A5103157503- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Pharmaceutical Economics and Policy
- Biosimilars and Bioanalytical Methods
- Chronic Disease Management Strategies
- Patient Satisfaction in Healthcare
- Healthcare cost, quality, practices
- Interprofessional Education and Collaboration
- Geriatric Care and Nursing Homes
- COVID-19 and healthcare impacts
- Diversity and Career in Medicine
- Acute Ischemic Stroke Management
- Global Cancer Incidence and Screening
- Telemedicine and Telehealth Implementation
- Stroke Rehabilitation and Recovery
- Venous Thromboembolism Diagnosis and Management
- Healthcare innovation and challenges
- Pharmaceutical industry and healthcare
- Global Health Care Issues
- Trauma and Emergency Care Studies
- Colorectal Cancer Screening and Detection
- Clinical practice guidelines implementation
Cornell University
2019-2025
Weill Cornell Medicine
2019-2025
Population Health Research Institute
2021
University of Pennsylvania
2019-2020
Mathematica Policy Research
2014
Center for Studying Health System Change
2012
Abstract Objective To measure the extent to which provision of mammograms was impacted by COVID‐19 pandemic and surrounding guidelines. Data Sources De‐identified summary data derived from medical claims eligibility files were provided Independence Blue Cross for women receiving mammograms. Study Design We used a difference‐in‐differences approach characterize change in performed over time queueing formula estimate clear queue missed Collection first 30 weeks each year 2018 2020. Principal...
To determine the degree of telemedicine expansion overall and across patient subpopulations diagnoses. We hypothesized that visits would increase substantially due to need for continuity care despite disruptive effects COVID-19.A retrospective study health insurance claims from January 1, 2018, through March 10, 2020 (prepandemic period), 11, 2020, October 31, (pandemic period).We analyzed 1,589,777 were submitted Independence Blue Cross (Independence) telemedicine-only providers who...
Private equity firms have increasingly acquired physician practices, and particularly dermatology practices. Analyzing commercial claims from the Health Care Cost Institute (2012–17), we used a difference-in-differences design within an event study framework to estimate prevalence of private acquisitions their impact on dermatologist prices, spending, utilization, volume patients. By 2017 one in eleven dermatologists practiced equity–owned practice, practices employed four advanced...
Background: Medical groups, health systems, and professional associations are concerned about potential increases in physician turnover, which may affect patient access quality of care. Objective: To examine whether turnover has changed over time it is higher for certain types physicians or practice settings. Design: The authors developed a novel method using 100% traditional Medicare billing to create national estimates turnover. Standardized rates were compared by physician, practice,...
Biosimilar drugs-lower-cost alternatives to expensive biologic drugs-have the potential slow growth of US drug spending. However, rates biosimilar uptake have varied across hospital outpatient providers. We investigated whether 340B Drug Pricing Program, which offers eligible hospitals substantial discounts on purchases, inhibits uptake. Almost one-third participate in program. Using a regression discontinuity design and two high-volume biologics with competitors, filgrastim infliximab, we...
The Merit-based Incentive Payment System (MIPS) is a major Medicare value-based purchasing program, influencing payment for more than 1 million clinicians annually. There growing concern that MIPS increases administrative burden, and little known about what it costs physician practices to participate in the program.
Audio Interview with Dhruv Khullar on the trend of hospital acquisition physician practices in United States. 8m 57s Download AbstractHospital has become a dominant American medicine. The FTC and DOJ recently issued guidelines that could strengthen their approach to vertical integration health care.
Background Transport by mobile stroke units (MSUs), which provide access to computed tomography scanning and intravenous blood pressure medications thrombolytics, reduces time treatment may improve short‐term functional outcomes for patients with acute stroke. The longer‐term clinical financial impacts remain incompletely understood. aim of the study was determine whether MSU care is associated better health, utilization, spending suspected Methods Results This a retrospective, observational...
This Viewpoint discusses the differences between Medicare Advantage (MA) and traditional trade-offs service convenience that beneficiaries make when selecting MA; highlights factors switching from MA to difficult or impossible (the “trap”); suggests possible reforms.
<h3>Importance</h3> Biosimilars, or highly similar versions of complex biologic drugs, have the potential to slow drug spending growth; however, biosimilar uptake in United States has been slow. Little is known about barriers following launch. <h3>Objective</h3> To examine patient, physician, and practice characteristics associated with use Medicare population. <h3>Design, Setting, Participants</h3> This cross-sectional study used regression analysis estimate association between various...
Hawaii Medical Service Association (HMSA), the Blue Cross Shield of Hawaii, introduced Population-based Payments for Primary Care (3PC), a new capitation-based primary care payment system, in 2016. The effect this system on quality measures has not been evaluated.To evaluate whether 3PC was associated with changes quality, utilization, or spending its first year.Observational study using HMSA claims and clinical registry data from January 1, 2012, to December 31, 2016, propensity-weighted...
Policy makers are increasingly using performance feedback that compares physicians to their peers as part of payment policy reforms. However, it is not known whether peer comparisons can improve broad outcomes, beyond changing specific individual behaviors such reducing inappropriate prescribing antibiotics. We conducted a cluster-randomized controlled trial with Blue Cross Shield Hawaii examine the impact providing on quality care primary providers in setting shift from fee-for-service...
<h3>Importance</h3> Despite limited effectiveness of pay-for-performance (P4P), payers continue to expand P4P nationally. <h3>Objective</h3> To test whether increasing bonus size or adding the behavioral economic principles increased social pressure (ISP) loss aversion (LA) improves P4P. <h3>Design, Setting, and Participants</h3> Parallel studies conducted from January 1 December 31, 2016, consisted a randomized clinical trial with patients cluster-randomized by practice site an active...
Over 95% of hospitals in the United States use pooling alliances, known as Group Purchasing Organizations (GPOs), to purchase medications, devices, and supplies. While GPOs create savings for through lowered prices reduced administrative burden, critics allege that these supply chain intermediaries reduce competition, particularly if concentrate purchasing from larger, dominant manufacturers. Using a mixed-methods design, we studied whether influence hospital behavior explored contracting...
This cross-sectional study describes changes in annual Medicare Part B spending for biologic drugs after biosimilar entry, focusing on the first 4 products to experience competition: filgrastim, infliximab, epoetin alpha, and pegfilgrastim.
Abstract Background Transport by mobile stroke units (MSUs), which provide access to computed tomography scanning and intravenous blood pressure medications thrombolytics, reduces time treatment may improve short-term functional outcomes for patients with acute stroke. The longer-term clinical financial impacts remain incompletely understood. Objective Determine whether MSU care is associated better health, utilization, spending suspected Design Retrospective, observational study of Medicare...