Studying Health System Change
"Factors Affecting Physicians' Medicare Service Volume"
PowerPoint Slides | PDF Handout of Slides
Edwin Huff, Centers for Medicare and Medicaid Services - Boston Regional Office
"Quality of Care for Medicare Recipients: Lessons from the Second National Healthcare Quality and Disparities Report"
PowerPoint Slides | PDF Handout of Slides
P Rural Public Health Preparedness
Room 309- Third Level
Chair: Hugh Tilson, University of North Carolina, Chapel Hill
Panelists:
Paul Campbell, Harvard University
PowerPoint Slides | PDF Handout of Slides
Paul Kuehnert, Maine Bureau of Health
PowerPoint Slides | PDF Handout of Slides
Michael Meit, University of Pittsburgh
PowerPoint Slides | PDF Handout of Slides
John Shutske, University of Minnesota
PowerPoint Slides | PDF Handout of Slides
Invited Papers: This panel will explore the state of rural public health systems research including issues and needs related to preparedness for natural and man-made disasters. The panelists will present and critique a new state-level survey of the state of preparedness, report on the work of an ad hoc national action group, assess the threats and research needs related to agro terrorism and food system defense as a unique rural issue, and invite input into the proposed research agenda for these issues.
Web Resources for HSR & Public Health
Room 202 - Second Level
Chair: Marjorie Cahn, National Library of Medicine
PowerPoint Slides | PDF Handout of Slides
Panelists:
Vivian Auld, National Library of Medicine
PowerPoint Slides | PDF Handout of Slides
Catherine Selden, National Library of Medicine
Research Update: NLM staff will provide an update on new and improved products and services, freely available on the Web from NLM and its partners, geared toward health services researchers and public health services researchers. Come learn about these Web resources including collaborative projects, databases, subject access projects, outreach and training, research and informatics, and standards and vocabulary initiatives.
C Medicaid, SCHIP & Access to Care: National, State & Local Perspectives
Room 203 - Second Level
Chair: Paul Wise, Brigham and Women's Hospital
Panelists:
Tatiana Andreyeva, RAND Corporation
"Changes in Children's Mental Health Care, 1997-2002"
PowerPoint Slides | PDF Handout of Slides
Keith Elder, University of South Carolina
"Insurance Trends: Rural, Minority Children Lag Over 20 Years"
PowerPoint Slides | PDF Handout of Slides
Alison Galbraith, Harvard Medical School
"Out-of-Pocket Financial Burden for Low Income Families with Children: Socioeconomic Disparities and Effects of Insurance"
PowerPoint Slides | PDF Handout of Slides
Kevin Mahoney, University of Maryland
"Lessons for Consumer Directed Programs from the Cash & Counseling Experience"
PowerPoint Slides | PDF Handout of Slides
Q Leaders & Outliers: How Should We Measure Quality & Safety? Room 208 - Second Level
Chair: Carol Haraden, Institute for Healthcare Improvement
Panelists:
Susan Abend, Qualidigm
"Development of the Medicare Patient Safety Monitoring System"
PowerPoint Slides | PDF Handout of Slides
Anne Elixhauser, Agency for Healthcare Research and Quality
"Comparative Rankings of Hospital Quality-Does the Data Source Matter?"
PowerPoint Slides | PDF Handout of Slides
Mary Beth Landrum, Harvard Medical School
"The Role of Information in Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Surgery"
PowerPoint Slides | PDF Handout of Slides
Paul Nietert, Medical University of South Carolina
"The Summary Quality Index (SQuId): A Summary Measure for Multiple Quality Indicators in Primary Care"
PowerPoint Slides | PDF Handout of Slides
Dennis Tsilimingras, Department of Veterans Affairs, Bedford, MA
"Validating AHRQ PSIs with NSQIP Postoperative Adverse Events"
PowerPoint Slides | PDF Handout of Slides
L Organizational Innovation for Quality Long-Term Care: The Evidence Base
Room 210 - Second Level
Chair: Robyn Stone, American Association of Homes and Services for the Aging
Panelists:
Christine Bishop, Brandeis University
PowerPoint Slides | PDF Handout of Slides
Lois Cutler, University of Minnesota
Penny Hollander Feldman, Visiting Nurse Service of New York
PowerPoint Slides | PDF Handout of Slides
Lauren Harris-Kojetin, Institute for the Future of Aging Services
PowerPoint Slides | PDF Handout of Slides
Terry Lum, University of Minnesota
PowerPoint Slides | PDF Handout of Slides
Mary Jane Koren, The Commonwealth Fund
Invited Papers: There is a growing consensus among long-term care providers, consumers, and policymakers that the structure and processes of the organization have a major influence on the quality of care delivered and the quality of life of residents/clients across the spectrum on long-term care settings. While much of the interest is based on anecdote and small descriptive studies, there is a growing body of scientific evidence to support these relationships. The panelists will review key findings from their studies of organizational innovation in nursing homes and home care. They will also underscore the need for additional applied research to better understand which elements on organizational innovation are most strongly related to positive outcomes and how specific interventions directly and/or indirectly affect quality of care/life.
R Increasing Non Visit-Based Communication Between Patients & Physicians: The Promise & the Problems
Room 302 - Third Level
Chair: Robert Berenson, The Urban Institute
PowerPoint Slides | PDF Handout of Slides
Panelists:
Jinnet Fowles, Park Nicollet Institute
PowerPoint Slides | PDF Handout of Slides
Steven Katz, University of Michigan Health System
PowerPoint Slides | PDF Handout of Slides
Invited Papers: Many patients are seeking to communicate with their physicians and other health professionals outside of face-to-face office visits, both online and on the phone. Yet, there are numerous issues in promoting these alternatives, particularly with relation to Internet-based e-mail communication, including quality of care, information security, operational feasibility, and reimbursement. This session will explore these issues in detail and provide a case study from one organization currently implementing a secure Internet-based service that fosters such communication.
Instrumental Variable Estimation
Room 304 - Third Level
Chair: John Brooks, University of Iowa
PowerPoint Slides | PDF Handout of Slides
Methods Workshop: As treatment rates expand with new insurance mechanisms, treated patients will less resemble patients in control trials and the consequences of treatment for these patients will be uncertain. Policymakers need to evaluate the treatment consequences for these patients to assess whether treatments are over- or underutilized in practice. Observational health care databases contain substantial treatment variation that can be used to assess treatment consequences in practice, but treatment selection issues limit the inferences that can be made from these data using analysis methods that control for observed differences among patients. Instrumental variable estimation can possibly overcome the treatment selection biases innate in observational data and yield estimates that are appropriate to assess questions of over- or underutilization in practice. Using several applied examples, this session will 1) define treatment selection bias and describe how instrumental variable estimation can overcome this problem and 2) provide the appropriate interpretation of estimated instrumental variable treatment effects. It will emphasize the assumptions underlying instrumental variable estimation and approaches (statistical and theoretical) for finding instrumental variables that satisfy these assumptions.
The Perfect Storm: Challenges on the Horizon for Funding & Regulatory Controls in Research
Room 306 - Third Level
Chair: Mary Durham, Kaiser Foundation Hospitals
Panelists:
Steven Cole, The Permanente Federation (Kaiser Permanente)
Andrew Nelson, HealthPartners Research Foundation
PowerPoint Slides | PDF Handout of Slides
Carol Stocks, Agency for Healthcare Research and Quality
Special Session: The appetite of the public, health care providers, and policymakers for health services research has never been greater. Yet, the regulatory environment for research (e.g., HIPAA, state and federal laws) has made conducting that work more and more difficult. Panelists will discuss the likely impact of Bush administration political agendas, the complex web of federal and state regulations, and funding cuts on health services researchers over the next four years. This will include the release of the first phase of a study called "Impact of the HIPAA Privacy Rule on Health Services Research," recently completed by AHRQ.
W Health Workforce Studies-A Profession-Specific Perspective
Room 313 - Third Level
Chair: Jean Moore, State University of New York, Albany
Panelists:
Ann Boulis, University of Pennsylvania
"Physician Gender, Physician Marriage and the Supply and Distribution of Medical Services"
PowerPoint Slides | PDF Handout of Slides
Sat Ananda Hayden, University of North Carolina at Charlotte
"Applying a Public Policy Approach to Issues of Global Nurse Migration"
PowerPoint Slides | PDF Handout of Slides
Christian Meghea, American College of Radiology
"Who's Overworked and Who's Underworked among Radiologists?"
PowerPoint Slides | PDF Handout of Slides
Joanne Spetz, University of California, San Francisco
"The Supply of LPNs and RNs' and "Can Wage Increases End Nursing Shortages? A Re-examination of the Supply Curve of Registered Nurses"
PowerPoint Slides | PDF Handout of Slides
10:30 a.m. - 12:00 p.m.
Concurrent Sessions
Q Crowded House: Crowding, Staffing & Patient Safety
Room 200 - Second Level
Chair: Marie Bismark, Harvard School of Public Health
Panelists:
Jack Chen, University of New South Wales
"A Cluster Randomized Controlled Trial of the Medical Emergency Team System"
PowerPoint Slides | PDF Handout of Slides
Christopher Gorton, Pennsylvania Health Care Cost Containment Council
"Variation in Volume-Outcome Relationships for Hospitals and Surgeons Performing CABG Surgery"
PowerPoint Slides | PDF Handout of Slides
Peter Sprivulis, Brigham and Women's Hospital
"Hospital Overcrowding is Associated with Increased Seven Day Emergency Admission Mortality: A New Imperative for Patient Safety"
PowerPoint Slides | PDF Handout of Slides
Joel Weissman, Massachusetts General Hospital
"The Relation of Crowded Working Conditions to Patient Safety in Hospitals"
PowerPoint Slides | PDF Handout of Slides
Mei Zhao, University of North Florida
"Hospital Financial Performance, Nurse Staffing and the Outcomes of Patient Care"
PowerPoint Slides | PDF Handout of Slides
P Public Health Services Research, Moving to the Mainstream: Recent Experience with Performance Measures, Quality Improvement, Accreditation & Certification
Room 309- Third Level
Chair: F. Douglas Scutchfield, University of Kentucky
Panelists:
Arthur Davidson, Denver Public Health
PowerPoint Slides | PDF Handout of Slides
Paul Halverson, University of Arkansas for Medical Sciences
PowerPoint Slides | PDF Handout of Slides
Evelyn Knight, University of Kentucky
PowerPoint Slides | PDF Handout of Slides
Glen Mays, University of Arkansas for Medical Sciences
PowerPoint Slides | PDF Handout of Slides
Harrison Spencer, Association of Schools of Public Health
PowerPoint Slides | PDF Handout of Slides
Invited Papers: This session attempts to provide the audience with illustrations of quality assurance and quality controls arrival in the public health sector of the health care system. Recently, we have seen the advent of quality tools, comparable to those used in acute health care settings, which are being incorporated into public health. These include performance measurement, accreditation of public health units, certification of public health workers and paying for performance. This panel will discuss the state-of-the-art issues and research in these areas.
O Inside the Black Box: How Management Characteristics Influence the Delivery of Patient Care
Room 311 - Thirdd Level
Chair: Thomas Rundall, University of California, Berkeley
Panelists:
Todd Gilmer, University of California, San Diego
"Clinic Characteristics Related to the Efficient Production of Health for Adults with Diabetes"
PowerPoint Slides | PDF Handout of Slides
Tricia Johnson, Rush University
"How Do Physicians in Managed Care Networks Respond to an Increase in Clinical Autonomy?"
PowerPoint Slides | PDF Handout of Slides
Mark Meterko, Department of Veterans Affairs, Boston, MA
"Civility among Healthcare Employees: The Impact on Patients"
PowerPoint Slides | PDF Handout of Slides
Amy Smalarz, Brandeis University
"The Effect of Physician Group Culture and Structure on Patients' Utilization and Quality of Care Outcomes"
PowerPoint Slides | PDF Handout of Slides
Carol VanDeusen Lukas, Department of Veterans Affairs, Boston, MA
"The Role of Management Support in Implementing Innovative Clinical Practices"
PowerPoint Slides | PDF Handout of Slides
PowerPoint Slides | PDF Handout of Slides
S The Impact of SCHIP & Medicaid Expansion on Children
Room 203 - Second Level
Chair: Cindy Brach, Agency for Healthcare Research and Quality
Panelists:
Laura Shone, University of Rochester
"Deterring Crowd-out in State Children's Health Insurance (SCHIP) Programs: How Would Waiting Periods Affect Children in New York?"
Anna Sommers, The Urban Institute
"Dynamics of
Medicaid and SCHIP Eligibility Among Children: 1996-2000"
PowerPoint Slides | PDF Handout of Slides
Abstract
Susan Haber, RTI International
"Dynamics of Children's Enrollment in Public Health Insurance: A Three-State Comparison"
PowerPoint Slides | PDF Handout of Slides
Benjamin Sommers, Harvard University
"Does a Patchwork Approach to Health Insurance Expansion Exacerbate Public Insurance Drop-out?"
PowerPoint Slides | PDF Handout of Slides
Genevieve Kenney, The Urban Institute
"The Impacts of the State Children's Health Insurance Program (SCHIP) on Access to Care and Use of Services: Findings from Ten States"
CSAT Program Update
Room 202- Second Level
Chairs: Mady Chalk, Center for Substance Abuse Treatment
PowerPoint Slides | PDF Handout of Slides
Julie Harkins, both from the Center for Substance Abuse Treatment
PowerPoint Slides | PDF Handout of Slides
Research Update: This session will provide an overview of the SAMHSA/CSAT Matrix priority areas, including Substance Abuse Treatment Capacity. The session will focus on Access to Recovery (ATR), Screening, Brief Intervention, Referral and Treatment (SBIRT), Program Evaluation Activities, and the Network for Improvement of Addiction Treatment (NiaTx).
C Organizational & Community Factors in Quality & Safety of Care for Children
Room 312- Third Level
Chair: David Bergman, Stanford University
Panelists:
Samantha Jones, University of Sheffield
"Outcomes at 6 Months Post-Admission to Pediatric Intensive Care: Report of a National Study of Pediatric Intensive Care Units in the United Kingdom”
PowerPoint Slides | PDF Handout of Slides
Mina Lai, California Department of Health Services
"The Impact of Chronic Care Coordination on Young People (age 0-5) with Asthma: A Statewide Evaluation of the California Community Asthma Intervention"
PowerPoint Slides | PDF Handout of Slides
Sandra Magnetti, University HealthSystem Consortium
"Patient Safety for Infants and Children in Academic Medical Center Hospitals: Organizational and Human Factors Related to Harmful Medical Event Outcomes-Evidence Using Electronic Medical Error-Event Reporting Systems"
PowerPoint Slides | PDF Handout of Slides
Barbara Mark, University of North Carolina, Chapel Hill
"Nurse Staffing and Pediatric Quality of Care"
PowerPoint Slides | PDF Handout of Slides
Sally Turbyville, National Committee for Quality Assurance
"Follow--up Care for Children Prescribed Attention Deficit Hyperactivity (ADHD) Medication"
PowerPoint Slides | PDF Handout of Slides
M Topics in Medicare Risk Adjustment
Room 207 - Second Level
Chair: Melvin Ingber, Centers for Medicare and Medicaid Services
Panelists:
Eric Olmsted, RTI International
PowerPoint Slides | PDF Handout of Slides
John Kautter, RTI International
PowerPoint Slides | PDF Handout of Slides
John Robst, Centers for Medicare and Medicaid Services
PowerPoint Slides | PDF Handout of Slides
Invited Papers: Presentations will be made on: the development of the risk adjustment method for the new Medicare drug benefit; the enhanced risk adjustment model for HMOs and other capitated plans; and the development of concurrent models, one of which is being applied to the CMS Physician Group Practice (PGP) demonstration. The PGP demonstration applies risk adjustment to a pay-for-performance system design in a fee-for-service environment.
D Findings in Health Care Disparities on the Road Less Traveled
Room 208 - Second Level
Chair: Vanessa Sheppard, Georgetown University Medical Center
Panelists:
Rebecca Gelber, Harvard Medical School
"Disparities in the Management of Early Breast Cancer among Asian Americans and Pacific Islanders"
PowerPoint Slides | PDF Handout of Slides
Dolly John, Department of Veterans Affairs, Houston, TX
"Medicare+Choice Enrollment and Plan Benefits among Black, Hispanic and White Medicare Enrolled VA: Using Veterans in CY2000"
Andrea Kronman, Boston University Medical Center
"Racial Disparities in Primary Care and Utilization of Health Services at the End of Life"
PowerPoint Slides | PDF Handout of Slides
Mihail Samnaliev, University of Massachusetts Medical School
"Racial Disparities among Medicaid Beneficiaries with Mental Disorders"
PowerPoint Slides | PDF Handout of Slides
Junling Wang, University of Tennessee
"Racial/Ethnic Disparities in Access to New Prescription Drugs"
PowerPoint Slides | PDF Handout of Slides
Equity in Health: The Contribution of Research
Room 210 - Second Level
Chair: Barbara Starfield, Johns Hopkins University
Panelists:
James Macinko, New York University
PowerPoint Slides | PDF Handout of Slides
Martin McKee, London School of Hygiene and Tropical Medicine
PowerPoint Slides | PDF Handout of Slides
Jennifer Ruger, Yale University
PowerPoint Slides | PDF Handout of Slides
Methods Workshop: This session considers methodological issues in research on equity in health. Moving from the stage of describing inequities ("social determinants research"), we deal with the relationship between the current state of knowledge about the impact of health services to consider what needs to be done to move policy toward a better distribution of health across populations and subpopulations.
A Leveraging Private Dollars to Expand Health Care
Room 302 - Third Level
Chair: Deborah Chollet, Mathematica Policy Research, Inc.
Panelists:
Elizabeth Kilbreth, University of Southern Maine
Ellen Schneiter, State of Maine
PowerPoint Slides | PDF Handout of Slides
Vondie Woodbury, Muskegon Community Health Project
PowerPoint Slides | PDF Handout of Slides
Invited Papers: The erosion of employer-based coverage is among the largest problems confronting states and communities in the U.S. The erosion of private coverage, most acute among low-wage workers, has coincided with rising enrollment in Medicaid and SCHIP. This session will discuss three initiatives that leverage employer contributions to expand private coverage. They are based, respectively, in the large-employer sector, state government, and the community. Panelists will describe each program, the kernel of opportunity that was the basis for the program, the experience of the program, and prospects for the future.
Understanding Approaches to Account for Clustering of Observations in HSR
Room 304 - Third Level
Chair: A. Russell Localio, University of Pennsylvania
PDF Handout
Methods Workshop: This workshop will focus on alternative approaches to analyzing clustered data from randomized and observational studies, with special emphasis on binary outcome data. The presentation will discuss options such as mixed effects models, generalized estimating equations, survey methods, and Bayesian methods in the context of their underlying assumptions and software requirements. It will also cover less well-known analytic challenges, such as distinguishing within and among cluster effects as well as confounding by cluster. Finally, there will be an overview of options for reporting multicenter binary outcome data on additive as well as relative scales. The session will include copies of slides and an extensive bibliography.
B Evaluating the Impact of Parity Mental Health & Substance Abuse Benefits in the Federal Employees Health Benefits Program
Room 306 - Third Level
Chair: Howard Goldman, University of Maryland, Baltimore
Panelists:
Audrey Burnam, RAND Child Policy Project
"Does Quality of Behavioral Health Care Change with Parity Benefit Expansion?"
PowerPoint Slides | PDF Handout of Slides
Richard Frank, Harvard Medical School
"The Impact of Parity Mental Health and Substance Abuse Benefits on Spending and Utilization in the Federal Employees Health Benefits Program"
M. Susan Ridgely, RAND
"How Did Health Plans Implement Parity for Federal Employees?"
PowerPoint Slides | PDF Handout of Slides
Chapin White, Congressional Budget Office
PowerPoint Slides | PDF Handout of Slides
The Health Care Financing & Organization (HCFO) Program: Grants for Policy Relevant Research (& More!)
Room 313 - Third Level
Chair: Deborah Rogal, AcademyHealth
Panelists:
Bonnie Austin, AcademyHealth
PowerPoint Slides | PDF Handout of Slides
Jack Hoadley, Georgetown University
Special Session: AcademyHealth serves as the national program office for The Robert Wood Johnson Foundation's HCFO program, a multifaceted initiative seeking to bridge the policy and research communities. The program funds grants on significant health care policy and market developments, convenes meetings, and disseminates results to public and private stakeholders in a number of ways. Learn the ins and outs of getting a HCFO grant and working with program staff from the idea stage to the grant phase to getting your findings in the right hands. The panel features program staff and a current grantee.
12:15 p.m. - 1:45 p.m.
Opening Luncheon Plenary
Ballroom A/B/C - Third Level
Welcoming Remarks
Tom Rundall, Conference Chair, University of California, Berkeley
The Imperfection of Medicine
Atul Gawande, Harvard University
Alice S. Hersh New Investigator Award Presentation
Awardee: Katrina Armstrong, Department of Veterans Affairs, Philadelphia, PA
Presenter: Mark Pauly, University of Pennsylvania
Sponsored in part by Harvard Pilgrim Health Care
2:00 p.m. - 3:15 p.m.
Poster Session A & Dessert
Exhibit Hall D - Second Level
Features:
Sponsored in part by The Robert Wood Johnson Foundation
3:30 p.m. - 7:00 p.m.
International Exchange
3:30 p.m. - 5:00 p.m. - Panel I
Innovations in Health Information Technology Around the World
Room 200 - Second Level
Chair: Don Detmer, American Medical Informatics Association
Panelists:
William Ho, Hong Kong Hospital Authority
PowerPoint Slides | PDF Handout of Slides
David Ingram, University College of London
PowerPoint Slides | PDF Handout of Slides
Arne Kverneland, Department of Health Informatics, Denmark
PowerPoint Slides | PDF Handout of Slides
Ilias Iakovidis, European Union
PowerPoint Slides | PDF Handout of Slides
International guests will provide a critical update on HIT in the U.K., discuss standards for electronic health records in the European Union, and describe the experience of gaining physician support for HIT in Hong Kong.
Sponsored by The Commonwealth Fund and Kaiser Permanente
5:30 p.m. - 7:00 p.m. - Panel II
Disease Management in Germany : Lessons for the U.S.
Room 200 - Second Level
Chair: Uwe Reinhardt, Princeton University
Panelists:
Stuart Guterman, The Commonwealth Fund
PowerPoint Slides | PDF Handout of Slides
Karl Lauterbach, Institute of Health Economics and Clinical Epidemiology of the University of Cologne
Mary Naylor, University of Pennsylvania
PowerPoint Slides | PDF Handout of Slides
Sophia Schlette, Bertelsmann Foundation
PowerPoint Slides | PDF Handout of Slides
PowerPoint Slides | PDF Handout of Slides
This panel will report on recent developments in the area of disease management in Germany and their relevance to the U.S.
Sponsored by The Commonwealth Fund and the Bertelsmann Foundation
3:30 p.m. - 5:00 p.m.
Concurrent Sessions
Measuring Health Care Quality: Data from the National Center for Health Statistics
Room 309 - Third Level
Chair: Diane Makuc, National Center for Health Statistics
Panelists:
Irma E. Arispe, National Center for Health Statistics
PowerPoint Slides | PDF Handout of Slides
Rosemarie Hirsch, National Center for Health Statistics
PowerPoint Slides | PDF Handout of Slides
Kathleen O'Connor, National Center for Health Statistics
Jane E. Sisk, National Center for Health Statistics
PowerPoint Slides | PDF Handout of Slides
Research Update: Measurement of health care quality benefits from the use of multiple perspectives on health care.
Establishment-based surveys sample providers and collect information about the provider, health care encounter, and patient. Population-based surveys collect information about individuals health outcomes and health-related events, regardless of whether the individual has seen a health care provider. This session will describe quality of care measures that may be obtained from publicly available data files of both types of surveys including the National Health Care Survey, the National Health and Nutrition Examination Survey (NHANES), the National Health Interview Survey (NHIS), and the National Survey of Children's Health. Examples of how different surveys complement one another in assessing quality will also be provided.
Help With Publishing Instead of Perishing: Meet the Editors
Room 202 - Second Level
Chair: Bradford Gray, Milbank Quarterly
PowerPoint Slides | PDF Handout of Slides
Panelists:
Jeffrey Alexander, Medical Care Research and Review
PowerPoint Slides | PDF Handout of Slides
Parmeeth Atwal, Health Affairs
PowerPoint Slides | PDF Handout of Slides
Ann Barry Flood, Health Services Research
PowerPoint Slides | PDF Handout of Slides
John Piette, Medical Care
PowerPoint Slides | PDF Handout of Slides
Mark Schlesinger, Journal of Health Politics, Policy and Law
Kathy Swartz, Inquiry
PowerPoint Slides | PDF Handout of Slides
Skill and Career Development: In this session, editors from leading health services research and policy journals will briefly describe their journals' niches and comment on factors that affect the likelihood those will find their way into print. There will be time for comments and questions from the audience.
C State Variations in Health Services & Performance for Children & Youth with Special Health Care Needs
Room 203 - Second Level
Chair: Christina Bethell, Oregon Health and Science University
PowerPoint Slides | PDF Handout of Slides
Panelists:
Stephen Blumberg, National Center for Health Statistics
PowerPoint Slides | PDF Handout of Slides
Sally Fogerty, State of Massachusetts Center for Community Health
Jeffrey Lobas, University of Iowa
PowerPoint Slides | PDF Handout of Slides
Virginia Sharp, Seattle Children's Hospital & Regional Medical Center
PowerPoint Slides | PDF Handout of Slides
Nora Wells, Federation For Children With Special Needs
PowerPoint Slides | PDF Handout of Slides
Invited Papers: New national data from the National Survey on Children with Special Health Care Needs shows substantial variation across states in both access to and quality of health care services and the health and family impact experienced by children and youth with special health care needs (CYSHCN) and their families. The panelists will characterize the nature and magnitude of variations observed across 15 indicators of access, impact, and quality of care; present case studies from four states; and discuss implications for state policies and programs, families, and health care providers. Medicaid, Title V, and family perspectives will be represented.
R Enhancements to Primary Care in the Treatment of Chronic Disease
Room 311 - Third Level
Chair: Morris Weinberger, Department of Veterans Affairs, Durham, NC
Panelists:
Gretchen Alkema, University of Southern California
"The Impact of Telephone-Based Care Management on Mortality Risk of Frail Older Adults"
Dawn Clancy, Medical University of South Carolina
"Group Visits Improve Compliance with Preventive and Treatment Guidelines in Uninsured or Inadequately Insured Patients with Type 2 Diabetes"
PowerPoint Slides | PDF Handout of Slides
Amer Kaissi, Trinity University
"Assessment of Chronic Illness Care for Diabetes in Primary Care Clinics"
PowerPoint Slides | PDF Handout of Slides
Cheryl Schraeder, Carle Foundation
"Care Management for Elders with Chronic Conditions in a Medicare Coordinated Care Demonstration"
Shin-Yi Wu, RAND Corporation
"CCM Implementation and Patient Perceived Self-Management Support for their Chronic Illness"
PowerPoint Slides | PDF Handout of Slides
H The Market for Health Insurance
Room 312 - Third Level
Chair: Jon Christianson, University of Minnesota
Panelists:
Didem Bernard, Agency for Healthcare Research and Quality
"What Happens When Workers Fail to Take Up Employment-Related Health Insurance? Evidence from 1996 and 2001"
M. Kate Bundorf, Stanford University
"Employer Offers of Health Insurance and Worker Enrollment Decisions: The Role of Health Risk"
Peter Groeneveld, Department of Veterans Affairs, Philadelphia, PA
"Hospital Market Effects on Uptake and Utilization of Innovative Healthcare Technologies: 1983-2001"
James Reschovsky, Center for Studying Health System Change
"Why Employer Coverage Changed? 1997-2003"
Jessica Vistnes, Agency for Healthcare Research and Quality
"Health Insurance Enrollment Decisions: Understanding the Role of Preferences for Coverage"
O Organizational Studies of Primary Care Practice
Room 207 - Second Level
Chair: Benjamin Crabtree, Robert Wood Johnson Medical School
Panelists:
Reuben McDaniel, University of Texas at Austin; William Miller, Lehigh Valley Hospital; Leif Solberg, HealthPartners Research Foundation; Kurt Stange, Case Western Reserve University
Invited Papers: Primary care practices have ongoing access to the majority of the U.S. population; however, due to their broad focus and multiple competing demands, the translation of evidence-based recommendations in these settings is less than optimal. Innovative change models are needed that acknowledge the competing demands of a busy practice and that lead to sustainable enhancements in quality of care. Panelists will highlight characteristics of primary care practices as complex systems, present real world examples of practice change strategies, and offer new models for thinking about organizational change.
D Eliminating Health Disparities: Measurement, Methodology & Data Needs
Room 208 - Second Level
Chair: Thomas McGuire, Harvard Medical School
Panelists:
Amitabh Chandra and Ben Le Cook, both from Harvard University; Carol Link, New England Research Institutes
Invited Papers: In spite of the large number of papers documenting health care disputes, identification of the magnitudes and mechanics of disputes suffer due to methodological and data shortcomings. These papers contend with central methodological questions, such as adjusting for "health status" in observational studies, the role of geography and geographical adjustments, and the need for randomization. Presentations are methodological and empirical.
Q Structuring Priorities for Quality Improvement: Are We Using the Right Criteria?
Room 210 - Second Level
Chair: Lisa Simpson, University of South Florida
Panelists:
Robert Blendon, Harvard University; George Isham, HealthPartners; Jonathan Lomas, Canadian Health Services Research Foundation; Elizabeth McGlynn, RAND
Roundtable: This dynamic session will examine the promises and pitfalls of various strategies for setting priorities in quality improvement, both nationally and internationally, and the extent to which these strategies are responsive to diverse stakeholder needs, result in progress, exclude certain issues or populations, and have unintended consequences.
Sponsored in part by the Division of Health Care Policy & Research, Mayo Clinic
M Transitioning from Medicare Drug Discount Card to Benefit
Room 302 - Third Level
Chair: Brigid Goody, Centers for Medicare and Medicaid Services
Panelists:
Teresa Doksum and Marian Wrobel, both from Abt Associates, Inc.; Kelly Dougherty, Harvard University; Daniel Waldo and Sunyna Williams, both from the Centers for Medicare and Medicaid Services
Invited Papers: The Medicare Modernization Act of 2003 created a drug discount card and transitional assistance program available in 2004 and a new Part D drug benefit available in 2006. Both new programs: 1) invite the private sector to deliver a public benefit, 2) involve choice on the part of beneficiaries in terms of both whether to enroll and which plan to choose, and 3) engage similar organizations (health plans, insurers, PBMs, pharmacies, manufacturers, and the states). Because of these similarities, CMS has conducted analyses of drug shopping behaviors of Medicare beneficiaries and of information reported by drug card sponsors as well as sponsored two independent evaluations of the impacts on the drug card program on beneficiaries and other stakeholders. This session will present findings from the analysis of sponsor-submitted data as well as information gathered from beneficiary focus groups and key informant interviews with representatives of card sponsors, the pharmacy sector, manufacturers, State Health Insurance Program counselors, and other stakeholders. The presentations will focus on a critical discussion of the implications of these findings for the Part D drug benefit.
Recent Advances in the Analysis of HSR Data
Room 304 - Third Level
Chair: Sharon-Lise Normand, Harvard Medical School
Panelists:
Joseph Hogan, Brown University
PDF Handout
Tom TenHave, University of Pennsylvania
PowerPoint Slides | PDF Handout of Slides
Methods Workshop: Health services researchers are often faced with "incomplete" data. Examples include missing outcome information in a cohort study or missing an important confounder in an observational study. Consequently, many assumptions are made that cannot be checked empirically. These relate to the"missing at random" assumption for incomplete data, the "no unmeasured confounder" for assessing causal effects of treatments or of mediators, and the "exclusion restriction" assumption in the use of instrumental variables. This session will introduce new strategies for representing and assessing assumptions in interpretable ways. New methods for assessing the effect of "mediating" variables will be discussed and demonstrated. Methods will be illustrated using a number of real studies, including an assessment of how antidepressant medication mediates an intention-to-treat effect in a randomized encouragement study.
W Health Workforce Studies-An Organizational Perspective
Room 306 - Third Level
Chair: Bob Konrad, University of North Carolina, Chapel Hill
Panelists:
Kimberly Gregory, Cedars-Sinai Medical Center
"Clinical Staffing on Labor and Delivery Units in California”
Atul Grover, The Lewin Group, Inc.
"The Impact of Organizational Changes on Supply and Demand for Intensivist Services"
Gary Hart, University of Washington
"Staffing Patterns and Vacancy Rates of the Nation's Federally Funded Rural Health Centers"
David Mohr, Department of Veterans Affairs, Boston, MA
"The Influence of Organizational Culture on Physician and Nurse Resignation Rates"
Holly Rodin, University of Minnesota
"Increasing the Supply of Certified Nursing Assistants"
B Behavioral Health Care Through the Life Cycle: Different Needs, Different Services
Room 313 - Third Level
Chair: Constance Horgan, Brandeis University
Panelists:
Jeffrey Harman, University of Florida
"Physician Office Visits for Depression by Older Americans: Who Do They See and What Type of Care is Provided?"
Brooke Harrow, University of Massachusetts, Boston
"Does Motivation Influence Alcohol and Other Drug Use (AOD) Treatment Outcomes for Adolescents?"
Dean Krahn, William S. Middleton Memorial Veterans Hospital
"Depression and At-Risk Alcohol Use Outcomes for Older Primary Care Patients in Integrated Care and Enhanced Specialty Referral"
Jennifer Yu, University of California, San Francisco
"The Impact of Childhood Learning Disabilities on Adult Functioning and the Influence of Elementary Special Education Services" and "The Effectiveness of Substance Abuse Treatment Programs on Adolescents with Learning Disabilities"
5:30 p.m. - 7:00 p.m.
Concurrent Sessions
Data & Measurement for Reducing Health & Health Care Disparities
Room 309- Third Level
Chair: Robin Weinick, Massachusetts General Hospital
PowerPoint Slides | PDF Handout of Slides
Panelists:
David Baker, Northwestern University
PowerPoint Slides | PDF Handout of Slides
Joseph Betancourt, Massachusetts General Hospital
PowerPoint Slides | PDF Handout of Slides
Alan Zaslavsky, Harvard Medical School
PowerPoint Slides | PDF Handout of Slides
Methods Workshop: An understanding of data and measurement issues is crucial to assessing progress toward eliminating racial and ethnic disparities in health and health care. This workshop will emphasize data collection and related measurement issues for efforts by the Department of Health and Human Services, states, and the private sector. Discussions will include the recent National Research Council Report, "Eliminating Health Disparities: Measurement and Data Needs," development and testing of instruments to collect self-reported race and ethnicity, and collection data on race and ethnicity in hospitals.
O Management Practices that Result in Higher Quality of Care
Room 311- Third Level
Chair: Martin Charns, Department of Veterans Affairs, Boston, MA
Panelists:
James Conway, Harvard University
PowerPoint Slides | PDF Handout of Slides
Sue Dyrenforth, VHA National Center for Organization Development
Patricia Gabow, Denver Health and Hospital
PowerPoint Slides | PDF Handout of Slides
Carol VanDeusen Lukas, Department of Veterans Affairs, Boston, MA
PowerPoint Slides | PDF Handout of Slides
PowerPoint Slides | PDF Handout of Slides
Invited Papers: The need to improve quality of care and patient safety is well documented and the goal of dramatically improved care is highly sought after. Yet, there is a substantial gap in our knowledge regarding what to change and how to implement those changes to achieve the goal of dramatically improved quality of care. Recent research has shown that more is needed than traditional quality improvement projects. In this panel discussion, two examples of successful organizational transformation-those of Denver Health and Dana-Farber Cancer Institute-will be presented and discussed.
S Medicaid Cost, Growth & Program Design Issues
Room 203 - Second Level
Chair: Genevieve Kenney, The Urban Institute
PowerPoint Slides | PDF Handout of Slides
Panelists:
Joanna Campbell, University of Texas Medical Branch
"The Effect of Public Subsidies for Community-Based Services on Eldercare Decisions"
PowerPoint Slides | PDF Handout of Slides
Peter Cunningham, Center for Studying Health System Change
"Medicaid Cost Containment and Access to Prescription Drugs"
PowerPoint Slides | PDF Handout of Slides
Amy Davidoff, University of Maryland, Baltimore County
"What Explains the Recent Dramatic Growth in Adult Medicaid Enrollment?"
PowerPoint Slides | PDF Handout of Slides
Allyson Hall, University of Florida
"Lapses in Medicaid Coverage: Impact on Cost and Utilization Among Diabetics Enrolled in Medicaid"
PowerPoint Slides | PDF Handout of Slides
Neal Wallace, Portland State University
"Effects of Medicaid Benefit Changes on Expenditures for Persons with Chronic Conditions"
PowerPoint Slides | PDF Handout of Slides
ASPE Research Update
Room 202- Second Level
Chair: Don Cox, Office of the Assistant Secretary for Planning and Evaluation
PowerPoint Slides | PDF Handout of Slides
Panelists:
Barbara Greenberg, Office of the Assistant Secretary for Planning and Evaluation
PowerPoint Slides | PDF Handout of Slides
Ruth Katz, Office of the Assistant Secretary for Planning and Evaluation
PowerPoint Slides | PDF Handout of Slides
Meredith Kelsey, Office of the Assistant Secretary for Planning and Evaluation
PowerPoint Slides | PDF Handout of Slides
Research Update: This session will provide an update of ongoing research activities of the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and present ASPE's FY 2005 research agenda. The focus will be on health policy and long-term care research, human services policy, and departmental data needs.
Q Financing & Quality of Care
Room 312- Third Level
Chair: Paul Shekelle, Department of Veterans Affairs, Los Angeles, CA
Panelists:
Laurence Baker, Stanford University
"Hospital Financial Performance and Patient Safety"
PowerPoint Slides | PDF Handout of Slides
Stephen Grossbart, Catholic Healthcare Partners
"What's the Return? Assessing the Effect of 'Pay-for-Performance' Initiatives on the Quality of Care Delivery"
PowerPoint Slides | PDF Handout of Slides
H. Joanna Jiang, Agency for Healthcare Research and Quality
"Achieving High Quality-Low Cost Hospital Performance: The Effects of Market and Organizational Characteristics"
PowerPoint Slides | PDF Handout of Slides
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