Recent Events

Title: The Impact of Massachusetts Health Reform on Disparities in Processes and Use of Care
Speaker: Nancy Kressin, PhD – Boston University School of Medicine
Date: April 25, 2012
Time: 4:00 – 5:30 pm
Place: BU School of Management, 595 Commonwealth Ave, Room 302

The Boston University Health Policy Institute is pleased to announce the seventh seminar in its 2011 – 2012 Health Policy and Management Seminar Series.

Professor Nancy Kressin will present “The Impact of Massachusetts Health Reform on Disparities in Processes and Use of Care” on Wednesday, April 25, 2012, 4:00 – 5:30 pm, in SMG Room 302.

Professor Kressin will open by discussing issues in studying Massachusetts health reform and highlighting gaps in the research that has been published to date.  She will discuss her research on clinical processes of care and the potential effects of reform on those care processes, as well as her examinations of hospital readmission, hospital admission for ambulatory care sensitive conditions, and the use of referral-sensitive procedures in the pre- and post- reform eras in Massachusetts as well as in several comparison states.

Nancy Kressin, PhD, is Professor of Medicine, Boston University School of Medicine (BUSM), and Director of the Healthcare Disparities Research Program in the Department of Medicine at BUSM, and a Senior Research Career Scientist in the Health Services Research & Development Service of the VA Boston Healthcare System.  She is nationally recognized for her research on disparities in cardiovascular care processes and outcomes, and has led numerous disparities-related projects funded by the NIH/NHLBI, Department of Veterans Affairs, American Heart Association and private foundations.  Her research has examined possible underlying mechanisms for racial/ethnic disparities in health outcomes and health care by studying patient and provider perspectives on treatment decision-making (e.g., invasive cardiac procedure use, hypertension and dental care) and on patients’ adoption of recommended therapies for chronic diseases.  Dr. Kressin has implemented intervention studies designed to reduce disparities in care and health outcomes by enhancing patient-provider communication and by using electronic reminders in EMRs.  Currently, she and her physician and economist colleagues at BUSM are studying the effects of Massachusetts health reform on the use of care.  Dr. Kressin earned a bachelor’s degree in Public Health from the University of North Carolina and subsequently trained in interdisciplinary social science at Syracuse University’s Maxwell School of Citizenship and Public Affairs, with a focus on cross-cultural psychology.

 

Title: The Role of Law in the Epidemic of Harmful Side Effects from Prescription Drugs: The Risk Proliferation Syndrome
Speaker: Donald Light
Date: Monday, April 23, 2012
Time: 3:00 – 4:00pm
Place: B.U. School of Law, Barristers Hall, 765 Commonwealth Avenue, First Floor

Prescription drugs are one of the most beneficial parts of modern medicine. Yet they have become the major iatrogenic source of illness and death. This presentation will explain the Risk Proliferation Syndrome that centers around legal and regulatory practices harmful to society, science, medicine, and patients.

Donald Light has been the Lokey Visiting Professor at Stanford University and is a professor of comparative health care at the University of Medicine and Dentistry of New Jersey. A founding fellow of the Center for Bioethics at the University of Pennsylvania, he has received the William Foote Whyte distinguished career award for applied sociology and is the editor of The Risks of Prescription Drugs (Columbia 2010).

 

Title: Risk-Adjusted Payment and Performance Assessment for Primary Care
Speaker: Randall P. Ellis, Ph.D. – BU Department of Economics
Date: February 28, 2012
Time: 4:00 – 5:30 pm
Place: School of Management, 595 Commonwealth Ave, Room 210

Abstract

We describe an alternative framework for paying primary care practices through risk-adjusted bundled capitation payments and risk-adjusted performance and bonus payments.  Using MarketScan’s commercial claims and encounter data, we calibrate models of bundled payment to cover expected primary care activity levels (PCAL), explaining 67% of the variation in this outcome at the individual level and 72% of the practice‐level variation.  We also predict 9 patient outcomes for performance assessment and explain 17% to 86% of practice‐level variation. We demonstrate that the model works well for diverse payers, plan types, ages, and physician specialties.  We also discuss implementation of the model in one health plan.

Professor Ellis teaches in the Department of Economics at Boston University, and currently serves as the President of the American Society of Health Economists and an associate editor of the Journal of Health Economics.  He co-founded DxCG, Inc. (now Verisk Health, Inc.), a healthcare information and consulting firm.  He sold all interests in the company in 2004.  Dr. Ellis has led numerous research projects funded by the Centers for Medicare & Medicaid Services (CMS) and others that have developed the Diagnostic Cost Group (DCG) model.  In 2000 and 2004, CMS implemented DCG models to pay Medicare Advantage health plans. This body of work received the AcademyHealth 2008 Health Services Research Impact Award.  Dr. Ellis has written and coauthored over 100 articles, reports and papers on diverse health topics including: risk adjustment, provider response to the reimbursement system, optimal insurance, health plan competition, the economics of mental health, health demand modeling in developing countries, and the cost-effectiveness of cancer screening. His current research focuses on primary care payment and is funded by grants from the Australian Research Council and The Commonwealth Fund.

 

Title: The Constitutional Fight Over Health Care Reform
Speaker: Kevin Outterson, J.D., LL.M. – B.U. School of Law
Date: January 31, 2012
Time: 4:00 – 5:30 pm
Place: School of Management, 595 Commonwealth Ave, Room 210

The Supreme Court will soon decide whether President Obama’s health care reform law is constitutional. Professor Outterson will discuss the two constitutional arguments against health care reform, including some of the briefs filed with the Court by various interest groups. Professor Outterson filed briefs at the Supreme Court in these cases.

Professor Outterson teaches health law and corporate law at Boston University, where he co-directs the Health Law Program, currently ranked #2 in the country by US News. He serves as the Editor-in-Chief of the Journal of Law, Medicine & Ethics; faculty advisor to the American Journal of Law & Medicine; immediate past chair of the Section on Law, Medicine & Health Care of the AALS; and a member of the Board of the American Society of Law, Medicine & Ethics. Before teaching, Professor Outterson was a partner at two major US law firms.

 

Title: Efficiency in Health Care: Does Anyone REALLY Know What It Is?
Speaker: James Burgess, Ph.D. – B.U. School of Public Health
Date: Tuesday, December 20, 2011
Time: 4:00 – 5:30 pm
Place: School of Management, 595 Commonwealth Ave, Room 211

Professor Burgess will challenge common perceptions and definitions of efficiency in health care, document numerous circular or flawed definitions that are commonly employed, and present opportunities for directions for improving or developing new ways of defining efficiency in health care. Establishing more shared understanding of this important concept is crucial for making progress in better outcomes for patients with better allocations of scarce resources.

Dr. Burgess is a Professor of Health Policy & Management at Boston University School of Public Health and a Senior Investigator at the Center for Organization, Leadership & Management Research, VA Boston Healthcare System. His research specialties include: health economics; health quality and outcomes; value-based purchasing; productivity and inefficiency; cost-effectiveness analysis and decision analysis; industrial organization; mixed method modeling; and cost and quality risk adjustment.

 

Title: Complexity Science and Health Care from Three Perspectives
Speakers: Robin Ball, Jonathan Cave, and Frances Griffiths – University of Warwick (U.K.)
Date: November 17, 2011
Time: 4:00 – 5:30
Place: School of Management, 595 Commonwealth Ave, Room 416

Professor Ball will introduce complexity science from the perspective of theoretical physics and will suggest how there might be added value from using the tools of complexity science in research on health and health care. Professor Cave, an economist and game theorist, will describe a case study of illegal drug taking and how complexity science brought new understanding to the problem. Professor Griffiths, a primary care physician and sociologist, will explore the potential future of health care when social networking becomes a major source of health-related information.

Robin C. Ball, BA, MA, PhD, DSc, FInstP, is Professor of Theoretical Physics, Head of the Department of Physics, and Chair, Warwick Complexity Complex. Jonathan Cave, PhD, is Senior Tutor in Economics, Director, Mathematics and Economics Degree course, Associate Member, Warwick Complexity Complex, and Senior Research Fellow, RAND Europe. Frances Griffiths, MB, BS, FRCGP, PhD, is Professor of Medicine in Society, Head of the newly formed Social Science and Systems Research Group, Warwick Medical School, and Associate Member, Warwick Complexity Complex.

 

Title:  Composite Measures of Performance for Health Care Provider Organizations
Speaker: Professor Michael Shwartz, Richard D. Cohen Professor in Management
Date: October 18, 2011
Time:  4:00 – 5:30
Place: School of Management, 595 Commonwealth Ave, Room 210

The increasing focus on quality of care, value-based purchasing, and pay-for-performance methods of paying for care in the U.S. has led to the development of various measures for assessing the performance of hospitals, physician groups, and other provider organizations.  Individual performance indicators are valuable for identifying specific areas for improvement and tracking improvement progress.  However, when assessing overall performance, it is useful to aggregate individual measures into a composite measure of performance.  A composite performance measure provides a summary indication of the extent to which top managers have created a culture of improvement and have designed processes that ensure high performance throughout the organization. It allows senior leaders to benchmark their organization’s performance against other high-performing organizations and to monitor changes over time.

Using data on 28 performance indicators from 112 VA nursing homes, we will illustrate different methods for creating composite measures of performance.  These methods include: weighting of observed performance indicators; weighting of shrunken indicators derived from a Bayesian multivariate normal model; benefit-of-the-doubt approaches based on optimization models; and survey-based performance measures.  Also, using data on 6 hospital-based performance measures, we will highlight some of the policy and research issues raised when constructing a simple composite measure of performance.