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Quality of Care for Dual-Eligible Beneficiaries in Managed Care Plans

管理式护理计划中双重资格受益人的护理质量

基本信息

批准号：
9915835
负责人：
Laura Margaret Keohane
金额：
$ 12.04万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-04-01 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9915835
关键词：
Address Adult Advance Care Planning Advisory Committees Affect Age Aging Award Caring Characteristics Clinical Complex Country County Data Data Analyses Dental Doctor of Philosophy Dual Enrollment Elderly Emergency department visit Enrollment Face Goals Grant Health Health Policy Health Services Health Status Healthcare Hospitalization Incentives Individual Knowledge Long-Term Care Low income Managed Care Managed Care Programs Measurement Measures Medicaid Medicare Medicare/Medicaid Mentors Mentorship Methods Outcome Patient Self-Report Performance Policies Population Qualitative Methods Qualitative Research Quality of Care Reading Reporting Research Research Methodology Research Personnel Research Project Grants Resources Role Services Surveys Time Training Training Activity Transportation Universities beneficiary care coordination care systems career cost design disability dual eligible end of life end of life care financial incentive functional status health care delivery health care service utilization hospice environment improved innovation medical schools negative affect prevent professor programs skills socioeconomics training opportunity trend

项目摘要

PROJECT ABSTRACT Laura M. Keohane, PhD, MS is an Assistant Professor in the Department of Health Policy at the Vanderbilt University School of Medicine. As a health services researcher, Dr. Keohane seeks to identify and understand how policy can address health care barriers related to age, disability, and socioeconomic circumstances. This training grant will support her career goal of becoming a leading independent investigator in quality of care for low-income older adults and specifically dual-eligible beneficiaries who have both Medicare and Medicaid coverage. This population includes some of the county's highest-need, highest-cost elderly adults. During the award period, Dr. Keohane will gain additional expertise in qualitative research methods, survey and Medicaid data analysis, and clinical health outcomes for older adults. Her primary mentor, Dr. Melinda Buntin, is a nationally recognized health economist with extensive Medicare policy knowledge, and her co-mentor, Dr. David Stevenson, is a leading expert in end-of-life care and long-term services and supports. Dr. Buntin and Dr. Stevenson will chair an advisory committee of established researchers and clinicians who will provide mentorship in evaluating quality of care for aging populations. Dr. Keohane's training activities will include methods coursework, guided readings on quality of care, and a clinical practicum on health care delivery for older adults. A complementary set of research projects will provide opportunities for Dr. Keohane to apply new skills to investigating an emerging health policy issue for dual-eligible beneficiaries: quality of care in managed care plans. Although over one in four dual-eligible beneficiaries receives Medicare benefits through a managed care plan, there is little evidence demonstrating whether these plans have better health outcomes for older adults with complex health needs and limited socioeconomic resources. To address these gaps, the first aim will use national survey data to compare health and functional status changes over time for dual-eligible beneficiaries in managed care plans versus traditional Medicare. The second aim will employ qualitative data analysis to understand how managed care plans may influence health outcomes by fulfilling quality reporting requirements. The third aim will examine whether improvements in a specific reporting requirement, documenting engagement in advance care planning activities, were associated with better end-of-life outcomes. Finally, the fourth aim will evaluate whether a reduction in Medicaid benefits negatively affected quality of care for dual-eligible beneficiaries and whether participation in managed care plans mitigated this impact. Collectively, the results from these aims will provide evidence that informs important policy decisions about the role of managed care in improving health outcomes for low-income elderly adults. By providing the training necessary to conduct mixed-methods research and to better understand the clinical health needs of aging adults, this award will enable Dr. Keohane to become a successful independent researcher.

项目摘要