- Patient Population Loss At A Large Pioneer Accountable Care Organization And Implications For Refining The Program
John Hsu is director of the Clinical Economics and Policy Analysis Program, Mongan Institute, at Massachusetts General Hospital MGH and an associate professor in the Department of Medicine and in the Department of Health Care Policy at Harvard Medical School, both in Boston
Health Aff (Millwood) 35:422-30. 2016
- Is the Kaiser Permanente model superior in terms of clinical integration?: a comparative study of Kaiser Permanente, Northern California and the Danish healthcare system
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...
- Distributing $800 billion: an early assessment of Medicare Part D risk adjustment
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...
- Fixing flaws in Medicare drug coverage that prompt insurers to avoid low-income patients
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...
- Early experiences with e-health services (1999-2002): promise, reality, and implications
Kaiser Permanente Medical Care Program, Division of Research, Oakland, California 94612, USA
Med Care 44:491-6. 2006
..E-health services may improve the quality and efficiency of care; however, there is little quantitative data on e-health use...
- Unintended consequences of caps on Medicare drug benefits
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...
- Medicare beneficiaries' knowledge of Part D prescription drug program benefits and responses to drug costs
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...
- Implementation of an outpatient electronic health record and emergency department visits, hospitalizations, and office visits among patients with diabetes
Division of Research, Kaiser Permanente Northern California, Oakland, California 94610, USA
JAMA 310:1060-5. 2013
..Although the use of EHRs has potential to improve patient health outcomes, the existing evidence has been limited and inconsistent...
- Care-seeking behavior in response to emergency department copayments
Division of Research, Kaiser Permanente Medical Care Program, Oakland, California 94612, USA
Med Care 43:810-6. 2005
..Patients are increasingly paying for more of their medical care through cost-sharing, yet little is known about how patients change the ways that they seek care in response...
- 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...
- Outpatient electronic health records and the clinical care and outcomes of patients with diabetes mellitus
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
- Responses to Medicare drug costs among near-poor versus subsidized beneficiaries
Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford St, 9th Floor, Suite 901, Boston, MA, 02114
Health Serv Res 48:1653-68. 2013
..We compared responses to drug costs for LIS recipients with near-poor (≤200 percent of the Federal Poverty Level) and higher income beneficiaries without the LIS...
- Hypertension treatment in a medicare population: adherence and systolic blood pressure control
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
Kaiser Permanente Division of Research, 2000 Broadway, 3rd Floor, Oakland, CA 94612, USA
Health Serv Res 41:1801-20. 2006
..To evaluate the effect of emergency department (ED) copayment levels on ED use and unfavorable clinical events. Data Source/Study Setting. Kaiser Permanente-Northern California (KPNC), a prepaid integrated delivery system...
- High-deductible health insurance plans: efforts to sharpen a blunt instrument
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...
- Perspectives from deductible plan enrollees: plan knowledge and anticipated care-seeking changes
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...
- 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...
- Meaningful variation in performance: a systematic literature review
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...
- Coping with prescription drug cost sharing: knowledge, adherence, and financial burden
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...
- 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...
- Consumer-directed health plans with health savings accounts: whose skin is in the game and how do costs affect care seeking?
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
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
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...
- Implementing a hybrid approach to select patients for care management: variations across practices
Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford St, 9th Fl, Boston, MA 02114 E mail
Am J Manag Care 22:358-65. 2016
..We sought to describe the patient and practice characteristics associated with high-risk patient identification and selection for a CMP during clinical review, and to explore variation across primary care practices...
- Nearly One-Third Of Enrollees In California's Individual Market Missed Opportunities To Receive Financial Assistance
Vicki Fung is a senior scientist at the Mongan Institute Health Policy Center, Massachusetts General Hospital, and an assistant professor in the Department of Medicine at Harvard Medical School, both in Boston, Massachusetts
Health Aff (Millwood) 36:21-31. 2017
..Regardless of how the structure of the individual market evolves in the coming years, efforts are likely needed to steer lower-income enrollees away from financially suboptimal plan choices...
- Care coordination and electronic health records: connecting clinicians
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...
- Screening Mammography for Free: Impact of Eliminating Cost Sharing on Cancer Screening Rates
Anupam B Jena
Department of Health Care Policy, Harvard Medical School, Boston, MA
Health Serv Res 52:191-206. 2017
..To study the impact of eliminating cost sharing for screening mammography on mammography rates in a large Medicare Advantage (MA) health plan which in 2010 eliminated cost sharing in anticipation of the Affordable Care Act mandate...
- Use of e-Health services between 1999 and 2002: a growing digital divide
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...
- Impact of Copayment Changes on Children's Albuterol Inhaler Use and Costs after the Clean Air Act Chlorofluorocarbon Ban
Alison A Galbraith
Center for Healthcare Research in Pediatrics, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
Health Serv Res . 2016
..To examine changes in children's albuterol use and out-of-pocket (OOP) costs in response to increased copayments after the Food and Drug Administration banned inhalers with chlorofluorocarbon (CFC) propellants...
- The next step towards making use meaningful: electronic information exchange and care coordination across clinicians and delivery sites
Division of Research, Kaiser Permanente Northern California, Oakland, CA Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN School of Public Health, University of California at Berkeley, Berkeley Care Management Institute Kaiser Permanente, Oakland, CA Mongan Institute for Health Policy, Massachusetts General Hospital Department of Health Care Policy, Harvard Medical School, Boston, MA
Med Care 52:1037-41. 2014
..Care for patients with chronic conditions often requires coordination between multiple physicians and delivery sites. Electronic Health Record (EHR) use could improve care quality and efficiency in part by facilitating care coordination...
- Financial barriers to care among low-income children with asthma: health care reform implications
Mongan Institute for Health Policy, Massachusetts General Hospital, Boston2Department of Medicine, Harvard Medical School, Boston, Massachusetts
JAMA Pediatr 168:649-56. 2014
..The Patient Protection and Affordable Care Act (ACA) includes subsidies that reduce patient cost sharing for low-income families. Limited information on the effects of cost sharing among children is available to guide these efforts...
- 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
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...
- Systematic review of benefit designs with differential cost sharing for prescription drugs
Oluwatobi Awele Ogbechie
Mongan Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Rm 901B, Boston, MA 02114 E mail
Am J Manag Care 21:e338-48. 2015
..To evaluate the effects of health insurance benefit designs that introduced or increased the price difference between prescription drugs representing potential clinical substitutes...
- Patients' perspectives on nonadherence to statin therapy: a focus-group study
Division of Research, Oakland, CA, USA
Perm J 14:4-10. 2010
..Nonadherence to statin therapy is associated with poor cardiovascular outcomes...
- 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...
- Cost-sharing: patient knowledge and effects on seeking emergency department care
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...
- 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
- Matching patients and practitioners based on beliefs about care: results of a randomized controlled trial
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...
- Patient Characteristics and Differences in Hospital Readmission Rates
Michael L Barnett
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts2Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women s Hospital, Boston, Massachusetts
JAMA Intern Med 175:1803-12. 2015
..Medicare penalizes hospitals with higher than expected readmission rates by up to 3% of annual inpatient payments. Expected rates are adjusted only for patients' age, sex, discharge diagnosis, and recent diagnoses...
- 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...