Title: Identifying Best Practices in the Coordination of Care
Grantee Institution: Center for Studying Health System Change
Principal Investigator: Ann S. O’Malley, M.D., M.P.H.
Grant Period: October 2007–September 2008
Paragraph Summary: The researchers will examine how care is coordinated in ambulatory care settings. Specifically, they will identify and document “best practices” in physician offices that have developed care coordination processes and determine the financial implications of increased coordination. For example, the researchers will assess whether a periodic care coordination fee or itemized billing for coordination activities is more efficient. They will also examine a group of “average practices” to assess how they set priorities for coordination activities and what barriers they encounter. The objective of the proposed project is to better inform the replication of organized care coordination processes in medical practices.
Title: Paying Physician Group Practices for Quality: A Regional Natural Experiment
Grantee Institution: University of Washington School of Public Health and Community Medicine
Principal Investigator: Douglas A. Conrad, Ph.D.
Grant Period: October 2007–March 2009
Paragraph Summary: The researchers will evaluate the impact of a quality-based scorecard and financial incentives developed by Premera Blue Cross in Washington State. They will compare clinics exposed to two waves of a progressive “paying for quality” intervention with a control group of clinics not subject to the intervention. Specifically, the researchers will assess the joint effects of quality-based financial incentives and the quality scorecard on physicians’ clinical quality, patient satisfaction, and efficiency in caring for patients. They will distinguish the effects on quality, patient satisfaction, and efficiency of providing information to medical groups relative to their performance on an array of clinical quality measures from the incremental effect on quality and efficiency of clinical quality-based financial incentives. The objective of the project is to assist organizational leaders and public policymakers to craft more cost-effective quality incentives.
Title: Effects of Prior Authorization of New Medications among Medicaid Beneficiaries with Bipolar Disorder
Grantee Institution: Harvard Pilgrim Health Care Inc.
Principal Investigator: Stephen B. Soumerai, Sc.D.
Grant Period: October 2007–March 2009
Paragraph Summary: The researchers will evaluate the effects of prior authorization of new medications among Medicaid beneficiaries with bipolar disorder in the state of Maine. As part of their study, they will: (1) describe baseline demographic and clinical characteristic and patterns of treatment; (2) examine the impact of prior authorization on utilization and expenditures of preferred versus non-preferred atypical antipsychotic (AA) agents and anticonvulsant (AC) agents among patients continuously enrolled for the entire study period in Maine and New Hampshire (comparison state); and (3) examine the impact of prior authorization on rates of hospital admission and rates of cessation of all medical treatment, two potential adverse outcomes. The objective of the project is to examine the effect of prior authorization, an increasingly popular drug utilization management policy for patients with chronic mental illness, on medication use and associated outcomes.
