Do Acquisitions of Hospice Agencies by Private Equity Firms and Publicly Traded Corporations Impact End-of-Life Quality and Cost of Care?

私募股权公司和上市公司收购临终关怀机构是否会影响临终护理质量和护理成本？

• 批准号: 10351004
• 负责人: Robert Tyler Braun
• 金额: $ 11.3万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10351004
• 关键词: Administrator; Affect; Aging; Applications Grants; Area; Atlases; Behavior; Caring; Characteristics; Client satisfaction; Clinical; Cross-Sectional Studies; Data; Databases; Education; Elderly; Event; Fee-for-Service Plans; Foundations; Funding; Geriatrics; Goals; Growth; Health Policy; Health Resources; Health Sciences; Health Services; Healthcare; Holly; Hospice Care; Incentives; Industry; Interview; Investments; Leadership; Long-Term Care; Medicare; Medicare claim; Mentored Research Scientist Development Award; Mentors; Methodology; Methods; Modeling; National Institute on Aging; Nursing Staff; Organizational Culture; Outcome; Ownership; Patients; Perception; Physician Executives; Physicians; Policies; Privatization; Process; Provider; Public Health; Qualitative Methods; Qualitative Research; Quality of Care; Quality of life; Quasi-experiment; Research; Research Design; Research Personnel; Research Training; Role; Structure; Training; United States Centers for Medicare and Medicaid Services; Universities; Work; care costs; care delivery; career; clinical care; cost; econometrics; end of life; end of life care; health care delivery; health care service organization; hospice environment; improved; instructor; intervention delivery; medical schools; mid-career faculty; novel; operation; patient population; payment; population health; pressure; professor; response; service providers; skills; success; trend

PROJECT SUMMARY/ABSTRACT This is a K01 Mentored Research Scientist Development Award submitted to the National Institute on Aging by Robert Tyler Braun, an Instructor in the Department of Population Health Sciences at Weill Cornell Medical College (WCMC). Dr. Braun's career goal is to become an independent researcher on improving end-of-life care for the elderly by assessing various policy interventions and delivery models of hospice care. This K01 application will provide Dr. Braun with the necessary training 1) to gain expertise in aging and hospice research; 2) to understand clinical care for hospice patients; and 3) to gain methodological skills to conduct qualitative studies related to hospice delivery and care. Dr. Braun has assembled a mentor team of accomplished researchers from WCMS and Vanderbilt University School of Medicine (VUSM): Dr. Lawrence Casalino (primary mentor) who is the Livingston Farrand Professor of Public Health at WCMC and an expert on health care organization and behavior, and qualitative methods; Dr. Holly Prigerson (co-mentor) who is the Irving Sherwood Wrights Professor of Geriatrics at WCMC and an expert on end-of-life care; Dr. David Stevenson (co-mentor) who is a professor and the holder of the Endowed Directorship in Health Policy Education at VUMC and an expert in the delivery of hospice care; and Dr. Mark Unruh (co-mentor) who is an Associate Professor in the Department of Population Health Sciences at WCMC with expertise in long-term care and Medicare claims data. Over the past couple of decades, the hospice industry has moved from largely a not-for-profit sector to predominately for-profit. Facilitated by relatively easy market entry and generous Medicare payments, PE firms and PTCs have been acquiring hospices (many of them non-profit), with the goal to deliver short-term, above market returns to their investors. Despite this emergence, little is known of its effect on hospice care. Building on his previous research and training on assessing this phenomenon in physician practices, Dr. Braun will identify the organizational, staffing, patient, and quality characteristics associated with PE and PTC acquisitions using publicly available hospice data from Center for Medicare and Medicaid Services (CMS) (Aim 1), use rigorous econometric methods to assess the effect PE and PTC acquisition on hospice care using patient-level Medicare claims (Aim 2), and use qualitative methods to assess organizational, cultural, and delivery aspects of hospices post-acquisition integration (Aim 3). This research will be a foundation for an R01 grant application and will incorporate the new skills acquired through his training, which inform opportunities for improvement in hospice delivery of care.

项目摘要/摘要 这是提交给国家的K01指导研究科学家发展奖 人口健康科学系讲师罗伯特·泰勒·布劳恩（Robert Tyler Braun）老化研究所 在Weill Cornell医学院（WCMC）。布劳恩博士的职业目标是成为独立的 通过评估各种政策干预措施和 临终关怀的交付模型。该K01申请将为Braun博士提供必要的培训 1）获得衰老和临终关怀研究的专业知识； 2）了解临终关怀患者的临床护理； 3）获得方法论技巧，以进行与临终关怀和护理有关的定性研究。 Braun博士已经组建了一个由WCMS组成的有成就研究人员的导师团队， 范德比尔特大学医学院（VUSM）：劳伦斯·卡萨利诺（Lawrence Casalino）博士（主要导师） WCMC的利文斯顿·法兰德公共卫生教授，医疗保健组织专家 行为和定性方法；霍莉·普里格森（Holly Prigerson WCMC的老年医学教授，以及临终护理的专家；戴维·史蒂文森（David Stevenson）博士 是VUMC卫生政策教育授权董事的教授兼持有人， 提供临终关怀的专家； Mark Unruh博士（联盟），他是副教授 WCMC的人口健康科学系具有长期护理和医疗保险方面的专业知识 索赔数据。 在过去的几十年中，临终关怀行业已经从一个非营利组织转移了 主要营利性的部门。相对容易的市场进入和慷慨的Medicare促进 付款，体育公司和PTC已经收购了招待所（其中许多是非营利组织），其目标是 将短期以上的市场收益交付给投资者。尽管出现了这种出现，但知之甚少 对临终关怀的影响。基于他以前的研究和评估这种现象的培训 医师实践，Braun博士将确定组织，人员配备，患者和质量 使用中心公开可用的临终关怀数据与PE和PTC收购相关的特征 对于Medicare和Medicaid服务（CMS）（AIM 1），使用严格的计量经济学方法来评估 使用患者级的Medicare索赔（AIM 2）对PE和PTC的收购对临终关怀护理进行影响，并使用 收购后的招待所的组织，文化和交付方面的定性方法 集成（目标3）。这项研究将成为R01赠款申请的基础，并将合并 通过他的培训获得的新技能，这为改善临终关怀的机会提供了信息 提供护理。