Grant Partners

Project Directors: James Maxwell, PhD, Director of Research and Policy (Principal Investigator) and Pat Fairchild, MA, Vice President of JSI US Division“An Assessment of CHCs’ Implementation of Alternative Payment and Delivery System Reforms” will assess the current status and readiness of Community Health Centers (CHCs) to implement payment and delivery system reforms as well as to identify the primary barriers and facilitators to implementing these reforms. Relying on qualitative data collected through key informant interviews among staff at 18-20 CHCs and quantitative data available through the Uniform Data Set (UDS) from the Health Resources and Service Administration (HRSA), the research team plans to: identify the financial incentives and structural requirements being placed on CHCs based on the key components of their contracts for Medicaid’s Primary Care Payment Reform Initiative (PCPRI) and with Medicaid Managed Care Organization (MCO) plans; document the current status of CHCs in implementing components of payment and delivery system reforms; highlight and elucidate the primary barriers and facilitators to implementing reforms; and analyze the extent to which risk-based contracting and alternative payment reforms are associated with changes in CHCs’ costs and revenues. 

Project Directors: Robin Clark, PhD, Director of Research and Evaluation (Principal Investigator) and Deborah Gurewich, PhD, Associate Director of Research and Evaluation“Identification of Effective Community-Based Models for Coordinating Care for Persons with Substance Use Disorders” will analyze community-based approaches for coordinating care for patients with substance use disorders (SUD) and identify those models that appear most effective in accomplishing care coordination. Through their work, which will be based on assessing different care coordination models employed at three sites serving the Worcester area, the team will provide insight into the relative efficacy of different community-based approaches for engaging and coordinating services for patients with SUDs. Efficacy will measured based on a comparison of selected cost and quality metrics as well as self-reported patient experience.   

Inpatient admissions that originate in the emergency department (ED) result in a significant portion of total health care spending each year, yet there is both wide variation in admission patterns and little understanding of best practices for post-ED care management and potential cost savings. In their project “Identifying Best Practices to Reduce Hospital Admission from the Emergency Department,” the research team will complete an in-depth study of three common conditions leading to admissions from the ED. By analyzing top-performing hospitals, the researchers will develop strategies and best practices around improving care and reducing costs.

In their project titled “Best Opportunities for Improving Massachusetts Health within Budget Constraints,” the research team will use published cost effectiveness research and Massachusetts-specific data on current health care use to identify opportunities to reduce the use of overused low-value care and increase the use of underused high-value care.  Their simulation model will allow health care leaders to estimate total cost savings and health gains that could be achieved by reallocating resources from inefficient to efficient interventions.   

The research team will use the APCD in their project titled “Understanding High-Cost Patients in Massachusetts” to provide in-depth analysis of the small percentage of patients who consume a disproportionately large share of health care spending in the state. By gaining a more detailed understanding of high-cost patients—their diagnoses, co-morbidities, demographic factors, and providers—the researchers hope to help inform the development and targeting of potential cost containment policies, practices, and payment models for Massachusetts.

In their project “Analysis of the Massachusetts All-Payer Claims Database to Describe the Epidemiology of Readmissions,” the research team will use the Massachusetts All-Payer Claims Database (APCD) to better understand patterns of hospital readmissions in Massachusetts. Most research on readmissions has been conducted using Medicare data or on data sets that describe only inpatient hospital encounters. By using the APCD, this research will shed new light on the diagnoses and patterns of care associated with readmissions in Massachusetts for all populations. This analysis could help providers develop and focus work around preventing avoidable readmissions.