Rachel M Werner

Summary

Affiliation: University of Pennsylvania
Country: USA

Publications

  1. ncbi request reprint The "Hassle Factor": what motivates physicians to manipulate reimbursement rules?
    Rachel M Werner
    Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
    Arch Intern Med 162:1134-9. 2002
  2. ncbi request reprint Racial profiling: the unintended consequences of coronary artery bypass graft report cards
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
    Circulation 111:1257-63. 2005
  3. ncbi request reprint Comparing the supply of pediatric subspecialists and child neurologists
    Rachel M Werner
    Division of General Internal Medicine, The University of Pennsylvania, Philadelphia, PA 19104, USA
    J Pediatr 146:20-5. 2005
  4. pmc The impact of hospital pay-for-performance on hospital and Medicare costs
    Gregory B Kruse
    The Wharton School, University of Pennsylvania, Philadelphia, PA 19104, USA
    Health Serv Res 47:2118-36. 2012
  5. ncbi request reprint Lying to insurance companies: the desire to deceive among physicians and the public
    Rachel M Werner
    University of Pennsylvania, USA
    Am J Bioeth 4:53-9. 2004
  6. doi request reprint Characteristics and outcomes of America's lowest-performing hospitals: an analysis of acute myocardial infarction hospital care in the United States
    Ioana Popescu
    Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City VA Medical Center, Iowa City, Iowa, USA
    Circ Cardiovasc Qual Outcomes 2:221-7. 2009
  7. pmc Changes in patient sorting to nursing homes under public reporting: improved patient matching or provider gaming?
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia VAMC, Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
    Health Serv Res 46:555-71. 2011
  8. pmc Does hospital performance on process measures directly measure high quality care or is it a marker of unmeasured care?
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia, USA
    Health Serv Res 43:1464-84. 2008
  9. ncbi request reprint Hospital performance measures and quality of care
    Rachel M Werner
    Leonard Davis Institute of Health Economics, VA Center for Health Equity Research and Promotion, University of Pennsylvania, Philadelphia, PA, USA
    LDI Issue Brief 13:1-4. 2008
  10. pmc The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia VAMC, PA, USA
    Health Serv Res 48:1393-414. 2013

Detail Information

Publications41

  1. ncbi request reprint The "Hassle Factor": what motivates physicians to manipulate reimbursement rules?
    Rachel M Werner
    Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
    Arch Intern Med 162:1134-9. 2002
    ..This study sought to determine the relationship between the likelihood of a successful appeal, appeals process length, and severity of the health condition and physicians' willingness to sanction deception...
  2. ncbi request reprint Racial profiling: the unintended consequences of coronary artery bypass graft report cards
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
    Circulation 111:1257-63. 2005
    ..If physicians believe that racial and ethnic minorities are at higher risk for poor outcomes, report cards could worsen existing racial and ethnic disparities in health care...
  3. ncbi request reprint Comparing the supply of pediatric subspecialists and child neurologists
    Rachel M Werner
    Division of General Internal Medicine, The University of Pennsylvania, Philadelphia, PA 19104, USA
    J Pediatr 146:20-5. 2005
    ..To examine physician workforce characteristics and workforce projections of one vulnerable pediatric subspecialty, child neurology, and compare this subspecialty with other pediatric subspecialties, general pediatrics, and adult neurology...
  4. pmc The impact of hospital pay-for-performance on hospital and Medicare costs
    Gregory B Kruse
    The Wharton School, University of Pennsylvania, Philadelphia, PA 19104, USA
    Health Serv Res 47:2118-36. 2012
    ..To evaluate the effects of Medicare's hospital pay-for-performance demonstration project on hospital revenues, costs, and margins and on Medicare costs...
  5. ncbi request reprint Lying to insurance companies: the desire to deceive among physicians and the public
    Rachel M Werner
    University of Pennsylvania, USA
    Am J Bioeth 4:53-9. 2004
    ..48 to 4.64 after controlling for differences in time perception. These findings highlight the ethical challenge facing physicians and patients in balancing patient advocacy with honesty in the setting of limited societal resources...
  6. doi request reprint Characteristics and outcomes of America's lowest-performing hospitals: an analysis of acute myocardial infarction hospital care in the United States
    Ioana Popescu
    Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City VA Medical Center, Iowa City, Iowa, USA
    Circ Cardiovasc Qual Outcomes 2:221-7. 2009
    ..Little is known about hospitals with consistently poor adherence with AMI process measures and whether these hospitals also have increased patient mortality...
  7. pmc Changes in patient sorting to nursing homes under public reporting: improved patient matching or provider gaming?
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia VAMC, Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
    Health Serv Res 46:555-71. 2011
    ..To test whether public reporting in the setting of postacute care in nursing homes results in changes in patient sorting...
  8. pmc Does hospital performance on process measures directly measure high quality care or is it a marker of unmeasured care?
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia, USA
    Health Serv Res 43:1464-84. 2008
    ..First, measured activities may directly improve care. Second, success on these measures may be a marker for other unmeasured aspects of high quality care. Our objective is to test the contribution of both possible effects...
  9. ncbi request reprint Hospital performance measures and quality of care
    Rachel M Werner
    Leonard Davis Institute of Health Economics, VA Center for Health Equity Research and Promotion, University of Pennsylvania, Philadelphia, PA, USA
    LDI Issue Brief 13:1-4. 2008
    ..This Issue Brief summarizes studies that examine and quantify the relationship between frequently used measures of hospital performance and hospital mortality...
  10. pmc The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia VAMC, PA, USA
    Health Serv Res 48:1393-414. 2013
    ..This study tests the effect of P4P on quality of care in a large-scale setting-the implementation of P4P for nursing homes by state Medicaid agencies...
  11. doi request reprint Do consumers respond to publicly reported quality information? Evidence from nursing homes
    Rachel M Werner
    Philadelphia VA Medical Center and University of Pennsylvania, 1230 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, United States
    J Health Econ 31:50-61. 2012
    ..However, the magnitude of the effect was small. We conclude that there has been minimal consumer response to information in the post-acute care market...
  12. doi request reprint Quality of care among obese patients
    Virginia W Chang
    Philadelphia VA Medical Center, Department of Medicine, University of Pennsylvania School of Medicine, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104 6021, USA
    JAMA 303:1274-81. 2010
    ..Moreover, obese patients often feel that clinicians are biased or disrespectful because of their weight. These observations raise the concern that obese patients may receive lower quality of care...
  13. pmc Performing well on nursing home report cards: does it pay off?
    Jeongyoung Park
    American Board of Internal Medicine, Philadelphia, PA 19106, USA
    Health Serv Res 46:531-54. 2011
    ..To examine whether high performance or improvement on quality measures leads to economic rewards for nursing homes in the presence of public reporting...
  14. ncbi request reprint Relationship between Medicare's hospital compare performance measures and mortality rates
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
    JAMA 296:2694-702. 2006
    ..It is unknown whether these process performance measures are related to hospital-level outcomes...
  15. pmc Open access in the patient-centered medical home: lessons from the Veterans Health Administration
    Gala True
    Center for Evaluation of Patient Aligned Care Teams CEPACT, Philadelphia Veterans Affairs Medical Center, Building 4100, University and Woodland Aves, Philadelphia, PA 19104, USA
    J Gen Intern Med 28:539-45. 2013
    ..An early focus of implementation was on creating open access, defined as continuity and capacity in primary care...
  16. doi request reprint Changes in the relationship between nursing home financial performance and quality of care under public reporting
    Jeongyoung Park
    American Board of Internal Medicine, Philadelphia, PA, USA
    Health Econ 20:783-801. 2011
    ..These findings have important policy implications as federal and state governments use market-based incentives to increase demand for high-quality care and induce providers to compete based on quality...
  17. pmc Impact of public reporting on unreported quality of care
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia VAMC, Division of General Internal Medicine, University of Pennsylvania School of Medicine, USA
    Health Serv Res 44:379-98. 2009
    ..Our objective is to examine the effect of publicly reporting quality information on unreported quality of care...
  18. ncbi request reprint Support for physician deception of insurance companies among a sample of Philadelphia residents
    G Caleb Alexander
    University of Pennsylvania, Philadelphia, USA
    Ann Intern Med 138:472-5. 2003
    ..Some physicians seem to be willing to sanction deception of insurance companies. Little is known about public attitudes regarding this practice...
  19. ncbi request reprint The pay-off on nursing home report cards
    Rachel M Werner
    VA Center for Health Equity Research and Promotion and Leonard Davis Institute of Health Economics, University of Pennsylvania, USA
    LDI Issue Brief 16:1-4. 2011
    ....
  20. pmc Quality improvement under nursing home compare: the association between changes in process and outcome measures
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia VAMC and Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
    Med Care 51:582-8. 2013
    ..Understanding what processes, if any, lead to successful improvements in resident outcomes could create a stronger case for the continued use of these outcome measures in nursing home report cards...
  21. doi request reprint The patient-centered medical home: an evaluation of a single private payer demonstration in New Jersey
    Rachel M Werner
    Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
    Med Care 51:487-93. 2013
    ..Whether the PCMH achieves these goals is not known...
  22. ncbi request reprint The future of child neurology: a profile of child neurology residents
    Daniel Polsky
    Division of General Internal Medicine, University of Pennsylvania, Blockley Hall, Rm 1208, Philadelphia, PA 19104 6021, USA
    J Child Neurol 19:6-13. 2004
    ....
  23. pmc Clinical concerns about clinical performance measurement
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
    Ann Fam Med 5:159-63. 2007
    ..In its current state, performance measurement is better suited to improving measured care than improving the care of individual patients...
  24. doi request reprint Medicare's new hospital value-based purchasing program is likely to have only a small impact on hospital payments
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, and University of Pennsylvania, Philadelphia, USA
    Health Aff (Millwood) 31:1932-40. 2012
    ..These results raise questions about whether the new pay-for-performance program will substantially alter the quality of hospital care, and they highlight the challenges of designing effective quality improvement incentives...
  25. doi request reprint Public reporting on hospital process improvements is linked to better patient outcomes
    Rachel M Werner
    Center for Health Equity Research and Promotion at the Philadelphia Veterans Affairs Medical Center, Philadelphia, USA
    Health Aff (Millwood) 29:1319-24. 2010
    ..Although we cannot conclude that public reporting caused the improvement in processes or outcomes, these results are encouraging, since improving process performance may improve quality more broadly...
  26. doi request reprint The effect of pay-for-performance in hospitals: lessons for quality improvement
    Rachel M Werner
    Center for Health Equity Research and Promotion, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    Health Aff (Millwood) 30:690-8. 2011
    ..These findings suggest that tailoring pay-for-performance programs to hospitals' specific situations could have the greatest effect on health care quality...
  27. ncbi request reprint Strategies to attract medical students to the specialty of child neurology
    Rachel M Werner
    Division of General Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    Pediatr Neurol 30:35-8. 2004
    ..These schools should implement a curriculum in neuroscience and child neurology that specifically exposes students early and maintains their interest in the field of child neurology...
  28. pmc Paying for performance in population health: lessons from health care settings
    David A Asch
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    Prev Chronic Dis 7:A98. 2010
    ..Nevertheless, with careful attention, conditions for successful pay-for-performance in population health might be met...
  29. pmc Impact of public reporting on quality of postacute care
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia VAMC, The Division of General Internal Medicine, University of Pennsylvania School of Medicine, PA, USA
    Health Serv Res 44:1169-87. 2009
    ..This study tests whether public reporting in the setting of nursing homes resulted in improvement of reported and broader but unreported quality of postacute care...
  30. doi request reprint State adoption of nursing home pay-for-performance
    Rachel M Werner
    Philadelphia VA and University of Pennsylvania, PA, USA
    Med Care Res Rev 67:364-77. 2010
    ..Although the number of states that are implementing nursing home P4P is growing, the structure of these incentives varies across states, and little evidence exists to guide the planning or implementation of these initiatives...
  31. doi request reprint Comparison of change in quality of care between safety-net and non-safety-net hospitals
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104, USA
    JAMA 299:2180-7. 2008
    ..As such, some have expressed concern that these incentives have the potential to worsen existing disparities among hospitals...
  32. doi request reprint Variation in long-term acute care hospital use after intensive care
    Jeremy M Kahn
    University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
    Med Care Res Rev 69:339-50. 2012
    ..These findings highlight the need for research into LTAC admission criteria and the incentives driving variation in LTAC utilization across hospitals...
  33. ncbi request reprint The unintended consequences of publicly reporting quality information
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center
    JAMA 293:1239-44. 2005
    ..Given these limitations, it may be necessary to reassess the role of public quality reporting in quality improvement...
  34. doi request reprint Impact of changes in clinical practice guidelines on assessment of quality of care
    Grace A Lin
    Division of General Internal Medicine, University of California, San Francisco, CA 94143 0320, USA
    Med Care 48:733-8. 2010
    ..The impact of guideline changes over time-and whether evolving clinical evidence can render measures based on prior guidelines misleading-is not known...
  35. doi request reprint Advancing nursing home quality through quality improvement itself
    Rachel M Werner
    Division ofGeneral Internal Medicine, University of PennsylvaniaSchool of Medicine, Philadelphia Veterans Affairs Medical Cente, Philadelphia, Pynnsylvania, USA
    Health Aff (Millwood) 29:81-6. 2010
    ..This could foster a culture of upstream identification and solving of problems that would supplement existing downstream requirements to meet specific safety and care standards...
  36. doi request reprint Making the 'pay' matter in pay-for-performance: implications for payment strategies
    Rachel M Werner
    Philadelphia VA, Philadelphia, PA, USA
    Health Aff (Millwood) 28:1498-508. 2009
    ..Bonuses vary considerably by payment strategy, which suggests that the strategy selected should vary depending on program goals. These findings are relevant to P4P for any type of provider...
  37. pmc The patient centered medical home: mental models and practice culture driving the transformation process
    Peter F Cronholm
    Department of Family Medicine and Community Health, The University of Pennsylvania, Philadelphia, PA 19104, USA
    J Gen Intern Med 28:1195-201. 2013
    ..The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. The PCMH model is a departure from more traditional models of healthcare delivery and requires significant transformation to be realized...
  38. ncbi request reprint Malpractice premiums and the supply of obstetricians
    Daniel Polsky
    Division of General Internal Medicine, University of Pennsylvania School of Medicine, Blockley Hall, Rm 1204, 423 Guardian Drive, Philadelphia, PA 19104, USA
    Inquiry 47:48-61. 2010
    ..3% of the supply of obstetricians...
  39. doi request reprint Process quality measures and asthma exacerbations in the medicaid population
    Pierre L Yong
    Department of Medicine, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
    J Allergy Clin Immunol 124:961-6. 2009
    ..Asthma quality assessment often focuses on controller medication use, yet claims-based studies find conflicting associations between this care process and clinical outcomes...
  40. pmc The relationship between measured performance and satisfaction with care among clinically complex patients
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
    J Gen Intern Med 23:1729-35. 2008
    ....
  41. pmc Measuring quality of care in patients with multiple clinical conditions: summary of a conference conducted by the Society of General Internal Medicine
    Rachel M Werner
    Center for Health Equity Research and Promotion, Philadelphia VAMC, Philadelphia, PA, USA
    J Gen Intern Med 22:1206-11. 2007
    ..This research should evaluate the impact of quality measurement on these patients and expand the range of quality measures relevant to the care of clinically complex patients...