Is the Kaiser Permanente model superior in terms of clinical integration?: a comparative study of Kaiser Permanente, Northern California and the Danish healthcare systemMartin Strandberg-Larsen
Section for Health Services Research, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Øster Farimagsgade 5, Building 10, Stairway B 1014 Copenhagen K, Denmark
BMC Health Serv Res 10:91. 2010
..Further, we examined the associations between specific organizational factors and clinical integration within each system...
- Fixing flaws in Medicare drug coverage that prompt insurers to avoid low-income patients
John Hsu
Clinical Economics and Policy Analysis program, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA
Health Aff (Millwood) 29:2335-43. 2010
..We demonstrate that improving the accuracy of Medicare's risk and subsidy adjustments could mitigate these perverse incentives...
- Distributing $800 billion: an early assessment of Medicare Part D risk adjustment
John Hsu
Center for Health Policy Studies and Division of Research, Kaiser Permanente Medical Care Program, Oakland, California, USA
Health Aff (Millwood) 28:215-25. 2009
..Combining RxHCCs with individual-level information on prior-year drug use greatly improves performance and decreases incentives for plans to select against bad risks...
Early experiences with e-health services (1999-2002): promise, reality, and implicationsVicki Fung
Kaiser Permanente Medical Care Program, Division of Research, Oakland, California 94612, USA
Med Care 44:491-6. 2006
..Subjects with greater clinical need and better ties to the health system were more likely to use both types of e-health services...
Medicare beneficiaries' knowledge of Part D prescription drug program benefits and responses to drug costsJohn Hsu
Center for Health Policy Studies and the Division of Research, Kaiser Permanente Medical Care Program, 2000 Broadway, Third Floor, Oakland, California 94612, USA
JAMA 299:1929-36. 2008
..Medicare Part D drug benefits include substantial cost sharing...
- Unintended consequences of caps on Medicare drug benefits
John Hsu
Division of Research, Kaiser Permanente, Oakland, Calif 94612, USA
N Engl J Med 354:2349-59. 2006
..Little information exists about the consequences of limits on prescription-drug benefits for Medicare beneficiaries...
- Care-seeking behavior in response to emergency department copayments
Mary Reed
Division of Research, Kaiser Permanente Medical Care Program, Oakland, California 94612, USA
Med Care 43:810-6. 2005
..CONCLUSIONS: When faced with an ED copayment, patients in the health system most commonly shifted toward seeking care from other available alternatives, and rarely avoid medical care altogether...
- Outpatient electronic health records and the clinical care and outcomes of patients with diabetes mellitus
Mary Reed
Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
Ann Intern Med 157:482-9. 2012
..Physicians can receive federal payments for meaningful use of complete certified electronic health records (EHRs). Evidence is limited on how EHR use affects clinical care and outcomes...
- Office visit copayments: patient knowledge, response, and communication with providers
Nancy J Benedetti
Center for Health Policy Studies and the Division of Research, Kaiser Permanente Medical Care Program, Oakland, California 94612, USA
Med Care 46:403-9. 2008
..There is limited information on patients' knowledge about their cost-sharing requirements and how that influenced their care-seeking behavior...
- Patient-provider communication regarding drug costs in Medicare Part D beneficiaries with diabetes: a TRIAD Study
Julie A Schmittdiel
Division of Research, Kaiser Permanente, Oakland, CA, USA
BMC Health Serv Res 10:164. 2010
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- Hypertension treatment in a medicare population: adherence and systolic blood pressure control
Vicki Fung
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94610, USA
Clin Ther 29:972-84. 2007
..Despite substantial trial evidence that demonstrates the effectiveness of pharmacologic treatment for reducing blood pressure (BP) and cardiovascular events, many patients are nonadherent to their hypertension treatment...
- Cost-sharing for emergency care and unfavorable clinical events: findings from the safety and financial ramifications of ED copayments study
John Hsu
Kaiser Permanente-Division of Research, 2000 Broadway, 3rd Floor, Oakland, CA 94612, USA
Health Serv Res 41:1801-20. 2006
..CONCLUSIONS: Relatively modest levels of patient cost-sharing for ED care decreased ED visit rates without increasing the rate of unfavorable clinical events...
- Meaningful variation in performance: a systematic literature review
Vicki Fung
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA, USA
Med Care 48:140-8. 2010
..Recommendations for directing quality improvement initiatives at particular levels (eg, patients, physicians, provider groups) have been made on the basis of empirical components of variance analyses of performance...
- Perspectives from deductible plan enrollees: plan knowledge and anticipated care-seeking changes
Mary Reed
Division of Research, Center for Health Policy Studies, Oakland, California 94612, USA
BMC Health Serv Res 9:244. 2009
..We examined knowledge of deductible plan details among new enrollees, as well as anticipated care-seeking changes in response to the deductible...
- High-deductible health insurance plans: efforts to sharpen a blunt instrument
Mary Reed
Division of Research, Kaiser Permanente, Oakland, California, USA
Health Aff (Millwood) 28:1145-54. 2009
..Consumers need more information and decision support to understand their benefits and to differentiate when care is necessary, discretionary, or unnecessary...
- Meaningful variation in performance: what does variation in quality tell us about improving quality?
Joseph V Selby
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94612, USA
Med Care 48:133-9. 2010
..However, the absolute amount of variation, expressed in clinically meaningful units, is less frequently reported. Moreover, changes in variance components have not been studied as quality improves...
- Coping with prescription drug cost sharing: knowledge, adherence, and financial burden
Mary Reed
Division of Research, Kaiser Permanente Medical Care Program, 2000 Broadway, Oakland, CA 94612, USA
Health Serv Res 43:785-97. 2008
..Assess patient knowledge of and response to drug cost sharing...
- Timely detection of localized excess influenza activity in Northern California across patient care, prescription, and laboratory data
Sharon K Greene
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
Stat Med 30:549-59. 2011
..Although limited to one health plan, location, and year, these results can inform the choice of data streams for public health surveillance of influenza...
- Consumer-directed health plans with health savings accounts: whose skin is in the game and how do costs affect care seeking?
Mary Reed
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94610, USA
Med Care 50:585-90. 2012
..Employers are increasingly offering high-deductible health insurance plans with associated health savings accounts (HSAs), but there is limited information on account contributions or effects on patient care seeking...
- Comparative effectiveness of different beta-adrenergic antagonists on mortality among adults with heart failure in clinical practice
Alan S Go
Division of Research, Kaiser Permanente of Northern California, Oakland, CA 94612 2304, USA
Arch Intern Med 168:2415-21. 2008
..Randomized trials have demonstrated the efficacy of selected beta-blockers in systolic heart failure, but the comparative effectiveness of different beta-blockers in practice is poorly understood...
- Falling into the coverage gap: Part D drug costs and adherence for Medicare Advantage prescription drug plan beneficiaries with diabetes
Vicki Fung
Division of Research, Kaiser Permanente Medical Care Program, 2000 Broadway, 3rd Floor, Oakland, CA 94612, USA
Health Serv Res 45:355-75. 2010
..To compare drug costs and adherence among Medicare beneficiaries with the standard Part D coverage gap versus supplemental gap coverage in 2006...
- Health information technology and physician-patient interactions: impact of computers on communication during outpatient primary care visits
John Hsu
Kaiser Permanente Medical Care Program, Division of Research, Oakland, CA, USA
J Am Med Inform Assoc 12:474-80. 2005
..The aim of this study was to evaluate the impact of introducing health information technology (HIT) on physician-patient interactions during outpatient visits...
- Care coordination and electronic health records: connecting clinicians
Ilana Graetz
Center for Health Policy Studies, Division of Research, Kaiser Permanente Medical Care Program, Oakland, California, USA
AMIA Annu Symp Proc 2009:208-12. 2009
..To examine the association between use of electronic health records (EHR) and care coordination...
- Use of e-Health services between 1999 and 2002: a growing digital divide
John Hsu
Kaiser Permanente Medical Care Program, Oakland, CA 94612, USA
J Am Med Inform Assoc 12:164-71. 2005
..To evaluate the patterns of e-Health use over a four-year period and the characteristics of users...
- In consumer-directed health plans, a majority of patients were unaware of free or low-cost preventive care
Mary E Reed
Kaiser Permanente Northern California Division of Research, Oakland, California, USA
Health Aff (Millwood) 31:2641-8. 2012
..Special efforts to educate consumers about preventive care cost-sharing exemptions may be necessary as more health plans, including Medicare, adopt this model...
- Improving treatment intensification to reduce cardiovascular disease risk: a cluster randomized trial
Joe V Selby
Patient Centered Outcomes Research Institute, Washington, DC, USA
BMC Health Serv Res 12:183. 2012
..The purpose of this study is to evaluate provision of new information to non-physician outreach teams on need for treatment intensification in patients with increased CVD risk...
- The impact of generic-only drug benefits on patients' use of inhaled corticosteroids in a Medicare population with asthma
Vicki Fung
Center for Health Policy Studies, Kaiser Permanente Division of Research, Oakland, California, USA
BMC Health Serv Res 8:151. 2008
..We examined changes in ICS use following the introduction of generic-only coverage in a Medicare Advantage population from 2003-2004...
- Evaluating real-time syndromic surveillance signals from ambulatory care data in four states
W Katherine Yih
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 133 Brookline Ave, 6th Floor, Boston, MA 02215, USA
Public Health Rep 125:111-20. 2010
..We evaluated a real-time ambulatory care-based syndromic surveillance system in four metropolitan areas of the United States...
- Comparative effectiveness of beta-adrenergic antagonists (atenolol, metoprolol tartrate, carvedilol) on the risk of rehospitalization in adults with heart failure
Alan S Go
Division of Research, Kaiser Permanente of Northern California, Oakland, California, USA
Am J Cardiol 100:690-6. 2007
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- Matching patients and practitioners based on beliefs about care: results of a randomized controlled trial
Edward Krupat
Office of Educational Development, Harvard Medical School, Boston, MA 02115, USA
Am J Manag Care 10:814-22. 2004
..To determine whether an intervention designed to inform and guide patients in choosing a primary care provider (PCP) could increase satisfaction and trust...
- Cost-sharing: patient knowledge and effects on seeking emergency department care
John Hsu
Division of Research, Kaiser Foundation Research Institute, Oakland, CA 94612, USA
Med Care 42:290-6. 2004
..The use of cost-sharing to control healthcare expenditures is increasing, but there is scant information about patients' knowledge of cost-sharing or its influence on behavior...
- New risk-adjustment system was associated with reduced favorable selection in medicare advantage
J Michael McWilliams
Department of Health Care Policy at Harvard Medical School, Boston, Massachusetts, USA
Health Aff (Millwood) 31:2630-40. 2012
..Similar risk-adjustment methods may help reduce incentives for plans competing in health insurance exchanges and accountable care organizations to select patients with favorable clinical risks...
- Effect of increased cost-sharing on oral hypoglycemic use in five managed care organizations: how much is too much?
Douglas W Roblin
Research Department, Kaiser Permanente, Atlanta, Georgia 30305, and the Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA
Med Care 43:951-9. 2005
..For patients with a chronic disease, increased cost-sharing for medications may lead to unintended consequences, including reduced use of medications essential for control of their disease...
