Addiction Treatment in Medicaid Health Homes

医疗补助健康之家的成瘾治疗

• 批准号: 9226043
• 负责人: Christina Marie Andrews
• 金额: $ 14.54万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9226043
• 关键词: Acute; Adopted; Affect; Affordable Care Act; Area; Award; Caring; Chronic; Community Services; Complex; Contracts; Country; Data; Doctor of Philosophy; Drug Addiction; Drug abuse; Effectiveness; Goals; Health; Health Personnel; Health Services Research; Health Surveys; Healthcare; Home environment; Individual; Insurance; Knowledge; Link; Location; Measurement; Measures; Medicaid; Mentored Research Scientist Development Award; Mentors; Methods; Modeling; National Institute of Drug Abuse; Overdose; Performance; Pharmaceutical Preparations; Policies; Primary Health Care; Probability; Professional counselor; Proliferating; Provider; Quality of Care; Research; Resources; Services; Social Work; Social support; Structure; Sum; Supervision; Surveys; System; Training; Training Activity; Treatment outcome; Withdrawal; addiction; behavioral health; beneficiary; career development; cost; cost effectiveness; design; family support; flexibility; health care delivery; health difference; health information technology; improved; innovation; medical specialties; organizational structure; person centered; primary care setting; programs; public health relevance; screening; skills; theories; treatment effect

 DESCRIPTION (provided by applicant): Established under the Affordable Care Act, health homes (HHs) represent a major innovation in health service delivery for Medicaid beneficiaries with chronic health conditions, offering person-centered care coordination with a strong focus on behavioral health care and social supports and services. HHs have potential to improve receipt of addiction treatment and use and costs of acute care for addiction-related conditions (ARCs). However, research is needed to determine if HHs are successful in identifying and treating addiction, and if so, what practices are most effective in doing so. Strategies for identifying and treating addiction differ significantly across state HH models. The overall goal of this K01 application is to provide intensive, supervised career-development training to enable me to assess the impact of state HH model practices for identification and treatment of addiction on receipt of addiction treatment, and use and costs of acute care for ARCs. The proposed Mentored Research Scientist Development Award will allow me to supplement my expertise in health services research with advanced training in: econometrics, organizational theory, and survey design and administration. I will be guided by my primary mentor, John Brooks, PhD, and co-mentors Peter Friedmann, MD, MPH, Thomas D'Aunno, PhD, and Janice Probst, PhD. My training plan includes structured mentoring and study with Dr. Brooks, on use of econometric methods to estimate treatment effects using observational data, including use of propensity score matching and instrumental variable estimators; Dr. D'Aunno, on organizational theory; Dr. D'Aunno and Dr. Friedmann, on designing a pilot survey to measure addiction treatment integration and service coordination in HH provider organizations, and Dr. Probst, on effective management and construct measurement using complex public insurance claims data. I will also complete formal coursework in each of these areas. Drawing from Medicaid Analytic Extract (MAX) data from 2012-2014, I will use the knowledge and skills acquired through these training activities to: (1) examine the relationship of HH structure to the probability of addictio treatment receipt among Medicaid enrollees who participated in HHs during the period 2012-2014; (2) assess the effect of addiction treatment receipt on use and cost of acute care for ARCs among Medicaid enrollees participating in HH during the period 2012-2014; and (3) design and pilot a survey of organizational structures and practices employed by HHs to identify and treat addictive disorders. In sum, the proposed K01 Award will provide me with the resources, training, and mentoring needed to initiate my long-term independent research program to conduct research that can improve the capacity of HHs to identify and treat addiction.

 描述（由申请人提供）：根据《平价医疗法案》建立的健康之家（HHS）代表了为患有慢性健康状况的医疗补助受益人提供健康服务的重大创新，提供以人为本的护理协调，重点关注行为健康护理和社会支持和服务。HHS有可能改善成瘾治疗的接受和成瘾相关疾病（ARC）的急性护理的使用和成本。然而，需要研究来确定HHS是否成功地识别和治疗成瘾，如果是，什么做法最有效。查明和 治疗成瘾在各州HH模型之间存在显著差异。这个K 01应用程序的总体目标是提供密集的，监督的职业发展培训，使我能够评估国家HH模型实践的影响，以识别和治疗成瘾对接受成瘾治疗，以及使用和急性护理ARC的成本。拟议的指导研究科学家发展奖将使我能够补充我在卫生服务研究方面的专业知识，并在以下方面进行高级培训：计量经济学，组织理论，调查设计和管理。我将由我的主要导师，约翰布鲁克斯，博士，和共同导师彼得弗里德曼，医学博士，公共卫生硕士，托马斯D 'Aunno，博士和珍妮丝普罗布斯特，博士指导。我的培训计划包括结构化的指导和与布鲁克斯博士的学习，关于使用计量经济学方法使用观察数据估计治疗效果，包括使用倾向评分匹配和工具变量估计; D 'Aunno博士，关于组织理论; D 'Aunno博士和Friedmann博士设计了一项试点调查，以衡量HH提供者组织中的成瘾治疗整合和服务协调，和Probst博士，关于使用复杂的公共保险索赔数据进行有效管理和构建测量。我还将完成这些领域的正式课程。从2012-2014年的Medicaid Analytic Extract（MAX）数据中，我将使用通过这些培训活动获得的知识和技能：（1）检查2012-2014年期间参加HHS的Medicaid登记者中HH结构与成瘾治疗接受概率的关系;（2）评估2012-2014年期间参加HH的Medicaid登记者接受成瘾治疗对ARC急性护理的使用和成本的影响;设计并试行一项由卫生保健所采用的组织结构和实践的调查，以识别和治疗成瘾性疾病。总而言之，拟议的K 01奖将为我提供启动长期独立研究计划所需的资源，培训和指导，以开展可以提高HHS识别和治疗成瘾的能力的研究。