A5072320710- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Chronic Disease Management Strategies
- Patient Satisfaction in Healthcare
- Emergency and Acute Care Studies
- Workplace Health and Well-being
- Musculoskeletal pain and rehabilitation
- Diabetes Management and Education
- Hepatitis C virus research
- Health disparities and outcomes
- Mental Health Treatment and Access
- Healthcare Systems and Technology
- Geriatric Care and Nursing Homes
- Healthcare cost, quality, practices
- Pharmaceutical Practices and Patient Outcomes
- Child and Adolescent Health
- Patient-Provider Communication in Healthcare
- Health Policy Implementation Science
- Medication Adherence and Compliance
- HIV/AIDS drug development and treatment
- Digital Mental Health Interventions
- Gastric Cancer Management and Outcomes
- Telemedicine and Telehealth Implementation
- Healthcare Decision-Making and Restraints
University of Rochester Medical Center
2019-2025
Golisano Children's Hospital
2023
University of Rochester
2021-2022
Geisinger Health System
2011-2019
Cornell University
2007-2019
Geisinger Medical Center
2011-2018
Massachusetts General Hospital
2014
NYU Langone Health
2014
University of Pennsylvania
2014
Pennsylvania State University
2010
The patient-centered medical home (PCMH) model emphasizes comprehensive, coordinated, care, with the goals of reducing spending and improving quality. To evaluate impact PCMH initiatives on utilization, cost, quality, we conducted a meta-analysis methodologically standardized findings from evaluations eleven major initiatives. There was significant heterogeneity across individual in many outcomes. Across evaluations, were not associated changes majority outcomes studied, including primary...
Objective To identify factors associated with perception of care coordination problems among chronically ill patients. Methods Patient‐level data were obtained from a random‐digit dial telephone survey adults chronic conditions. The measured respondents' self‐report and level patient activation, using the Patient Activation Measure ( PAM ‐13). Logistic regression was used to assess association between set characteristics. Results Respondents in highest activation stage had roughly 30–40...
One of the primary goals patient-centered medical home (PCMH) is to provide higher quality care that leads better patient outcomes. Currently, there only limited evidence regarding ability PCMHs achieve this goal. This article demonstrates effect in improving certain clinical outcomes, as shown by ProvenHealth Navigator (PHN), an advanced PCMH model developed and implemented Geisinger Health System. In study, authors examined claims data from Plan between 2005 2009 estimated PHN on reducing...
Background: Catatonia is often overlooked, and a key factor for underdiagnosis may be an inadequate understanding of catatonia's heterogeneous phenotypes. The aim this study was to identify the current state theoretical applied knowledge catatonic features among psychiatry trainees practitioners using Bush-Francis Rating Scale (BFCRS), most commonly used instrument score catatonia.Methods: We created online 50-item multiple-choice test 3-minute standardized patient video scored BFCRS. Email...
Patient-centered medical homes (PCMHs) have the potential to improve patient experience of care. Since 2006, Geisinger Health System has implemented its own version an advanced PCMH model, referred as ProvenHealth Navigator (PHN). To evaluate impact PHN on care, authors conducted a survey patients whose primary care clinics had been transformed "PHN sites" and were under case management at time survey. A comparable from non-PHN sites also was for comparison. The results suggest that in...
Early evidence suggests that the patient-centered medical home has potential to improve patient outcomes while reducing cost of care. However, it is unclear how this care model achieves such desirable results, particularly its impact on cost. We estimated savings associated with Geisinger Health System's clinics by examining longitudinal clinic-level claims data from elderly Medicare patients attending over a ninety-month period (2006 through first half 2013). also used these deconstruct...
Background: During 2020–21, states established essential caregiver (EC) programs which allowed nursing home residents to receive in-person supports during the COVID-19 pandemic. This study presents comparative data on designs of these programs. Methods: We conducted on-line searches for federal and states’ visitation reopening guidelines published in 2020–22. also compared differences between with without an EC program infection death rates among or general population, staff shortage rates,...
The motivational and affective properties of chronic pain significantly impact patients’ lives response to treatment but remain poorly understood. Most available phenotyping tools affect rely on self-report. Here we instead directly studied the willingness low-back (CLBP) patients expend effort win monetary rewards for wins at different probabilities levels difficulties in comparison matched free controls obtained functional brain imaging a sub-group our sample link behavior properties. We...
Delayed access to behavioral health services results in poor outcomes and higher costs. This brief report describes the elimination of a 702-person waitlist through phase-based care (PBC), an innovative approach that aligns resources with new patients high-acuity need. Two PBC clinics, one triage another treatment, were established. Comparisons pre-post interventions analyzed nonbehavioral medical encounters, productivity, no-show rates. Of 702 waitlisted persons, 614 attended clinics within...
ABSTRACT Objective To develop a bootstrapping method to augment time‐driven activity‐based costing (TDABC) analysis intended allow more realistic cost estimates. Data Sources Secondary data from multisite clinical trial conducted 2016 2018 on an ostomy self‐management telehealth intervention for cancer survivors. Study Design The was newly estimated by incorporating expected patient participation rates calculated via bootstrapping. This compared against the estimate obtained traditional...
Objective: To design and conduct a survey-based study to understand what internists neurologists know think about catatonia, with the goal of raising catatonia awareness among these practitioners informing future educational campaigns. Methods: The authors disseminated an online survey module Bush-Francis Catatonia Rating Scale (BFCRS) via X/Twitter, professional listservs, newsletters, from September 5, 2023, January 15, 2024. Attendings, fellows, residents, advanced-practice providers in...
The purpose of this study was to determine if primary care patients with low back pain (LBP) cluster into definable utilization subgroups that can be explained by patient and provider characteristics.Adult an incident LBP encounter were identified from Geisinger Clinic electronic health records over 5 years. Two-thirds the cohort had only one two encounters. Principal component analysis applied data remaining one-third on use ambulatory, inpatient, emergency department, surgery magnetic...
Overutilization and overreliance on Emergency Departments (EDs) as a usual source of care can lead to unnecessarily high costs undesirable consequences, such gap in coordination inadequate provision preventive care.To identify factors associated with multiple ED visits by patients, particular, the impact primary physicians (PCPs) their patients' visit rates.Geisinger Health Plan claims data among adult patients who averaged more than 1 within 12-month period between 2013 2014 were obtained...
Adolescents and young adults with special care health needs in the United States–many of whom have Medicaid coverage–at transition phase between pediatric adult often experience critical gaps. To address this challenge, a new model–referred to as Comprehensive Care Clinic (CCC)–has been developed implemented by Geisinger Health System since 2012. CCC comprises team, consisting generalist physician, advanced practitioner, pharmacist, nurse case manager, that develops closely follows...
Telemonitoring provides a potentially useful tool for disease and case management of those patients who are likely to benefit from frequent regular monitoring by health care providers. Since 2008, Geisinger Health Plan (GHP) has implemented telemonitoring program that specifically targets members with heart failure. This study assesses the impact this examining claims data GHP Medicare Advantage plan were enrolled in program, measuring its terms all-cause hospital admission rates,...
Objectives: Case volume-outcome associations bolster arguments to regionalize severe sepsis care, an approach that may necessitate interhospital patient transfers. Although transferred patients most closely reflect care processes involved with regionalization, between case volume and outcomes among are unclear. We investigated from another hospital. Design: Serial cross-sectional study using the Nationwide Inpatient Sample. Setting: United States nonfederal hospitals, years 2003–2011....
Engaging consumers to be more active participants in their health and care is an appealing strategy for reforming the U.S. system, but little known about how mount sustain communitywide consumer engagement initiatives. The Robert Wood Johnson Foundation launched a program 2006 fourteen communities align forces around improving quality efficiency by promoting public reporting expanding involvement of all facets care. These multistakeholder organizations provide early glimpse into...
To examine the relationship between loneliness and self-reported delay or avoidance of medical care among community-dwelling older adults during coronavirus disease 2019 (COVID-19) pandemic.Analyses data from a nationally representative survey administered in June 2020, COVID-19 module Health Retirement Study. Bivariate multivariable analyses determined associations with likelihood of, reasons for, types avoidance.The rate since March 2020 was 29.1% all respondents (n = 1997), 10.1% higher...
Background: Case managers are employed in medical homes to coordinate care for clinically complex patients. Objective: To measure the association of patient perceptions case manager performance with overall satisfaction and subsequent health utilization. Design: Retrospective cohort study. Setting: Integrated system Pennsylvania. Patients: Members system–owned plan who 1) received primary system's clinics, 2) were exposed clinic-embedded managers, 3) completed a survey care. Measurements:...