2010 ARM: Agenda and Presentation Slides - Monday Morning
MONDAY, JUNE 28
Click on presenter's name for presentation slides.
POSTER SESSION B/CONTINENTAL BREAKFAST
8:00 a.m.-9:30 a.m.
Exhibit Hall C
Features:
Comparative Effectiveness Research
Coverage and Access
Global Health
Medicare
Prevention and Treatment of Chronic Illness
Quality and Efficiency: Measurement
First half of General Posters
Student Posters (posters will be on display during all three sessions)
Sponsored in part by Robert Wood Johnson Foundation
CONCURRENT SESSIONS
9:45 a.m.–11:15 a.m.
Measuring Health Disparities: Concepts and Methods
Room 302
Chair: Linda Bilheimer, National Center for Health Statistics
Panelists: Yukiko Asada, Dalhousie University; Marc Elliott, RAND; Allen Fremont, RAND; Elsie Pamuk, National Center for Health Statistics
Methods Workshop: This workshop addresses a variety of emerging methodological questions in the measurement of health disparities. Topics include: the use of univariate versus bivariate summary measures of disparity; cohort studies of socioeconomic disparities in life expectation; the use of modeling to improve estimates of disparities among small populations and/or communities over time; and the assessment of disparities in comparative effectiveness research. Level of difficulty is intermediate. Graduate training in statistics and some experience in disparities measurement are recommended.
The Promise and Threat of Comparative Effectiveness Research
Room 304
Chair: Daniel Fox, Milbank Memorial Fund
Panelists: Mark Gibson, Oregon Health and Science University; David Henry, Institute for Clinical Evaluative Sciences; David Nexon, The Advanced Medical Technology Association; Steven Pearson, Institute for Clinical and Economic Review; Gail Wilensky, Project HOPE
Roundtable: Findings from research on the comparative effectiveness of health services (CER) are informing policy, but also causing controversy, in the United States and other countries. Controversial issues about using CER in decisions about payment and coverage include its effects on quality, cost, and innovation. CER raises concerns among many stakeholders, including policymakers in the public and private sectors, manufacturers of drugs and devices, advocates on behalf of particular diseases and patients they afflict, many clinicians, and many clinical researchers. This policy roundtable explores the history and current discussion of CER with particular emphasis on what its sponsors have done to manage the politics of conducting it and how its usefulness to policymakers, health professionals, and the public could be enhanced.
Sponsored by University of California, San Francisco Philip R. Lee Institute for Health Policy Studies
Health IT and Improving the Delivery System: An Update
Room 306
Chair: Ashish Jha, Harvard University
Panelists: Julia Adler-Milstein, Harvard University; David Blumenthal, Department of Health and Human Services; Kevin Lanphear, Newburyport Family Practice
Roundtable: The session will provide a short update on the policy context driving HIT adoption and "meaningful use", how the provisions of "meaningful use" of Electronic Health Records (EHR) will help drive change in the healthcare system, and real-life examples of providers who have tried to implement an EHR and their experience with trying to meet the threshold of "meaningful use". The session will also provide updated information about the state of EHR and HIE activities in the United States.
The Effects of Benefit Design on Patients
Room 309
Chair: Lisa Dubay, Johns Hopkins Bloomberg School of Public Health
Panelists:
Niteesh Choudhry, Harvard Medical School
An Evaluation of the Impact of Copayment Reductions for Essential Cardiovascular Medications on Health Spending and Clinical Outcomes
Amy Davidoff, University of Maryland School of Pharmacy
Value Based Benefit Design in Medicare Beneficiaries with Diabetes
Charles Michalopoulos, MDRC
The Effects of Health Care Benefits for New Disability Insurance Beneficiaries: A Randomized Control Trial
James Wharam, Harvard Medical School and Harvard Pilgrim Health Care Institute
Two-Year Colorectal Cancer Screening Rates and Socioeconomic Disparities after Switching to a High-Deductible Health Plan
Public Health: Measurement and Quality Improvement
Room 310
Chair: Michael Stoto, Georgetown University
Panelists:
Bridget Booske, University of Wisconsin-Madison
County Health Rankings: Mobilizing Action Toward Community Health
Sheryl Davies, Stanford University
Measuring Hospital Preparedness for Pandemic and Mass Casualty Events: What is Most Important?
Alycia Infante, National Opinion Research Center
Strengthening Public Health Departments Through Process Improvement: Findings from the Common Ground Evaluation
Brenda Joly, University of Southern Maine
Quality Improvement in Local Health Departments: The Development of a Classification System
HCUP Data for Healthcare Research
Room 311
Chair: Anne Elixhauser, Agency for Healthcare Research and Quality
Panelist: Allison Russo, Thomson Reuters
Research Resources: This introductory session will provide an overview of the Healthcare Cost and Utilization Project (HCUP). HCUP provides all-payer, multi-year claims-based data on hospital inpatient, emergency department, and ambulatory surgery care. HCUP also includes analytic tools, free on-line statistics, and research reports based on these data. Attendees will receive an overview of the data as well as information needed to access and use these resources.
Medicare Spending and Payment Reform: Implications for Beneficiaries and Providers
Room 312
Chair: Robert Berenson, Urban Institute
Panelists: Michael Chernew, Harvard Medical School; Patricia Neuman, Henry J. Kaiser Family Foundation; Joseph Newhouse, Harvard University; Hoangmai Pham, Center for Studying Health System Change
Roundtable: Medicare spending has been a central topic in health reform discussions and will need to be addressed soon -- whether or not broad health reform legislation is enacted. The panel will discuss the Medicare’s fiscal hole and how new approaches to payment might affect it; what we know about geographic spending variations and what that tells us about opportunities for new payment policies; the main organizational and complementary payment reform innovations that are getting attention; and the implications of new payment approaches for beneficiaries.
Strategies to Manage Utilization: Impact on Cost, Access, and Outcomes
Room 313
Chair: Chien-Wen Tseng, University of Hawaii
Panelists:
Laurence Baker, Stanford University School of Medicine
Physician Acquisition of MRI: Effects on Utilization and Spending
Peter Groeneveld, University of Pennsylvania
Medicare Coverage with Evidence Development Policy and Access to New Technology
Matthew Maciejewski, Department of Veterans Affairs, Durham & Duke University
Turning the Tide? Medication Adherence after Copayment Reductions
Ateev Mehrotra, RAND
Associations Between Physician Characteristics and Relative Cost Profiles
Kevin Volpp, Leonard Davis Institute of Health Economics
The Impact of Hospital Profitability on Mortality Outcomes
Saving Dr. Ryan: Is There a Future for Primary Care Physicians in the U.S.?
Room 200
Chair: John McKinlay, New England Research Institutes
Discussant: Carolyn Clancy, Agency for Healthcare Research and Quality
Panelists:
Lawrence Casalino, Weill Cornell Medical College
A Martian View of Primary Care
Timothy Hoff, University at Albany School of Public Health
Primary Care Physicians and the Medical Home: Neither Ready, Willing, or Able
Lisa Marceau, New England Research Institutes
From the Patient’s Perspective: their Continuously Changing Relationship with Primary Care Physicians
David Mechanic, Rutgers, The State University of New Jersey
Is the Primary Health Care Crisis in America Solvable?
Hospital-Based Systems Redesign
Room 202
Chair: Robin Newhouse, University of Maryland School of Nursing
Panelists:
James Bramble, Creighton University
Team Training and Operating Room Performance
Amir Ghaferi, Michigan Surgical Collaborative for Outcomes Research
Hospital Characteristics Associated with Failure to Rescue in High Risk Surgery and Intensive Care Unit Staffing and Failure to Rescue with Major Surgery
Mary McCarthy, Madigan Army Medical Center
Measuring the Effects of Nurse Staffing on Patient Outcomes: The MilNOD Project
Organizational Factors and Care Delivery
Room 203
Chair: Christopher Friese, University of Michigan
Discussant: Kevin Frick, Johns Hopkins Bloomberg School of Public Health
Panelists:
Kathleen Carey, Boston University
Economies of Scale and Scope: The Case of Specialty Hospitals
Larry Hearld, University of Alabama at Birmingham
Is More Better? Examining the Relationship Between Provider Supply and Ambulatory Care Sensitive Hospitalizations
David Mohr, VA Boston Health Care System
The Role of Slack Resources and Influenza Vaccinations for Primary Care Practices
Emilie Powell, Northwestern University
Does Quantity of Emergency Department Sepsis Experience Impact Inpatient Sepsis Mortality?
Family Life and Child Health: Intergenerational Inquiries
Room 206
Chair: Alyna Chien, Children's Hospital Boston
Panelists:
Anthony Goudie, Cincinnati Children's Hospital Medical Center
Domestic Violence Impacting Children with Special Health Care Needs
Beth McManus, University of Wisconsin
Modeling Family and Health System Correlates of Caregiver Burden Among Families of Children with Developmental Delays and Disabilities
Beth Mohr, Brandeis University
Psychotropic Medication Use in Dependent Children of Active Duty Soldiers Following Parent’s Deployment
Jung Min Park, University of Illinois at Urbana-Champaign
Similarities and Differences in Mental Health Services Use for Children with and without Homeless Episodes
Whitney Witt, University of Wisconsin Madison
The Impact of Childhood Activity Limitations on Child and Family-Level Healthcare Related Financial Burden in the U.S.
Connection Between Safety Net Services/Providers and Health Reform
Room 207
Chair: Marianne Udow, Center for Health Care Research and Transformation
Panelists: Mark Hall, Wake Forest University; Peter Jacobson, University of Michigan School of Public Health; Sara Rosenbaum, George Washington University
Special Session: As we have learned from the experience of Massachusetts, health care reform does not mean the end of the “safety net.” Indeed, some data show that the safety net is even more important after reform to meet the increased demand for primary care, especially in underserved communities. Our panel will focus on the implications of insurance expansion on the mission and practice of the primary care safety net. We will present research that: compares the cost of well-structured safety net systems for the uninsured with the cost of covering a similar population through Medicaid or private insurance; considers how insurance expansion might change the safety net’s mission and operations; examines the sustainability and efficiency of safety net organizations; and describes resource use strategies for expanding safety net services to a larger percentage of the target population.
Operation Enduring Freedom/Operation Iraqi Freedom Returning Veterans Issues
Room 208
Chair: Nina Sayer, Department of Veterans Affairs
Panelists: Joan Griffin, Minneapolis Veteran Affairs Medical Center; Robert Kerns, Veterans Health Administration; Karen Seal, Department of Veterans Affairs, San Francisco; Heidi Terrio, Evans Army Community Hospital
Special Session: Over 1.8 million United States service members have served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). The physical and mental health care needs of these service members are the subject of considerable concern and active research. This session will feature presentations on high frequency morbidities that often co-occur in individuals previously deployed to OEF/OIF, including pain-related problems, mental health and traumatic brain injury, as well as models of service delivery to meet their health care needs. In addition, this session will feature research describing family caregivers of returning service members with war injuries. Discussion of implications for health services planning, policy and future studies will be facilitated.
Measuring Clinical Performance: The Path Forward
Room 210
Chair: Helen Burstin, National Quality Forum
Panelists: R. Adams Dudley, University of California, San Francisco; Dana Gelb Safran, Blue Cross Blue Shield of Massachusetts; Eric Schneider, RAND
Roundtable: Measuring clinical performance is an integral element of payment and reward systems in healthcare. While research on pay-for-performance has demonstrated mixed results, there is definite momentum toward reward for clinical outcomes. In this roundtable, we will discuss the tough issues, such as attribution, risk adjustment, data sources, and shared accountability that can have a profound effect on the implementation path forward.
CONCURRENT SESSIONS
11:30 a.m.–1:00 p.m.
How Health Services Research Was Used in Health Care Reform
Room 302
Chair: Karen Davis, The Commonwealth Fund
Panelists: Jack Ebeler, Committee on Energy and Commerce; Elizabeth Fowler, Senate Finance Committee; Jonathan Gruber, Massachusetts Institute of Technology; Mark McClellan, Brookings Institute; Cathy Schoen, The Commonwealth Fund
Special Session: Health services research played an important role in the Congressional health reform discussions. Panelists will discuss how research created an overall framework for a high performance health system and informed design of key coverage and delivery system reform provisions, with a particular focus on issues surrounding affordability and delivery system redesign through accountable care organizations and patient-centered medical homes. Congressional staff reactors will offer insights into the type of research used during the reform process and areas where further study will prove useful in future legislative efforts.
Observational Data Analysis for Comparative Effectiveness Research
Room 304
Chair: Sebastian Schneeweiss, Brigham and Women's Hospital and Harvard Medical School
Panelist: Jeremy Rassen, Harvard Medical School
Methods Workshop: About 80 percent of ongoing comparative effectiveness research is based on non-randomized studies. This session will present main challenges in non-randomized analyses of intended treatment effects. It will then focus on confounding by indication and ways to adjust for confounding including restriction, propensity score analyses, and instrumental variable analyses. The course will also touch on important design issues like the new user design, exposure risk window and time-varying hazards. All concepts will be illustrated with published examples. Level of difficulty: Intermediate
Medicare Part D 2006-2009 and Beyond: New Data, Methods, and Results
Room 306
Chair: Aman Bhandari, Centers for Medicare and Medicaid Studies
Panelists: Jalpa Doshi, University of Pennsylvania; Melvin Ingber, RTI International; Christopher Powers, Centers for Medicare and Medicaid Services; William Shrank, Brigham and Women's Hospital/Harvard Medical School
Special Session: The implementation of the Medicare prescription drug benefit in 2006 represented one of the largest changes to Medicare since 1965. Research on Medicare Part D is expanding as new databases become available to researchers including prescription drug event (PDE) data and the Chronic Condition Warehouse. The panel will introduce new features of the Part D (PDE) data, methods and to demonstrate some of the latest research in this area. Innovative uses of the data will be highlighted. The panel will conclude with details on the gaps in the evidence base and potential policy implications for the Part D program. The panelists have had access to a variety of data sources, offering new evidence and the most complete picture of the Part D landscape to our knowledge.
Impact of Organizational Practices on Financial and Quality Outcomes
Room 309
Chair: Andrew Garman, Rush University
Discussant: Thomas D'Aunno, Columbia University
Panelists:
Julia Adler-Milstein, Harvard University
Organizational Complements to Electronic Health Record Use
Yaozhu (Juliette) Chen, Covance Market Access Services
Informing a Business Case to Prevent Infections Acquired in Acute Care Hospitals
Phuong Hoang, Brandeis University
Effect of Senior Health Center Team Care on Patients’ Use of Outpatient and Inpatient Services in an Integrated Health Care Network
Courtney Jackson, New England Research Institute
Coping with Organizational Intrusions on the Doctor-Patient Relationship: A Qualitative Study
Hospital/Facility-Level Variations: Implications for Disparities
Room 310
Chair: Ninez Ponce, University of California, Los Angeles
Panelists:
L. Elizabeth Goldman, University of California, San Francisco
Accuracy of Diagnostic Mammography at Facilities Serving Vulnerable Women
Ashish Jha, Harvard University
The Characteristics of the Best and Worst U.S. Hospitals: Implications for Disparities
Dan Ly, Weill Cornell Medical College
How Do Minority-Serving Hospitals Perform on Patient Safety Indicators?
Susannah Bernheim, Yale University
Mortality and Readmission Rates at Safety Net and Non-Safety Net Hospitals
Nancy Sonnenfeld, National Center for Health Statistics
Hospital Characteristics Associated with Racial and Ethnic Disparities in Waiting Times at U.S. Emergency Departments
MEPS: A National Information Resource to Support Health Care Research and to Inform Health Policy and Practice
Room 311
Chair: Steven Cohen, Agency for Healthcare Research and Quality
Panelists: Jessica Banthin, Agency for Healthcare Research and Quality; Joel Cohen, Agency for Healthcare Research and Quality
Research Resources: AHRQ’s Medical Expenditure Panel Survey (MEPS) collects longitudinal 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 and provide an update on MEPS capacity to support modeling efforts to inform health care policy, practice and health care reform initiatives.
Missing Data in Longitudinal Studies: Models and Sensitivity Analyses
Room 312
Chair: Jack Needleman, University of California, Los Angeles
Panelist: Joseph Hogan, Brown University
Methods Workshop: Missing data continues to be a problem in clinical and health services research using longitudinal data. Although there are several models available for handling 'non-ignorable' missingness, the focus of most current research in this area is on formulation and execution of coherent sensitivity analyses that examine the robustness of findings under a wide range of assumptions about the missing data mechanism. This workshop will briefly review missing data mechanisms and their use with longitudinal data, and then focus on principles and methods of carrying out sensitivity analyses. The use of informative prior information about missing data mechanisms also will be discussed. The methods will be illustrated with two detailed case studies from recent clinical trials. Level: Intermediate/Advanced
Nursing Process of Care and Job Experiences
Room 313
Chair: Ying Xue, University of Rochester
Panelists:
Donna Havens, University of North Carolina, Chapel Hill
Nurse Reports of Relational Coordination: An Emerging Theory to Improve Communication Across the HealthCare Team
Matthew McHugh, University of Pennsylvania, School of Nursing
Do Nurses' Job Perceptions Provide a Barometer for the Patient Experience?
Joanne Spetz, University of California, San Francisco
Changes in Nurse Satisfaction from 2004 to 2008
Lynn Unruh, University of Central Florida
What Predicts Perceptions of Job Difficulties among Newly Licensed RNs?
Olga Yakusheva, Marquette University
Impact of Unit-Level Nurse Staffing on Readiness for Hospital Discharge and Post-Discharge Utilization
Wither or Bloom? Moving from Successful Pilots on Reducing Avoidable Rehospitalizations to National Transformation
Room 200
Chair: Anne-Marie Audet, The Commonwealth Fund
Panelists: Amy Boutwell, Institute for Healthcare Improvement; Jane Brock, Colorado Foundation for Medical Care; Randall Krakauer, Aetna Foundation; Joseph McCannon, Institute for Healthcare Improvement
Roundtable:The roundtable will discuss how to design a national strategy to achieve rapid and sustainable system transformation in the United States. Panelists will use evidence from scientific studies and their own current work to examine application at each level of the health care system – local, regional, state, and national.
Processes for Care and Disease Management
Room 202
Chair: David Dorr, Oregon Health and Science University
Panelists:
Kenneth Coburn, Health Quality Partners
Care Coordination by Means of Community-Based Nurse Care Management
Rachel Everhart, Denver Health
Improving Chronic Disease Management and Preventive Care Through Patient-Centered Navigation
Jeffrey Pearson, Arbor Research Collaborative for Health
Improved Processes of Care for End-Stage Renal Disease Patients in a Centers for Medicare & Medicaid Services Disease Management Demonstration
Adam Powell, Minneapolis VA Medical Center
Pre-Post Evaluation of a VA Collaborative to Improve the Timeliness of Follow-Up after a Positive Colorectal Cancer Screening Test
Quality and Efficiency in Specific Conditions: Cardiovascular Disease, Diabetes, Asthma and ESRD
Room 203
Chair: Peter Hussey, RAND
Panelists:
Claudia Dahlerus, Arbor Research Collaborative for Health
Race and Ethnicity Data for End-Stage Renal Disease Patients
Karen Joynt, Harvard School of Public Health
Impact of Volume on Quality, Outcomes, and Costs of Care for Heart Failure
David Mosen, Kaiser Permanente Northwest
Is Patient Activation Associated with Future Utilization Outcomes for Adults with Diabetes?
Robert Saunders, National Committee for Quality Assurance
Comparison of Health Plan Quality and Emergency Department Discharges for Medicaid Members with Asthma
Using Microsimulation Models to Examine Public Health Investments
Room 206
Chair: Glen Mays, University of Arkansas for Medical Sciences
Panelists:
Erika Martin, University at Albany, State University of New York
Expanded HIV Screening: What Will It Cost, and Who Will Pay? A Budget Impact Analysis
Jeroen Van Meijgaard, University of California, Los Angeles
Assessing and Forecasting the Impact of Air Quality on Health Outcomes for a Local County Health Department
Wenya Yang, The Lewin Group
Who Pays the Costs? Who Realizes the Benefits? Using a Microsimulation Approach to Inform the Business Case for Smoking Cessation
Yiduo Zhang, The Lewin Group
Projected Lifetime Cost of Excess Weight among TRICARE Prime Plan Beneficiaries: the Business Case for Weight Loss Intervention
The Effect of Health Information Technology on Clinical Quality
Room 207
Chair: Jeffrey McCullough, Regents of the University of Minnesota
Panelists:
Kathryn Bowles, University of Pennsylvania
Impact of Telehomecare on Readmission in Heart Failure
Catherine DesRoches, Harvard Medical School/Massachusetts General Hospital
Changes in Safety and Efficiency of Outpatient Prescribing with Use of E-Prescribing Systems
Michael Fischer, Brigham and Women's Hospital
Prescribing in Compliance with Patient Formularies Increases Primary Adherence in Patients Receiving Electronic Prescriptions"
Ann Kutney-Lee, University of Pennsylvania
"Hospital Electronic Health Record Adoption and Nurse-Assessed Patient Safety Outcomes"
Tracy Yee, University of California, Los Angeles School of Public Health
"The Influence of Integrated Electronic Medical Records and Computerized Nursing Notes on Nurses’ Time Spent in Documentation"
Building Health Systems and Supporting Patients: Dispatches from the Old World
Room 208
Chair: Timothy Doran, University of Manchester
Panelists:
Saskia Droesler, Niederrhein University of Applied Sciences
International Comparability of Patient Safety Indicators in 13 OECD Member Countries: A Methodological Approach of Adjustment by Secondary Diagnoses
Dionne Kringos, Netherlands Institute for Health Services Research
Strategies for Safeguarding and Improving Access to Primary Care Services
Francis Okello, Family Health International
Burying the Dead but Saving the Sick: Supporting People Living with HIV Through Traditional Burial Groups in Ethiopia
Stuart Olmsted, RAND Corporation
Strengthening Laboratory Systems in Resource-Limited Settings
Matthias Wismar, European Observatory on Health Systems and Policies
Health Workforce Migration and the European Union
Building a Successful Career in Academia
Room 210
Chair: Michelle Mello, Harvard University
Panelists: Katrina Armstrong, University of Pennsylvania; Katherine Baicker, Harvard School of Public Health; Laurence Baker, Stanford University School of Medicine; Kenneth Thorpe, Emory University
Skill and Career Development: This session is aimed at graduate students and junior faculty and will provide strategic advice on building a successful research career in health policy and health services research in the academic setting. The panelists, a department chair and recently tenured faculty at highly ranked academic institutions, will share insights about factors that made a difference in their own career. They will also offer advice for junior investigators on matters such as building a reputation in the field, developing a portfolio of scholarship, having an impact on policy and practice, finding mentorship, achieving independence from mentors, and preparing for promotion review.
Sunday, June 27 Monday, June 28 - Part 1 (morning) Monday, June 28 - Part 2 (afternoon) Tuesday, June 29 Sessions are marked by theme letter—methods workshops are marked with
Behavioral Health
Prevention and Treatment of Chronic Illness
Consumer Engagement, Choices and Decision-Making
Insurance, Markets and Competition
Long-Term Care
Medicaid, CHIP & State Health Reform
Gender and Health