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presentation slides
Sunday, June 25 | Monday, June 26 | Tuesday, June 27
Tuesday, June 27
7:15 a.m. – 8:30 a.m.
Closing Breakfast Plenary
 Presentation of AcademyHealth Awards
Article-of-the-Year
Awardee: Richard L. Kravitz, University of California, Davis
Presenter: Sheldon Greenfield, University of California, Irvine
Dissertation
Awardee: Ben Sommers, Harvard University
Presenter: Katherine Swartz, Harvard University
Student Poster
Awardee: TBA
Presenter: Shoou-Yih Daniel Lee, Ph.D., University of North Carolina, Chapel Hill
Closing Remarks
David Helms
AcademyHealth
8:45 a.m. – 10:15 a.m.
Concurrent Sessions
Translating "Emerging" Evidence: The Challenge of Pay-for-Performance Research
Room 602 (level 6)
Chair: Irene Fraser, Agency for Healthcare Research and Quality
Panelists:
James Burgess, Department of Veterans Affairs & Boston University School of Public Health
Josep Figueras, European Observatory on Health Care Systems;
John Hsu, Kaiser Permanente
 PowerPoint Slides |  PDF Handout of Slides
Margaret Stanley, Puget Sound Health Alliance
Roundtable: The task of moving knowledge into practice faces particular challenges in areas where the knowledge base is still emerging, as in the case of Pay-for-Performance or Quality-Based Payment. Faced with growing concerns about quality, safety, and cost, many public and private purchasers are looking to use their market power as a way to shape quality. They are eager for evidence and tools to guide their work, but the field has yet to produce much by way of rigorous analyses to point the way. This panel brings together several leading researchers and purchasers in a dialogue about critical questions emerging from the conundrum.
Issues in Cost-Effectiveness Analysis
Room 4C-2 (level 4)
Chair: Michael Chernew, University of Michigan
Panelists:
Scott Braithwaite, Yale University
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Daniel Eisenberg, University of Michigan
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Daniel Polsky, University of Pennsylvania
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Methods Workshop: This session will present research examining new and controversial methodological issues related to cost-effectiveness analysis. Topics covered will include: generation of confidence interval around C-E ratios, adjusting the societal value of life-years for differences across age groups, and incorporating strength of evidence into CEA results.
Issues & Advances in Health Survey Methods
Room 619-620 (level 6)
Chair: Timothy Beebe, Mayo Clinic
Panelists:
Stephen Blumberg, National Center for Health Statistics
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Kathleen Thiede Call, University of Minnesota
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Karen Donelan, Massachusetts General Hospital
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Methods Workshop: Among others, epidemiologists, sociologists, economists, political scientists, policy analysts, and health care practitioners have long relied on the survey method in the study of health services. This session brings together survey experts to discuss some of the main issues and advances in health survey research methods. Topics include, but are not restricted to: 1) survey nonresponse (trends, association with bias, and potential remedies); 2) telephone coverage (trends, cell phone only households, and impact on health-related survey estimates); and 3) partnering with communities in survey design and implementation using a community-based participatory research model.
Market Dynamics & the Safety Net: Implications for the Uninsured
Room 4C-3 (level 4)
Chair: Peter Cunningham, Center for Studying Health System Change
Panelists:
Gloria Bazzoli, Virginia Commonwealth University
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Derek DeLia, Rutgers, The State University of New Jersey
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Kateryna Fonkych, RAND Child Policy Project
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Kenneth Thorpe, Rollins School of Public Health of Emory University
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Invited Papers: As the number of uninsured continues to increase, it is important to understand how recent developments in the health care marketplace are affecting the ability of safety net providers to provide care for the uninsured. The four papers in this session examine various aspects of changing market conditions, the effects of these changes on safety net hospitals, and implications for access to medical care for the uninsured. Included are analyses of the effects of financial pressures on safety net hospitals arising from a combination of policy changes (e.g., 1997 Balance Budget Act) and private sector pressures, as well as an analysis of safety net hospital pricing behavior and how it differs from that of other hospitals. Other papers in the session explore changes in the uninsured population that are affecting the demand for safety net services, including changes in the medical conditions of the uninsured and an increasing number of elderly uninsured receiving uncompensated care. The implications of these changes for safety net providers are discussed.
The Potential Impact of the New Prescription Drug Benefit on Medicare Beneficiaries
Room 4C-4 (level 4)
Chair: Stuart Guterman, The Commonwealth Fund
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Panelists:
Tanisha Carino, Avalere Health
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Dana Gelb Safran, Tufts-New England Medical Center
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Bruce Stuart, University of Maryland at Baltimore
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Scott Young, Agency for Healthcare Research and Quality
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Invited Papers: The papers presented at this session will address several issues that may be important in assessing the potential impact on Medicare beneficiaries of the new Medicare drug benefit. These issues include: the relationship between drug coverage, disease burden, and medication intensity; factors (including drug coverage) related to Medicare beneficiaries' adherence to prescription regimens and the implications of non-adherence; and variations in the restrictiveness of stand-alone Medicare prescription drug plans. The discussion will focus on the implications of these findings for beneficiaries' access to appropriate care under the new benefit.
Public Reporting of Health Care Quality: Evaluating its Role in Quality Improvement
Room 606 (level 6)
Chair: Rachel Werner, Department of Veterans Affairs & University of Pennsylvania
Panelists:
Kate Bundorf, Stanford University
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Lawrence Casalino, University of Chicago; Dana Mukamel, University of California, Irvine
Dennis Scanlon, Pennsylvania State University
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Invited Papers: Many organizations have adopted public reporting of health care quality to improve quality. Yet, many questions remain about the best way to implement public reporting to achieve the expected positive response. Are the quality rankings valid? Do providers improve quality of care in response to public reporting? Does overall quality of care improve as a result? This session will explore these issues in detail and provide the audience with illustrations of the benefits and challenges facing public reporting.
Benefit Structure, Service Utilization, & Costs of Behavioral Health Care
Room 607 (level 6)
Chair: Constance Horgan, Brandeis University
Panelists:
Colleen Barry, Yale University
“Effects of State Parity Laws on the Family Financial Burden of Children with Mental Health Care Needs”
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Marisa Elena Domino, University of North Carolina, Chapel Hill
“Putting Providers At Risk: How Strong Are Incentives For Upcoding and Undertreating?”
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Kalyani Gopalan, Community Care Behavioral Health Organization
“Intensive Substance Abuse Services: Who Continues in Subsequent Treatment?”
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John McConnell, Oregon Health and Science University
“The Effect of Eliminating Medicaid Coverage for Mental Health and Substance Abuse Treatment Services on Enrollee Utilization and Expenditures”
Jennifer Yu, University of California, San Francisco
“Mental Health Care Utilization as Adolescents Become Young Adults”
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Making Electronic Health Exchange Real for Providers and Consumers: Internet, Portal, EMR & Business Case
Room 608 (level 6)
Chair: Patricia MacTaggart, EDS
Panelists:
Timothy Dall, The Lewin Group, Inc.
“Developing a Business Case Model for Integrated Child Health Information Systems”
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Marie Eidem, Mayo Clinic
“Time to Reap: Improving Quality by Harvesting Data from the EMR”
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Kathryn Flynn, Duke University School of Medicine
“How Older Adults Use the Internet to Look for Health Information”
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Joy Grossman, Center for Studying Health System Change
“Hospital-Physician Portals: A First Step in Sharing Patient Data across Care Settings”
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Sandra McGinnis, Center for Health Workforce Development
“New York State Physicians and the Adoption of Innovation: Use of Internet and E-Mail in Practice, 1999-2004”
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Taking the Pulse of Nursing Homes in a Changing Policy Environment
Room 603 (level 6)
Chair: Christopher Murtaugh, Visiting Nurse Service of New York
Panelists:
Kathleen Dalton, RTI International
“Trends in Cost and Service Intensity for Medicare Skilled Nursing Care in Freestanding, Hospital-Based and Swing-Bed Settings, 1997-2003”
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Lisa Dwyer, National Center for Health Statistics
“Medication Practices for the Elderly in U.S. Nursing Homes”
Christopher Johnson, Texas A&M University Health Sciences Center
“Quality of Care for Veterans in Community Nursing Homes”
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Wen-Chieh Lin, University of Missouri, Columbia
“Area Variation in Rehabilitation Use in Nursing Homes”
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Dana Weinberg, Queens College – CUNY
“Nurses as Power Brokers: Changing Roles and Culture Change in Nursing Homes”
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Chronic Care: Patients & the Patient Journey
Room 604 (level 6)
Chair: Jinnet Fowles, Park Nicollet Institute
Panelists:
Amy Cohen, Department of Veterans Affairs, Los Angeles
“Implementing Best Practices to Improve the Quality of Care for Schizophrenia (EQUIP)”
Lisa Kern, Cornell University
“A Novel Screening Strategy for Selecting Patients for Diabetes Screening”
Kate Stewart, Harvard University
“Improved Treatment for Ischemic Heart Disease on Disability and Death in the Elderly”
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Sandra Wilson, Palo Alto Medical Foundation Research Institute
“Does Involving Patients in Treatment Decisions Improve Asthma Controller Medication Adherence?”
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Xinhua Yu, University of Minnesota
“The Use of Recommended Health Care Services among Elderly Cancer Survivors”
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Shocks to the System: Katrina, Emergency Preparedness, & the Public Health Response
Room 612 (level 6)
Chair:
Glen Mays, University of Arkansas for Medical Sciences
Panelists:
David Eisenman, University of California, Los Angeles
“Leveraging Social Networks For Protecting Vulnerable Communities' Health During Disasters”
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Sarah Laditka, University of South Carolina
“Ready or Not? Perceptions about Preparedness in Nursing Homes Before and After Hurricane Katrina”
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P.J. Maddox, George Mason University
“Reported Levels of Preparedness among Registered Nurses in the National Capital Region”
Lisa Meredith, RAND
“Trust Influences Response to Public Health Messages During a Bioterrorist Event”
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Nicole Wineman, JCAHO
“The Integration of Health Centers into Community Emergency Preparedness Planning: An Assessment of Linkages”
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Next Generation Measures & Outcomes of Disparities
Room 609 (level 6)
Chair: Ernest Moy, Agency for Healthcare Research and Quality
Panelists:
Kevin Fiscella, University of Rochester
“The Impact of Racial and Ethnic Disparities in Influenza Vaccination on Elderly Minority Deaths”
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Sharon Long, The Urban Institute
“Influenza Vaccination Trends Since 1997: Are We Making Progress Toward 2010 Goals?”
Jeffrey Silber, University of Pennsylvania
“Race, Income, and Operative Time”
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Susan Stockdale, University of California, Los Angeles
“Anxiety/Depression Diagnoses and Antidepressant Prescribing Patterns by Primary Care and Psychiatric Specialties, NAMCS 1995-2003”
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Amal Trivedi, Harvard Medical School
“Quality and Inequality in Medicare Managed Care”
Implications of Public & Private Reporting of Performance Data: Mechanisms for Driving Quality Improvement
Room 611 (level 6)
Chair: Deirdre Mylod, Press Ganey Associates, Inc.
Panelists:
Cathy Duquette, Newport Hospital and Clinic
“Rates of Change During Public and Private Reporting Cycles of Hospital Performance: Implications for Mechanisms Driving Quality Improvement”
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Judith Hibbard, University of Oregon
“Impact of Public and Private Hospital Performance Reports on Quality, Market Share and Reputation”
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Deirdre Mylod, Press Ganey Associates, Inc.
“Hospital Characteristics and Normative Rates of Improvement Using Private Feedback for Quality Improvement”
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10:30 a.m. – 12:00 p.m.
Concurrent Sessions
State, Federal, & International Roles in Public Health & Disaster Planning & Management
Room 602 (level 6)
Chair: Kristine Gebbie, Columbia University
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Panelists: Ross Anthony, RAND; Nathaniel Hupert, Weill Medical College of Cornell University
Roundtable: Interest in emergency preparedness planning and disaster management has never been at a higher level, yet many policy decisions regarding emergency preparedness are based on anecdote, individuals' experiences, and informally shared best practices. Basing this important area of public health and health systems policy-making on sound research is a priority. This session will begin with presentations regarding current approaches to stronger, evidence-based policy by the chair and two established scholars to stimulate audience interaction regarding work ongoing and needed research.
Alternative Methods for Practice-Based Evidence
Room 4C-2 (level 4)
Chair: Susan Horn, Institute for Clinical Outcomes Research
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Methods Workshop: This session will describe a rigorous, comprehensive, practice-based evidence study design, called Clinical Practice Improvement (CPI), and will compare it to randomized controlled trials and quasi-experimental designs. Examples will be presented in which actionable findings from CPI studies in post-acute care settings were implemented widely in practice, resulting in improved outcomes. CPI incorporates natural variation within data from routine clinical practice to determine what works, for whom, when, and at what cost. It is a type of observational study design whose measurements encompass a comprehensive view of the care management process: patient characteristics, process steps, and outcomes. This comprehensive measurement framework provides a basis for analyses of significant associations between process and outcome; patient differences are controlled by taking into account important patient covariates, such as severity of illness and functional status. CPI study findings can be used in clinical decision-making to compare effectiveness of treatments.
State Perspectives on Implementation of Medicare Part D
Room 4C-3 (level 4)
Chair: Joel Cantor, Rutgers, The State University of New Jersey
Panelists:
Kimberley Fox, University of Southern Maine
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Susan Payne, University of Southern Maine
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Cindy Parks Thomas, Brandeis University
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James Verdier, Mathematica Policy Research, Inc.
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Invited Papers: Controversy has surrounded the early implementation of Medicare Part D prescription drug coverage. This session will focus on lessons that states have to offer for the future of Part D and on early research findings on state responses to Part D. Papers will be presented on how states are re-designing their prescription drug coverage initiatives for Part D eligible populations, lessons for Medicare from state experimentation with prescription drug coverage policy (i.e., implementation of a preferred drug list and offering alternative state-based coverage under demonstration waivers), and early experiences of states in coordinating Medicare and Medicaid coverage through Special Needs Plans.
Advancing Quality Care: Responding to the IOM Quality Chasm Report on Improving the Quality of Health Care for Mental & Substance-Use Conditions
Room 611 (level 6)
Chair: Sarah Wattenberg, Center for Substance Abuse Treatment
Panelists:
Mady Chalk, Treatment Research Institute
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Katie McQueen, Harris County Hospital District
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Hyong Un, Aetna Health Information Solutions
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Benjamin Druss, Emory University
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Invited Papers: Panelists will review the evidence and rationale for connecting primary health care and treatment of substance use disorders. Evidence will be framed in different ways for communicating to research and clinical staff, the general public, and administrative staff. Barriers for connecting care will be listed, and participants will be asked to create a plan for improving service delivery. Future directions for research will be proposed, and strategies for creating new health care policy on screening, intervention, and referral within a health care system will be discussed. Finally, panelists will discuss mental health facilities, modeled on principles of the recent IOM Report.
Sponsored by the Center for Substance Abuse Treatment
Public Reporting & Pay-for-Performance: Experiences to Date
Room 608 (level 6)
Chair:
Mary Madison, Madison Consulting Group, LLC
Panelists:
Gary Fanjiang, Tufts-New England Medical Center
“Using Web-Based Quality Data to Choose a Primary Care Physician: Which Information Do Patients Rely on Most”
PowerPoint Slides | PDF Handout of Slides
Ateev Mehrotra, Harvard Medical School
“The Relationship Between Pay-for-Performance Incentives and Quality Improvement: A Survey of Massachusetts Physician Group Leaders”
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Irena Pesis-Katz, University of Rochester
“Pay-for-Performance – The Impact on Patient Quality of Care in a Community Setting”
Denise Remus, Premier, Inc.
“Financial Incentives Work! Results of the CMS Hospital Quality Incentive Demonstration Project Year One”
PDF Handout of Slides
Patrick Romano, University of California, Davis
“A Randomized Controlled Trial of an Educatonal and Motivational Intervention to Enhance Consumers' Use of Health Plan and Medical Group Quality Data”
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Markets, Financial Incentives, & Quality Care
Room 609 (level 6)
Chair: Jon Gabel, Center for Studying Health System Change
Panelists:
David Howard, Emory University
“The Role of Quality in the Formation of Exclusive Networks for Kidney Transplantation”
PowerPoint Slides | PDF Handout of Slides
Hsou-mei Hu, University of Michigan
“Are Insurance Gaps Costly for Diabetes Patients? Who Pays?”
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Dennis Scanlon, Pennsylvania State University
“The Effect of Hospital Safety Records and a Tiered Hospital Network on Inpatient Referrals”
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Matthew Solomon, University of California, Los Angeles
“The Effect of Cost-Sharing on the Adherence of Antihypertensive Medications”
Kevin Volpp, Department of Veterans Affairs, Philadelphia
“Effects of Hospital Price Competition on Quality of Care for Four High-Mortality Conditions”
From Research to Policy: Dealing With The "So What?" Factor
Room 612 (level 6)
Chair: Mary Pittman, Health Research and Educational Trust
Panelists:
Lisa Alecxih, The Lewin Group, Inc.
“The Administration on Aging (AOA) and Centers for Medicare and Medicaid Services (CMS) Aging and Disability Resource Center Grants: Supporting the New Initiative with Clear Federal Guidance and Technical Assistance”
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Susan Busch, Yale University
“An Employer Initiative to Increase Use of Preventive Health Care Services”
Ernest Moy, Agency for Healthcare Research and Quality
“State-Focused Health Care Quality Improvement: Translating Research from the National Healthcare Quality Report into State Action”
Thomas Rundall, University of California, Berkeley
“Evidence and Organizational Decision-Making: Never the Twain Shall Meet?”
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Claudia Williams, AZA Consulting
“How Policymakers View Evidence: Lessons from The Synthesis Project”
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Patient Safety & Methodological Issues
Room 604 (level 6)
Chair: Dana Gelb Safran, Tufts-New England Medical Center
Panelists:
Ronald Fisher, Virginia Commonwealth University
“Validating and Reporting Quality Performance Measurement Models with Multilevel Analysis”
PowerPoint Slides | PDF Handout of Slides
David Foster, Solucient, LLC
“Consequences and Costs of Medical Injuries in Medicare Inpatients”
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Jeffrey Geppert, Battelle Memorial Institute
“Socioeconomic Status and the Prevention Quality Indicators”
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Joachim Roski, National Committee for Quality Assurance
“Toward a Nationally Standardized Methodology”
Sarah Sampsel, National Committee on Quality Assurance
“Assessing Patient Safety: Potentially Harmful Drug-Disease Interactions in the Elderly”
PowerPoint Slides | PDF Handout of Slides
The Role of Language & Literacy in Health Care Disparities
Room 603 (level 6)
Chair: Ninez Ponce, University of California, Los Angeles
Panelists:
Michael Bradshaw, Medical College of Wisconsin
“A Bitter Pill? Language Barriers to Prescriptions for Patients with Limited English Proficiency (LEP): A Survey of Pharmacies”
PowerPoint Slides | PDF Handout of Slides
Dennis Kuo, Johns Hopkins University
“Pediatricians' Use of Language Services for Limited English Proficient (LEP) Families: A National Survey”
Edward Miller, Brown University
“The Digital Divide in Public E-Health: Accessibility and Privacy in State Health Department Websites”
PowerPoint Slides | PDF Handout of Slides
Michael Wolf, Northwestern University
“To Err is Human: Literacy and Misunderstanding of Prescription Drug Labels”
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Michael Wolf, Northwestern University
“Literacy and Mortality among the Elderly”
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MEPS: A National Information Resource to Support Health Care Research & Inform Health Care Policy & Practice
Room 606 (level 6)
Chair: Steven Cohen, Agency for Healthcare Research and Quality
Panelists: Karen Beauregard and Joel Cohen, both from Agency for Healthcare Research and Quality
Research Resources: AHRQ's Medical Expenditure Panel Survey (MEPS) collects data on the specific health services that Americans use, how frequently they use them, the cost of these services and how they are paid, as well as data on the cost, scope, and breadth of private health insurance held by and available to the U.S. population. This session will highlight research findings from recent MEPS studies on trends in health care costs, coverage, use and access, in addition to trends in employment related insurance coverage and premiums. An update will also be provided on the capacity of MEPS to support state level estimates, longitudinal analyses, analyses of prescription drug use and expenditures by therapeutic classes, forthcoming data releases, and other recent enhancements to the survey to inform health care policy and practice.
Best Abstracts & Article-of-the-Year
Room 607 (level 6)
Chair: David Murday, University of South Carolina
Panelists:
Xianglin Du, University of Texas at Houston
“Racial Disparities and Socioeconomic Status in Association with Survival in Older Men with Local/Regional Stage Prostate Cancer”
PowerPoint Slides | PDF Handout of Slides
Bruce Landon, Harvard Medical School
“Improving Chronic Disease Management for Underserved Populations: A National Evaluation of the HRSA Health Disparities”
Hoangmai Pham, Center for Studying Health System Change
“How Many Doctors Does It Take to Treat a Patient? The Challenges that Fragmented Care Poses for Pay-for-Performance”
Christopher Roebuck, Caremark
“Dollars to Doughnuts: Predicting Prescription Drug Costs of Beneficiaries and the Medicare Program Under Part D”
PowerPoint Slides | PDF Handout of Slides
Richard Kravitz, University of California, Davis
“Influence of Patients' Requests for Direct-to-Consumer Advertised Antidepressants: A Randomized Controlled Trial” (Article-of-the-Year)
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Challenges In Developing a Quality Monitoring System for Cancer Care
Room 4C-4 (level 4)
Chair: Melissa Hughes, Dana-Farber Cancer Institute
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Panelists:
Michael Hassett, Dana-Farber Cancer Institute
“Identifying Quality Targets for Breast Cancer Care”
Melissa Hughes, Dana-Farber Cancer Institute
“Institutional Variation in Concordance with Guidelines for Breast Cancer Care in The National Comprehensive Cancer Network: Implications for Choice of Quality Indicators”
PowerPoint Slides | PDF Handout of Slides
Eva Lepisto, National Comprehensive Cancer Network
“The Impact of Age on The Receipt of Guideline-Recommended Systemic Therapy for Breast Cancer”
PowerPoint Slides | PDF Handout of Slides
Joyce Niland, City of Hope National Medical Center
“The National Comprehensive Cancer Network (NCCN) Internet-Based Outcomes Database System”
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Rinaa Punglia, Dana-Farber Cancer Institute
“Development and Applications of Quality Measures: Studying Guideline-Concordant Use of Radiation Therapy after Mastectomy in the National Comprehensive Cancer Network”
PowerPoint Slides | PDF Handout of Slides
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