We investigated whether federally tax-exempt hospitals consider community health needs when deciding how much and what types of benefits to provide.Using 2009 data from hospital tax filings the Internal Revenue Service 2010 County Health Rankings, we employed both univariate multivariate analyses examine relationship between levels hospitals' benefit expenditures. The study sample included 1522 private, throughout United States.We found some patterns expenditures on benefits. Hospitals...

Given persistent barriers to effective electronic health record (EHR) system implementation and use, the authors investigated training practices in six organizations reputed have ambulatory care EHR "best practices." Using lenses of social cognitive adult learning theories, they explored themes related using qualitative data collected through 43 key informant interviews 6 physician focus groups conducted between February 2009 December 2010. The found consistent evidence that across known for...

Background: A capable workforce is central to the delivery of high-quality care. Research from other industries suggests that methodical use evidence-based management practices (also known as high-performance work [HPWPs]), such systematic personnel selection and incentive compensation, serves attract retain well-qualified health care staff HPWPs may represent an important underutilized strategy for improving quality patient safety. Purpose: The aims this study were improve our understanding...

Background: As hospitals focus on increasing health care value, process improvement strategies have proliferated, seemingly faster than the evidence base supporting them. Yet, most are associated with work practices for which solid does exist. Evaluating in context of evidence-based can provide guidance about would best a given organization. Methods: We combined literature review analysis key informant interview data collected from 5 case studies high-performance (HPWPs) organizations....

The objective of this study is to determine whether key hospital-level financial and market characteristics are associated with rural hospitals merge. Hospital merger status was derived from proprietary Irving Levin Associates data for 2005 through 2016 HCRIS, CMS Impact File Inpatient Prospective Payment System, MSA file, AHRF, U.S. Census 2004 2016. A discrete-time hazard analysis using generalized estimating equations used factors were merging between Factors included measures...

Empowering beneficiaries to choose a health plan that meets their needs during the transition Medicaid managed care is critical promote informed decision-making. This study uses North Carolina’s under 1115 waiver examine role of state, plans, and providers in informing about transition. We reviewed policy documents interviewed 43 individuals representing provider practices 10 State Department Health Human Services plans between December 2020 September 2021. Interviewees from state described...

To examine differences in Emergency Department (ED) utilization between Medicaid enrollees and the uninsured.We use nationally representative data for adults age 19-64 from 2004 Medical Expenditure Panel Survey. We calculate descriptive statistics highlighting distributions of measurable characteristics logit regressions describing coefficients 2 groups. Blinder-Oaxaca nonlinear decomposition methods are applied to quantify effect that groups have on ED utilization, as well magnitude...

Despite a good general understanding of the need to ensure provider adoption and use electronic health record (EHR) systems, many implementations fall short expectations, little is known about effective approaches in ambulatory care area. We aimed comprehensively study synthesize best practices for EHR system implementation healthcare organizations, emphasizing strategies that maximize physician use. Following an extensive literature review, we held 47 key informant interviews with...

Widespread implementation and use of electronic health record (EHR) systems has been recognized by healthcare leaders as a cornerstone strategy for systematically reducing medical errors improving clinical quality. However, EHR adoption requires significant capital investment providers, cost is often cited barrier. Despite the requirements, true business case system not made. This concern, lack can influence decision making about investments. The purpose this study was to examine role...

Cardiometabolic conditions increase in midlife, but early customized prevention strategies are not established for such women. To characterize and identify factors longitudinally related to constellations of cardiometabolic risk components multiracial/ethnic women midlife. We conducted a prospective, longitudinal, multiethnic cohort study 3003 midlife undergoing menopausal transition (MT). Metabolic syndrome (MetS) was defined as having at least three five components: high fasting...

Background: For many years, hospitals have relied on nonpatient care activities to complement patient revenues and strengthen financial performance. that lose money care, may mean the difference between net income loss. Little is known currently, however, about whether allow with negative margins offset their losses. Purpose: The aims of this study are (a) examine rely from losses (b) identify characteristics able such Data Methods: for came state California. sample consisted not-for-profit...

Growing evidence suggests the systematic use of high-performance work practices (HPWPs), or evidence-based management practices, holds promise to improve organizational performance, including improved quality and efficiency, in health care organizations. However, little is understood about investment required for HPWP implementation, nor business case investment.The aim this study enhance our understanding organizations' perspectives investment, reasons approaches evaluating that...

Not-for-profit (NFP) hospitals have come under increased public scrutiny for management practices that are inconsistent with their charitable focus. Of particular concern is the amount of community benefit provided by NFP compared to for-profit (FP) given substantial tax benefits afforded hospitals. This study examines hospital ownership and provision beyond traditional uncompensated care comparison using broader measures capture services, assessment partnership, community-oriented health...

Studies across industries suggest that the systematic use of high-performance work practices (HPWPs) may be an effective but underused strategy to improve quality care in healthcare organizations. Optimal HPWPs depends on how they are implemented, yet we know little about their implementation healthcare. We conducted 67 key informant interviews five organizations, each considered have exemplary place and deliver high-quality care, as part extensive study HPWP analyzed interview transcripts...

Gender pay equity is a desirable social value and an important strategy to fill every organizational stratum with gender-diverse talent fulfill organization’s goals mission. This study used national, large-sample data examine gender difference in CEO compensation among not-for-profit hospitals. Results showed the average unadjusted annual for female CEOs 2009 was $425,085 compared $581,121 male CEOs. With few exceptions, existed across all types of After controlling hospital- area-level...

Population health management (PHM) activities within care organizations have traditionally focused on coordinating services for populations who present in physicians' offices. With the recent proliferation of Accountable Care Organizations (ACOs), however, reach PHM has expanded. We aimed to study ACOs' evolving definitions their patient populations, and how these might be linked different types pursued by ACOs.Over a 2-year period, we conducted in-depth case studies 4 ACOs operating private...

Despite evidence of the importance cervical cancer screening, screening rates in United States remain below national prevention goals. Women Appalachia Ohio region have higher incidence and mortality along with lower rates. This study explored expectations Appalachian women regard to Papanicolaou (Pap) test cost perceptions as a barrier screening.Face-to-face interviews were conducted 571 who part multilevel, observational community-based research program Ohio. Eligible identified through 14...

Accountable care organizations (ACOs) are emerging across the healthcare marketplace and now include Medicare, Medicaid, private sector payers covering more than 24 million lives. However, little is known about process of organizational change required to achieve cost savings quality improvements from ACO model. This study applies complex innovation implementation framework understand challenges facilitators associated with process. We conducted four case studies ACOs, selected variation in...

The delivery of health care is a capital-intensive industry, and thus, hospital investment strategy continues to be an important area interest for both policy research. Much attention has been given hospitals’ capital policies with relatively little investments in financial assets, which serve role not-for-profit (NFP) hospitals. This study describes analyzes trends aggregate asset structure between NFP investor-owned (IO) hospitals during the post-capital-based prospective payment system...