Agenda & Presentation Slides

Sunday, June 8

Sunday, June 8 | Monday, June 9 | Tuesday, June 10

NEW! Kaiser Web casts

7:45 a.m.-8:45 a.m.
Meet-the-Experts Student Breakfast
Thurgood Marshall West (Mezzanine Level)
Karen Davis, The Commonwealth Fund; Paul Ginsburg, Center for Studying Health System Change; Merwyn Greenlick, Oregon State House of Representatives; Lisa Iezzoni, Harvard Medical School, Massachusetts General Hospital; Jeanne Lambrew, The University of Texas at Austin; Robert Mayberry, Baylor Health Care System; Elizabeth McGlynn, RAND Corporation; Catherine McLaughlin, Mathematica Policy Research, Inc./University of Michigan; Barbara McNeil, Harvard Medical School; Martin Roland, University of Manchester; Kenneth Thorpe, Emory University

All students are invited to attend this breakfast to meet informally with leading health services researchers and policy professionals.

9:00 a.m.-10:30 a.m.
Opening Breakfast Plenary
Marriott Ballroom (Lobby Level)

Welcoming Remarks
Vincent Mor, Conference Chair
Brown University

Chair Address: "The Need for a Unified Language & a Unified Time Frame"
Honoring ARM's Founders
Margarita Alegria, AcademyHealth Board Chair
Harvard University

Distinguished Investigator Award Presentation
Awardee: David Blumenthal, Massachusetts General Hospital
Presenter: Robert Blendon, Harvard School of Public Health

11:00 a.m.-12:30 p.m.

CONCURRENT SESSIONS

Q Patient Safety: Where Are We Now?
Thurgood Marshall North/East (Mezzanine Level)

Chair: Ashish Jha, Harvard School of Public Health
Panelists:

Helen Burstin, National Quality Forum
PowerPoint Presentation | PDF Handout of Slides

Maulik Joshi, Network for Regional Healthcare Improvement
PowerPoint Presentation | PDF Handout of Slides

Kaveh Shojania, University of Toronto
PowerPoint Presentation | PDF Handout of Slides

Invited Panel: Nine years after the Institute of Medicine 's landmark report To Err is Human, efforts to improve patient safety have been slow. While we have learned a great deal about the causes of patient harm, finding and implementing solutions has been a challenge. However, there is again renewed momentum to measure and improve safety. Join the panel in a discussion about the state of patient safety in the U.S. and globally, the role that measurement will play, and how states and regional organizations have taken the lead to improve safety in the United States.

Statistical Methods for Missing Data in Longitudinal Studies
Thurgood Marshall South (Mezzanine Level)

Chair: Sharon-Lise Normand, Harvard Medical School

Panelists:

Michael Daniels, University of Florida
PDF Handout of Slides

Joseph Hogan, Brown University

Methods Workshop: The session will start with a brief overview of missing data mechanisms as they apply to longitudinal data. Issues of model specification and conducting sensitivity analysis will be discussed. Three case studies will be used to illustrate the concepts in detail. Level of Difficulty: Advanced.

M Improving Medicare for the Long Haul: How Can We Improve Medicare's Performance for Its Current & Future Beneficiaries?
Thurgood Marshall West (Mezzanine Level)

Chair: Marilyn Moon, American Institutes for Research
Panelists: Melinda Beeuwkes Buntin, RAND Corporation; Michael Chernew, Harvard Medical School; Jack Hoadley, Georgetown University; Tricia Neuman, Henry J. Kaiser Foundation

Roundtable: Medicare will face many challenges in the future as it grapples with a growing beneficiary population and financial pressures. Nonetheless, Medicare remains a key piece of financial security for older Americans. The panel will look at various components of Medicare for lessons learned and prospects for the future. In particular, speakers will focus on financing, the traditional fee for service portion of the program, private plans, the drug benefit, and overall protections for beneficiaries.

AHRQ Research Update
Washington 1 (Exhibit Level)

Co-Chairs: Carolyn Clancy & Francis Chesley, both of the Agency for Healthcare Research and Quality
PowerPoint Presentation | PDF Handout of Slides

Research Update: The mission of the Agency for Healthcare Research and Quality (AHRQ) is to improve the quality, safety, efficiency, and effectiveness of health and health care for all Americans. In this session, AHRQ's director will provide an agency overview and update and describe AHRQ's initiatives designed to achieve this mission. This session will provide an update on the AHRQ budget and research priorities in health services research. The session will also include an interactive dialogue with the audience.

N Innovations in the Management of Complex Chronically Ill Patients: Lessons for Health Care Reform
Washington 2 (Exhibit Level)

Chair: Kenneth Thorpe, Emory University

Panelists: Robert Berenson, Urban Institute; John Hsu, Kaiser Permanente

Roundtable: This session will highlight emerging effective models for managing patients with one or more chronic illnesses. The roundtable participants will discuss the potential of these approaches to increase quality at the same or lower cost. Roadblocks for broader diffusion of these approaches will also be discussed.

S Using Data & Evidence to Drive State Medicaid Policy
Washington 3 (Exhibit Level)

Chair: Jeffrey Thompson, Washington State Health Care Authority
PowerPoint Presentation | PDF Handout of Slides

Panelists:

Steve Crystal, Rutgers University

William Lawrence, Agency for Healthcare Research and Quality
PowerPoint Presentation | PDF Handout of Slides

Marc Leib, Arizona Health Care Cost Containment System
PowerPoint Presentation | PDF Handout of Slides

Roundtable: Through the Medicaid Medical Directors Learning Network and other mechanisms, the clinical leaders of the nation's largest public health program are finding new ways to analyze data and use the latest research findings to make coverage decisions and drive quality improvement. This session will describe the network and highlight two projects to compare utilization patterns across states regarding atypical antipsychotic medications and durable medical equipment. Directors will respond to such question as: what is it like to be "in the trenches" making evidence-informed decisions; who helps you gather and interpret the data and evidence; and what has been your experience in interacting with researchers around coverage decisions related to new pharmaceuticals and other health care technologies?

C Health Care for Children with Special Health Care Needs
Washington 4 (Exhibit Level)

Chair: Alison Galbraith, Harvard Medical School/Harvard Pilgrim Health Care

Panelists:
Tommy Bird, University of Arkansas for Medical Sciences
"Gastroschisis & Mode of Delivery: National Trends & Evaluation of Outcomes, 1991-2005"
PowerPoint Presentation | PDF Handout of Slides

Delaney Gracy, Montefiore Medical Center
"Impact of the"Asthma Toolbox" for Improving Documentation of Pediatric Asthma Management in an Urban Community Health Center"
PowerPoint Presentation | PDF Handout of Slides

James Guevara, Children's Hospital of Philadelphia
"Effect of Parental Depression on School Attendance & Emergency Room Use"
PowerPoint Presentation | PDF Handout of Slides

Kathleen O'Connor, National Center for Health Statistics
"Health Care Use, Unmet Needs & Demographic Characteristics of Children with Special Health Care Needs Who Fled the 2005 Gulf Coast Hurricanes"
PowerPoint Presentation | PDF Handout of Slides

Jeffrey Silber, University of Pennsylvania/Children 's Hospital of Philadelphia
"Premature Infant Maturity at Discharge & Subsequent Healthcare Costs"
PowerPoint Presentation | PDF Handout of Slides

National Library of Medicine (NLM) Update: Health Services Research & Public Health Resources
Washington 5 (Exhibit Level)

Chair: Lisa Lang, National Library of Medicine
PowerPoint Presentation | PDF Handout of Slides

Panelists:

Kin Wah Fung, National Library of Medicine
PDF Handout of Slides

Deborah Zarin, National Library of Medicine
PowerPoint Presentation | PDF Handout of Slides

Research Resource: The National Library of Medicine is engaged in a broad array of activities of immediate and long term relevance to health services and public health systems researchers and policy makers. At this session, we will provide an update on activities related to our databases of ongoing research (HSRProj) and available datasets and survey tools (HSRR). We will describe the status of NLM's work in health data standards development, as well as in support of the development of personal health records (PHRs). We will also describe the current status of implementation of mandatory clinical trials reporting, including the addition of trial results ton the ClinicaTrials.gov database and implications for comparative effectiveness research and consumer education.

W Nursing: Costs, Quality & Supply
Washington 6 (Exhibit Level)

Chair: Joanne Spetz, University of California, San Francisco

Panelists:
Sung-Heui Bae, University of North Carolina, Chapel Hill
"The Impact of Nursing Unit Turnover on Patient Outcomes at Acute Care Hospitals"
PDF Handout of Slides

Carol Brewer, University at Buffalo, The State University of New York
"Understanding New Registered Nurse's Intent to Stay at Their Jobs"
PDF Handout of Slides

Chuan-Fen Liu, Department of Veterans Affairs, Seattle and University of Washington
"Nurse Staffing & Direct Inpatient Care Costs"
PDF Handout of Slides

Ciaran Phibbs, Department of Veterans Affairs, Palo Alto and Stanford University
"The Impact of Nurse Staffing & Human Capital on Patient Outcomes for VA Inpatient Care"
PowerPoint Presentation | PDF Handout of Slides

Joanne Spetz, University of California, San Francisco
"What is the Union Wage Premium for RNs?"
PowerPoint Presentation | PDF Handout of Slides

K Development of Health Care Consumerism in CTS Communities
Maryland A/B (Lobby Level)

Chair: Paul Ginsburg, Center for Studying Health System Change

Panelists:
Jon Christianson, University of Minnesota
"The Transition from Managed Care to Consumerism: A Community-Level Status Report"

Debra Draper, Center for Studying Health System Change
"Health Promotion & Wellness: Shifting the Emphasis from Illness Management to Health Management"

Paul Ginsburg, Center for Studying Health System Change
"Health Plans' Transparency of Price & Quality Information"
PowerPoint Presentation | PDF Handout of Slides

Ann Tynan, Center for Studying Health System Change
"Consumer-Directed Health Plans: Mixed Employer Signals, Complex Market Dynamics"

F Skinning the Cat: Using Patient-Level HQA Data to Explore Pay-for-Performance Composite Measures & Impacts on Hospital Rankings
Virginia A/B (Lobby Level)

Chair: Joel Weissman, Massachusetts General Hospital

Panelists:
Romana Hasnain-Wynia, Northwestern University, Feinberg School of Medicine
"Within & Between Hospital Disparities in Quality of Care for Racial & Ethnic Minorities"
PowerPoint Presentation | PDF Handout of Slides

Raymond Kang, American Hospital Association
"Does the Method of Summarizing Hospital Performance Impact Winners & Losers in Hospital Pay for Performance"
PowerPoint Presentation | PDF Handout of Slides

Christine Vogeli, Massachusetts General Hospital
"Quality of Care Provided to Individual Patients in U.S. Hospitals: Results from an Analysis of National Quality Alliance Data"
PowerPoint Presentation | PDF Handout of Slide

Joel Weissman, Massachusetts General Hospital
"Hospital Disparities & Pay for Performance"
PowerPoint Presentation | PDF Handout of Slides

W Improving the Jobs of Direct Care Workers in Long Term Care: Findings from the Better Jobs Better Care Demonstration
Delaware A (Lobby Level)

Chair: Peter Kemper, The Pennsylvania State University
PowerPoint Presentation | PDF Handout of Slides

Panelists:
Brigitt Heier, The Pennsylvania State University
"Did Better Jobs Better Care Improve Direct Care Worker Job Outcomes?"
PowerPoint Presentation | PDF Handout of Slides

Peter Kemper, The Pennsylvania State University
"Measuring Implementation in Formative Evaluations: Using Data from Multiple Perspectives"
PowerPoint Presentation | PDF Handout of Slides

Monika Setia, The Pennsylvania State University
"Did Better Jobs Better Care Reduce Direct Care Worker Turnover?"
PowerPoint Presentation | PDF Handout of Slides

Amy Stott, The Pennsylvania State University
"Did Better Jobs Better Care Change Management Practices & Readiness for Change?"
PowerPoint Presentation | PDF Handout of Slides

D Access, Insurance & Health Disparities
Delaware B (Lobby Level)

Chair: Lisa Gary, University of Alabama at Birmingham

Panelists:

Nakela Cook, Harvard University
"Implantable Cardiac Defibrillator Placement & Clinical Appropriateness by Race/Ethnicity & Gender"

Kevin Fiscella, University of Rochester
"Impact of Disparities in Cardiovascular"
PowerPoint Presentation | PDF Handout of Slides

Jessica Greene, University of Oregon
"Consumer Directed Health Plans & Disparities in Prescription Drug Use"
PowerPoint Presentation | PDF Handout of Slides

Nadereh Pourat, University of California, Los Angeles
"The Role of SCHIP & Medicaid in Disparities in Dental Care Utilization of Young Children in California"

I Innovative International Approaches in Primary Care
Maryland C (Lobby Level)

Chair: Richard Saltman, Emory University

Panelists:
George Freeman, Imperial College London
"Continuity of Care; Lessons from Major Research Programs in UK & Canada"
PowerPoint Presentation | PDF Handout of Slides

Bruce Guthrie, University of Dundee
"Quality of Cardiovascular Risk Measurement & Control in People with Type 2 Diabetes Under Comprehensive Pay for Performance in the United Kingdom"
PowerPoint Presentation | PDF Handout of Slides

Jean-Frederic Levesque, Institut national de sante publique de Quebec
"Implementing Integrated Models of Prevention & Management of Chronic Illness Care: Barriers & Facilitators in the Canadian Context"
PowerPoint Presentation | PDF Handout of Slides

Michaela Schiotz, University of Copenhagen
"Self-Management Support - A Comparison of Current Practices for Diabetics in the Danish Health Care System & in Kaiser Permanente"

Ipek Gurol Urganci, Imperial College London
"Predicting Population Risk for Resource Allocation in British Primary Care"

O Organizational Factors Affecting Hospital Quality & Safety
Virginia C (Lobby Level)

Chair: Kelly Devers, Virginia Commonwealth University

Panelists:
Kathleen Kerwin Fuda, Boston University
"Hourly Variation in the Patient to Nurse Ratio in Four Medical/Surgical Units"

Ingrid Nembhard, Yale University
"Improving Patient Mortality Rates: The Impact of Front-line Staff Collaboration on Quality of Care"
PowerPoint Presentation | PDF Handout of Slides

Amy Rosen, Department of Veterans Affairs, Bedford and Boston University
"Is There a Relationship Between Hospital Safety Culture & Safety Outcomes in VA Hospitals?"
PowerPoint Presentation | PDF Handout of Slides

Sara Singer, Harvard University
"Enhancing Organizational Resources & Managers' Engagement for Patient Safety: A Longitudinal Study"
PowerPoint Presentation | PDF Handout of Slides

Ernest Vina, Cedars Sinai Medical Center
"The Relationship Between Organizational Factors & High Performance Among Hospitals Participating in the CMS, Premier Hospital Quality Incentive Demonstration Project"
PowerPoint Presentation | PDF Handout of Slides

12:45 p.m.-2:15 p.m.

Poster Session "A" & Lunch
Exhibit Hall

Poster Abstracts

Features:

• Child Health
• Gender & Health
• Health Care Markets, Competition & Payment
• International Policy Innovations
• Long Term Care
• Public Health & Preparedness
• Quality
• State Health Initiatives
• Student Posters

2:30 p.m. - 4:00 p.m.

CONCURRENT SESSIONS

F Pay for Performance, Public Reporting & Disparities: What Do We Know?
Thurgood Marshall North/East (Mezzanine Level)

Chair: Lawrence Casalino, University of Chicago
PowerPoint Presentation | PDF Handout of Slides

Panelists:

Michael Belman, Blue Cross of California
PowerPoint Presentation | PDF Handout of Slides

Tim Doran, University of Manchester
PowerPoint Presentation | PDF Handout of Slides

Rachel Werner, Department of Veterans Affairs, Philadelphia and University of Pennsylvania
PowerPoint Presentation | PDF Handout of Slides

Roundtable: Do pay for performance and public reporting programs increase or decrease racial/ethnic/socioeconomic disparities in health care, or leave them unchanged? What do we know? How might programs be devised that would be likely to avoid unintended consequences and to reduce disparities? The panelists will discuss research in the UK; the experience of Blue Cross and the Integrated Healthcare Association in California; and several important lines of research into pay for performance and public reporting.

S Policy, Politics & Governance in State Insurance Coverage Expansions Efforts
Thurgood Marshall South (Mezzanine Level)

Chair: Walter Zelman, California State University Los Angeles

Panelists:

E. Richard Brown, University of California, Los Angeles; Sherry Glied, Columbia University; Jennifer Kolker, Drexel University; Brian Rosman, Health Care For All; Kenneth Thorpe, Emory University

This panel will consist of a presentation on a five-state study of recent state efforts to enact broad insurance coverage expansion legislation and a following discussion with individuals having unique insight into those efforts. The presentation and discussion will focus on the intersection of politics, policy and governance in coverage expansion efforts, with particular emphasis on the positions and roles of key interest groups. Discussants will also focus on the implications of recent state reform efforts for other states and for the 2008 national government agenda. The five states on which the presentation and discussion will focus are: California, New York, Illinois, Pennsylvania, and Massachusetts.

Composite Performance Measures in Health Care
Thurgood Marshall West (Mezzanine Level)

Chair: David Shahian, Massachusetts General Hospital
Panelists:

Sherrie Kaplan, University of California, Irvine
PowerPoint Presentation | PDF Handout of Slides

Sharon-Lise Normand, Harvard Medical School
PowerPoint Presentation | PDF Handout of Slides

Methods Workshop: Composite measures provide a comprehensive, multidimensional assessment of provider performance at various levels of the health care system (e.g. individual physician, physician network, clinic), and their use has been advocated by the Institute of Medicine. This session will provide an overview of composite measures and will introduce numerous advanced concepts for creating such measures including random effects models for profiling, latent variable models for simultaneously modeling multiple non-commensurate outcomes, item response theory models for modeling multiple commensurate outcomes, factor analysis, cluster analysis and reliability testing. A recently developed practical example will be illustrated-the Society of Thoracic Surgeons Composite CABG Scoring Methodology. (Intermediate)

J Obesity: Causes, Consequences & Care in the VA Integrated Health System
Washington 1 (Exhibit Level)

Chair: Seth Eisen, Department of Veterans Affairs, Office of Research and Development, Washington, DC

Panelists:

Polly Hitchcock Noel, Department of Veterans Affairs, San Antonio and University of Texas Health Science Center
PowerPoint Presentation | PDF Handout of Slides

Matthew Maciejewski, Department of Veterans Affairs, Durham and University of North Carolina, School of Pharmacy

William Yancy, Department of Veterans Affairs, Durham and Duke University

Research Update: The Veterans Health Administration is the largest integrated healthcare system in the United States, with 158 medical facilities and nearly 5.5 million active patients. Obesity among American veterans is highly prevalent and there is a need for novel approaches to identify and develop effective strategies in the provision of health care for the obese patient. This session will explore obesity related variations in health care delivery by presenting results from a retrospective cohort study of over 2 million outpatients in the VA hospital system. A study that examined survival and economic outcomes of obese veterans who had bariatric surgery in 2000-2006 and a descriptive study that followed obesity care practices over a 4-year period and the impact of that care on patient outcomes will also be presented. Discussion at the end of the session will identify care delivery implications and key research questions for the future.

Demystifying the Federal Grant Review Process
Washington 2 (Exhibit Level)

Chair: Willard Manning, University of Chicago
PowerPoint Presentation | PDF Handout of Slides

Panelists:

Martin Brown, National Cancer Institute

Francis Chesley, Agency for Healthcare Research and Quality

Diane Martin, University of Washington

Lester S. Gorelic, NCI Cancer Training Branch
PDF Handout of Slides

The goal of this session is to help new investigators understand the NIH and AHRQ review process. The session will cover: 1) different grant mechanisms; 2) do's and don'ts for the initial grant submission; and 3) issues in revising and resubmitting proposals. In addition, there will be some discussion of both AHRQ and NCI funding priorities.

P Surge Capacity & Health Care Preparedness: New Research on Surge Capacity
Washington 3 (Exhibit Level)

Chair: Kristine Gebbie, Columbia University

Panelists:

Sally Phillips, Agency for Healthcare Research and Quality
PowerPoint Presentation | PDF Handout of Slides

Stephen Pickard, Center for Disease Control and Prevention
PowerPoint Presentation | PDF Handout of Slides

Jeanne Ringel, RAND Corporation
PowerPoint Presentation | PDF Handout of Slides

Roundtable: The nation's capacity to provide appropriate care if there were an enormous surge of ill or injured patients is limited. While multiple policy documents have included some planning for such an event, the research base for determining exactly what a surge means at a local, regional or national level, and what best practices could facilitate response is limited. This roundtable will begin with a review of current research in this area and invite participants to assist in identifying the unanswered or unasked questions that should be addressed by the health policy and health services research community.

K The Evolution of Consumer-Driven Care
Washington 4 (Exhibit Level)

Chair: Melinda Beeuwkes Buntin, RAND Corporation

Panelists:
Teresa Gibson, Thomson Healthcare
"The Effects of Patient Cost-Sharing & Adherence to Antidiabetic Medications on Expenditures, Utilization & Complications"

David Lowsky, Stanford Graduate School of Business
"Health Savings Accounts: Only for the Healthy & Wealthy?"

Giridhar Mallya
"Are Physicians Ready to Practice in a Consumer-Driven Environment? A National Survey of Primary Care Physicians"
PowerPoint Presentation | PDF Handout of Slides

Ateev Mehrotra, RAND Corporation
"A Cost Comparison of Care at Retail Clinics & Other Care Settings for Three Acute Conditions"

William Westerfield, Blue Cross Blue Shield of Tennessee
"A Control Group Study of the Impact of CDHC on Utilization, Cost & Quality for Members Who Changed from TPPO Benefits in 2005 to CDHC in 2006"
PowerPoint Presentation | PDF Handout of Slides

L Improving Nursing Home Outcomes: Measurement & Policy
Washington 5 (Exhibit Level)

Chair: David Grabowski, Harvard Medical School

Panelists:
Natasha Bryant, Institute for the Future of Aging Services
"State Investments in Culture Change in Long Term Care"
PowerPoint Presentation | PDF Handout of Slides

R. Tamara Konetzka, University of Chicago
"The Impact of Public Reporting on Quality of Post-Acute Care"
PowerPoint Presentation | PDF Handout of Slides

Dana Mukamel, University of California, Irvine
"Does Risk Adjustment of the Quality Measures Included in the Nursing Home Compare Report Card Matter?"

Jeongyoung Park, University of Pennsylvania
"Nursing Home Quality & Financial Performance"
PowerPoint Presentation | PDF Handout of Slides

Jacqueline Zinn, Temple University
"Factors Influencing Nursing Home Response to Quality Measure Publication"
PowerPoint Presentation | PDF Handout of Slides

Health & Health Care Disparities: Data from the National Center for Health Statistics
Washington 6 (Exhibit Level)

Chair: Diane Makuc, National Center for Health Statistics

Panelists:

Rosemarie Hirsch, National Center for Health Statistics

Eve Powell-Griner, National Center for Health Statistics

Jane Sisk, National Center for Health Statistics
PowerPoint Presentation | PDF Handout of Slides

Research Resource: Measurement of racial/ethnic and socioeconomic disparities in health and health care is enhanced by using different types of data systems, including provider- and population-based surveys. Provider-based surveys collect information about provider organizations, clinicians, patients, and clinical management. Population-based surveys collect information about individuals' characteristics, their health conditions, and their health care access and use. This session will describe how disparities in health and health care can be measured and analyzed using publicly-available data files of several data systems including the National Health Care Surveys, the National Health Interview Survey, and the National Health and Nutrition Examination Survey (NHANES).

D Healthcare Experiences of Vulnerable Seniors
Maryland A/B (Lobby Level)

Chair: Amelia Haviland, RAND Corporation

Panelists:
Sherman Edwards, Westat
"Language & Mode of Interview Differences Among Chinese Respondents to a CAHPS Health Plan Survey"

Marc Elliott, RAND Corporation
"Differences in the Experiences of Vulnerable Medicare Beneficiaries with Managed Care & Original Med"

Amelia Haviland, RAND Corporation
"Disparities in Immunization Rates for Spanish-Speaking Hispanic Seniors"

Amy Heller, American College of Cardiology
"Patient Activation Status as a Predictor of Patient Experience Among Medicare Beneficiaries"

Dealing with Endogeneity & Selection Bias
Virginia A/B (Lobby Level)

Chair: Joseph Terza, University of Florida

Methods Workshop: We will review the problem of endogeneity (confounding) in empirical health services research and health policy analysis, and introduce a unifying modeling framework for parametric estimation of policy (causal) effects and related inference in the presence of endogeneity and selection bias. The conventional linear instrumental variables (IV) method and its nonlinear version - the generalized method of moments (GMM) - will be detailed along with the two-stage residual inclusion method (Terza et al., 2008, Journal of Health Economics). We will also introduce other control function methods for dealing with selection bias including classical methods for linear settings (e.g. Heckman's Mills ratio approach), and more recent developments in the nonlinear regression context (Terza, 2008, Econometric Reviews). All methods will be illustrated via empirical examples. Level of difficulty: This workshop is intended for applied researchers with introductory graduate training in regression modeling and estimation.

M Medicare Benefits & Beneficiary Utilization & Spending
Delaware A (Lobby Level)

Chair: Laura Dummit, George Washington University

Panelists:

Melissa Carlson, Mount Sinai School of Medicine
"Hospice Dis-Enrollment & its Impact on Quality of Care at the End of Life"
PowerPoint Presentation | PDF Handout of Slides

Vicki Fung, Kaiser Permanente
"The Medicare Part D Program: Are Beneficiaries Talking about Prescription Drug Costs with Doctors or Pharmacists?"

Jeanne Marie Madden, Harvard Medical School
"Declines in Cost-Related Medication Nonadherence & in Forgoing Basic Needs Following Medicare Part D"

Jessica Mittler, Harvard University
"Is More Better? Market Variations in Intensity of Medicare Service Use & Beneficiary Experiences with Care"

Dana Gelb Safran, Blue Cross Blue Shield of Massachusetts
"Prescription Coverage, Use & Spending Before & After Part D Implementation: A National Longitudinal Panel Study"

A Safety-Net Providers & Vulnerable Populations
Delaware B (Lobby Level)

Chair: Alice Zawacki, U.S. Census Bureau

Panelists:
Peter Cunningham, Center for Studying Health System Change
"Decreases in Physician's Willingness to Treat Charity & Medicaid Patients: The Effects of Changes in Physicians' Income & Practice Arrangements"
PowerPoint Presentation | PDF Handout of Slides

Rachel Gold, Kaiser Permanente Center for Health Research
"Insurance Continuity & Receipt of Diabetes Preventive Care in Oregon 's FQHCs"
PowerPoint Presentation | PDF Handout of Slides

Clarilee Hauser, Adelphi University
"Predictors of Emergency Department Utilization by Homeless Persons: A National Study"
PowerPoint Presentation | PDF Handout of Slides

Zeida Kon, University of North Texas Health Science Center
"Who are the Frequent Users of Emergency Rooms? A Study of the Characteristics of Frequent Users"
PowerPoint Presentation | PDF Handout of Slides

Anthony Lo Sasso, University of Illinois at Chicago
"The Effect of Federally Qualified Health Center Funding on Service Provision"
PowerPoint Presentation | PDF Handout of Slides

C Health Insurance & Health Care for Vulnerable Populations
Maryland C (Lobby Level)

Chair: Glenn Flores, UT Southwestern Medical Center and Children's Medical Center

Panelists:
Jane Brotanek, Medical College of Wisconsin
"Why are Mexican-American Toddlers at High Risk for Prolonged Bottle-Feeding & Iron Deficiency? A Qualitative Study"

Sandra Decker, National Center for Health Statistics
"Has Public Health Insurance for Older Children Reduced Disparities in Access to Care & Health Outcomes?"

Salomeh Keyhani, Department of Veterans Affairs. Bronx and Mount Sinai School of Medicine
"The Persistent Disconnect Between Practice and Guidelines in the Management of Children with Otitis Media"
PowerPoint Presentation | PDF Handout of Slides

Lawrence Kleinman, Mount Sinai School of Medicine
"Racial & Geographic Variations in the Use of Tympanostomy Tubes in Young Children in the United States"
PowerPoint Presentation | PDF Handout of Slides

Ramesh Raghavan, Washington University
"Health Insurance Discontinuities Following Emancipation from Foster Care"

Angela Snyder, Georgia Health Policy Center
"The Effectiveness of Foster Care Policy at Increasing EPSDT Visits"
PowerPoint Presentation | PDF Handout of Slides

Q Policy Interventions to Improve Quality
Virginia C (Lobby Level)

Chair: M. Kate Bundorf, Stanford University

Panelists:
Laurence Baker, Stanford University School of Medicine
"Is it Health Plans or Providers that Influence the Quality of Care?"

Amy Rosen, Department of Veterans Affairs, Bedford and Boston University
"Rates of Patient Safety Indicators (PSIs) Among VA Patients in the First Two Years Following ACGME Resident Duty Hour Reform"
PowerPoint Presentation | PDF Handout of Slides

Andrew Ryan, Brandeis University Schneider Institute for Health Policy
"The Relationship Between Performance on CMS/JCAHO Process Measures & Mortality: Evidence of Correlation, Not Causation"
PowerPoint Presentation | PDF Handout of Slides

Jeffrey Silber, University of Pennsylvania/Childrens' Hospital Of Philadelphia
"Impact of ACGME Duty Hour Rules on Prolonged Length of Stay Among Medicare Patients"
PowerPoint Presentation | PDF Handout of Slides

Rachel Werner, Department of Veterans Affairs, Philadelphia and University of Pennsylvania
"The Impact of Public Reporting on Unreported Quality of Care"

4:30 p.m. - 6:00 p.m.

CONCURRENT SESSIONS

25th Anniversary Founders Panel
Thurgood Marshall North/East (Mezzanine Level)

Chair: Robert Blendon, Harvard School of Public Health

Panelists: Stuart Altman, Brandeis University; Ronald Andersen, University of California, Los Angeles; Robert Brook, RAND Corporation; Gordon DeFriese, University of North Carolina, Chapel Hill; Clif Gaus, Health Professor, Inc.; Edward Hughes, Northwestern University; Representative Merwyn Greenlick, State of Oregon; Lawrence Lewin, Executive Consultant; Barbara McNeil, Harvard Medical School; William Pierskalla, University of California, Los Angeles

I Health Care Reform: What the U.S. Can Learn from the Experience of Other Developed Nations
Thurgood Marshall South (Mezzanine Level)

Chair: Robert Crane, Kaiser Permanente
Panelists: Karen Davis, The Commonwealth Fund; Uwe Reinhardt, Princeton University; Richard Saltman, Emory University

Roundtable: Despite spending more on health care than any other nation, the U.S. health care system performs less well on most measures and provides health care coverage to fewer of its citizens when compared to other industrialized nations. What can U.S. policymakers, health services researchers, and practitioners learn from other developed countries' experiences in health services delivery and reform? The panelists will describe how the U.S. health care system compares to other industrialized nations' health care systems and will identify promising innovations and approaches from other countries that should be considered as the U.S. contemplates health care reform.

A Evidence that Coverage for Financial Costs Makes a Difference in Access: Does Affordability Really Matter?
Thurgood Marshall West (Mezzanine Level)

Chair: Catherine McLaughlin, Mathematica Policy Research/University of Michigan

Panelists:

Margarita Alegria, Cambridge Health Alliance

Joel Cantor, Rutgers, The State University of New Jersey

Peter Cunningham, Center for Studying Health System Change
PowerPoint Presentation | PDF Handout of Slides

Jeff Kullgren, Brigham and Women's Hospital

Laura Shone, University of Rochester
PowerPoint Presentation | PDF Handout of Slides

Stephen Zuckerman, Urban Institute

Invited Papers: As improving access to care for the uninsured population gains more public, political, and media attention, proposals being offered in state legislatures, the U.S. Congress, and the presidential campaigns generally focus exclusively on removing financial barriers to health care, though health services researchers have long recognized that access is a multidimensional concept consisting of both financial and non-financial dimensions. There exists little evidence on the extent to which uninsured adults face non-financial barriers to health care in addition to their known financial challenges, or how non-financial barriers interact with financial problems in this population. In this session, presenters will report on three research projects that investigate the relative roles played by financial and non-financial barriers to access.

CMS Research Update
Washington 1 (Exhibit Level)

Chair: Thomas Reilly, Centers for Medicare & Medicaid Services
PowerPoint Presentation | PDF Handout of Slides

Panelists: Debbie Dean and Brian O'Donnell, both of the Iowa foundation for Medical Care
PowerPoint Presentation | PDF Handout of Slides

Research Update: This session will provide an overview of the Centers for Medicare & Medicaid Services (CMS) research agenda for the coming year. It will provide an overview of key research themes and planned projects. It will discuss factors shaping the agenda, including the outlook for the CMS research budget. It will have a special focus on important Medicare and Medicaid data bases that are available through the Office of Research, Development, and Information and how researchers can access these data.

Publishing Instead of Perishing: Meet the Editors
Washington 2 (Exhibit Level)

Chair:
Ann Barry Flood, Health Services Research
PowerPoint Presentation | PDF Handout of Slides

Panelists: Parmeeth Atwal, Health Affairs; Gloria Bazzoli, Virginia Commonwealth University; Arnold Epstein, Harvard University; Bradford Gray, Urban Institute; Catarina Kiefe, University of Alabama at Birmingham

Skill & Development: This skill and career development workshop is to help authors improve their success rate in publishing in top journals in the field and have a better understanding of what the different journals publish. Specifically, panelists will try to improve authors' understanding of the journals' peer review process and give useful hints about how to design and write a 'good' review manuscript or policy paper or research brief, etc. Finally, speakers will help authors differentiate among the journals, e.g., what types of subjects and presentation each journal prefers and who their audiences are.

L Inadequate Savings, Falling Housing Values & Increasing Long Term Care Costs: Implications for Financing Care for the Baby Boomers
Washington 3 (Exhibit Level)

Chair:
Christine Bishop, Brandeis University
PowerPoint Presentation | PDF Handout of Slides

Panelists:

Richard Johnson, Urban Institute
PowerPoint Presentation | PDF Handout of Slides

R. Tamara Konetzka, University of Chicago

Rudolph Penner, Urban Institute
PowerPoint Presentation | PDF Handout of Slides

Invited Papers: The well-being of older adults depends critically on the adequacy of their resources to meet uncertain health and long-term care needs as well as desired living expenses over the remaining years of life. Our three panelists will consider first, the adequacy of the baby boom generation's overall preparation for retirement; second, the financial implications of long-term care needs, which are likely to emerge late in retirement years; and third, the costs that boomers will face for long-term services and supports, which rely so heavily on paid and unpaid labor.

Updates on What States are Doing: Lessons Learned for State Health Reform
Washington 4 (Exhibit Level)

Chair: Len Nichols, New America Foundation

Panelists:

Ruth Lie, California Health and Human Services Agency

Bill Lindsey, Lockton Companies, LLC
PowerPoint Presentation | PDF Handout of Slides

Brian Rosman, Health Care For All

Senator Joseph Vitale, New Jersey State Senate
PowerPoint Presentation | PDF Handout of Slides

G Adverse Outcomes & Gender in Chronic Illnesses & Maternal Health
Washington 5 (Exhibit Level)

Chair: David Bott, Centers for Medicare and Medicaid Services

Panelists:
Nancy Berkman, RTI International
"The Effect of Guideline Changes on the Management of Women with Abnormal Pap Test Results"
PowerPoint Presentation | PDF Handout of Slides

Tommy Bird, University of Arkansas for Medical Sciences
"Outcomes Associated with Trial of Labor After Previous Cesarean Delivery: An Instrumental Variable Analysis of National Administrative Data"
PowerPoint Presentation | PDF Handout of Slides

Rada Dagher, University of Florida
"Job Strain, Work-Family Conflict & Maternal Postpartum Depression: A Longitudinal Analysis"

Andrea Kronman, Boston University Medical Center
"Are There Gender Differences in Risk Adjustment Prediction for Costs & Mortality?"
PowerPoint Presentation | PDF Handout of Slides

Janice Scobie, Mount Sinai School of Medicine
"Gender Disparities in the Control & Treatment of Hypertension & Cardiovascular Disease"
PowerPoint Presentation | PDF Handout of Slides

M Medicare Part D Enrollment & Payment
Washington 6 (Exhibit Level)

Chair:
Stuart Guterman, The Commonwealth Fund
PowerPoint Presentation | PDF Handout of Slides

Panelists:
Christine Bishop, Brandeis University
"Medicare Savings Due to Prescription Drug Coverage for Near-Poor Elders"
PowerPoint Presentation| PDF Handout of Slides

Austin Frakt, Department of Veterans Affairs, Boston and Boston University School of Public Health
"The Effects of Premium, Benefits & Marketing Networks on Enrollment into Medicare Stand-Alone Prescription Drug Plans"
PowerPoint Presentation | PDF Handout of Slides

John Hsu, Kaiser Permanente
"Spending $800 Billion on Outpatient Prescription Drugs: An Early Assessment of the Part D Risk Adjustment Approach for Paying Private Part D Plans"

Gerald Riley, Centers for Medicare and Medicaid Services
"Beneficiary Selection into the Medicare Part D Prescription Drug Program"

Yuting Zhang, University of Pittsburgh
"Medicare Part D: Early Evidence on Prescription Drug Treatment Patterns, Hospitalization Offsets & Medicare Spending"

E Early Results from the Cancer Care Outcomes & Research Consortium (CanCORS)
Maryland A/B (Lobby Level)

Chair: Katherine Kahn, RAND Corporation

Panelists:
John Ayanian, Harvard Medical School
"Mediators of Age-Related Differences in Use of Adjuvant Chemotherapy for Stage III Colon Cancer in the Cancer Care Outcomes Research & Surveillance (CanCORS) Consortium"

Paul Catalano, Harvard School of Public Health
"Representativeness of CanCORS Participants Relative to Surveillance, Epidemiology, & End Results (SEER) Cancer Registries"

Katherine Kahn, RAND Corporation
"Are We Being Too Cautious in the Use of Chemotherapy for Elderly Stage III Colon Cancer Patients? An Analysis from the Cancer Care Outcomes & Research Surveillance Consortium (CanCORS)"

Nancy Keating, Harvard Medical School
"Cancer Patients' Role in Treatment Decision Making: Are They Influenced by Type of Treatment or Strength of Evidence Supporting a Treatment?"

Addressing Selection Bias in Observational Studies
Virginia A/B (Lobby Level)

Chair: Matthew Maciejewski, Department of Veterans Affairs, Durham and University of North Carolina, School of Pharmacy
Panelists: David Grabowski, Harvard Medical School; Paul Hebert, Department of Veterans Affairs, Seattle; Steven Pizer, Department of Veterans Affairs, Boston and Boston University

Methods Workshop: Health services research frequently involves the evaluation of interventions in observational studies in which covariates are not balanced between treatment and control groups due to self-selection, which complicates the identification of unbiased associations or treatment effects. Research methods have been developed to improve the balance of observed covariates and address unobserved confounding. In this session, the audience will be presented with an overview of: 1) conceptual issues of how causation is attributed in observational studies where selection bias can arise, 2) propensity score methods (with examples) to address imbalance in observed covariates, and 3) selection/instrumental variables (IV) methods to address imbalance in unobserved covariates. The intended audience for this workshop is researchers familiar with quantitative methods who are interested in applying more advanced methods for addressing selection bias.

D Geographical & Contextual Factors in Health Disparities
Delaware A (Lobby Level)

Chair: Craig Thornton, Mathematica Policy Research, Inc.

Panelists:
Yuhua Bao, Weill Cornell Medical College
"Regionalization of Complex Cardiovascular Procedures & Disparities in Access to High-Volume Surgeons: Evidence from Florida"
PowerPoint Presentation | PDF Handout of Slides

Kristina Cordasco, Department of Veterans Affairs, Los Angeles and Robert Wood Johnson Clinical Scholars Program
"Linguistic Disparities in Healthcare Utilization & Residential Proximity to a Safety-Net Clinic"
PowerPoint Presentation | PDF Handout of Slides

Paul Hebert, VA Puget Sound Health Care System
"The Contribution of the Geographic Distribution of High Quality Hospitals to Racial Disparities in Neonatal Mortality in New York City"

Lee Mobley, RTI International
"Heterogeneity in Mammography Use Across the Nation: Separating Evidence of Disparities from the Disproportionate Effects of Geography"
PowerPoint Presentation | PDF Handout of Slides

Edmondo Robinson, University of Pennsylvania
"Effect of Area-Level Factors on Pay-for-Performance Hospital Measures"
PowerPoint Presentation | PDF Handout of Slides

V Mental Health for Active Duty Military & Veterans
Delaware B (Lobby Level)

Co-Chairs: Lisa Rubenstein, Department of Veterans Affairs, Los Angeles and University of California, Los Angeles & Manan Trivedi, U.S. Navy, BUMED

Panelists:

Eugenie Coakley, JSI Research and Training Institute, Inc.
"The Department of Defense Mental Health Referral Process for Returning Soldiers from Iraq & Afghanistan"
PowerPoint Presentation | PDF Handout of Slides

Magaly Freytes, Department of Veterans Affairs, Gainesville and University of Florida
"Post-deployment Readjustment Needs of Puerto Rican OEF/OIF Veterans & Families"
PowerPoint Presentation | PDF Handout of Slides

Alex Sox-Harris, Department of Veterans Affairs, Palo Alto and Stanford University
"Developing a New Quality Measure of Outpatient Addiction Treatment for the VA"
PowerPoint Presentation | PDF Handout of Slides

Tracy Stecker, Dartmouth Medical School
"Predicting Treatment Seeking in OIF National Guard Soldiers"
PowerPoint Presentation | PDF Handout of Slides

Marcia Valenstein, Department of Veterans Affairs, Ann Arbor and University of Michigan
"Are Measures to Promote Gun Safety & Slow Access Feasible & Acceptable?"
PowerPoint Presentation | PDF Handout of Slides

P Public Health Services & Policy Research
Maryland C (Lobby Level)

Chair: L. Michele Issel, University of Illinois at Chicago

Panelists:
Julia Costich, University of Kentucky
"Public Health Financial Management: Results of a National Survey"
PowerPoint Presentation | PDF Handout of Slides

Johanna Lauer, Center for Studying Health System Change
"A Community-Based Perspective on Local Public Health Workforce Challenges"
PowerPoint Presentation | PDF Handout of Slides

Glen Mays, University of Arkansas for Medical Sciences
"The Dynamics of Public Health Infrastructure: Using a Delivery System Typology to Assess Structural Change & Health Outcomes"
PowerPoint Presentation | PDF Handout of Slides

Sergey Sotnikov, Centers for Disease Control and Prevention
"Investigating the Impact of Partnerships on Revenue Generating Strategies of Local Public Health Departments"
PowerPoint Presentation | PDF Handout of Slides

Byung-Kwang Yoo, University of Rochester
"Does Influenza Vaccine Supply Affect Racial Disparities in Vaccination among Medicare Elderly?"

K Choice or Confusion? New Work on Consumer Engagement
Virginia C (Lobby Level)

Chair: Kristin Carman, American Institutes for Research

Panelists:
Yaniv Hanoch, University of Plymouth
"Does too much Choice Reduce the Quality of Older Adults Decisions? An Experiment with Prescription Drug Plans"
PowerPoint Presentation | PDF Handout of Slides

Amy Lischko
"Does Employee Understanding of Cost Sharing Matter?"
PowerPoint Presentation | PDF Handout of Slides

Hangsheng Liu, RAND Corporation
"The Effect of Managed Care Quality on Plan Choice in New York 's State Children's Health Insurance Program (SCHIP)"
PowerPoint Presentation | PDF Handout of Slides

Ateev Mehrotra, RAND Corporation
"Legislating Price Transparency: How Feasible is it for the Uninsured to Shop for Care?"
PowerPoint Presentation | PDF Handout of Slides

Mary Reed, Kaiser Permanente
"Deductible-Based Health Insurance Plans: Are Complex Deductible Exemptions Confusing Patients?"
PowerPoint Presentation | PDF Handout of Slides

6:15 p.m.-7:15 p.m.

Meeting of AcademyHealth Members
Maryland A/B (Lobby Level)
AcademyHealth Board officers will report on the state of AcademyHealth, including membership and financial reports as well as announcements of upcoming programs.

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Sunday, June 8 | Monday, June 9 | Tuesday, June 10

Complete Program Agenda