Are community health centers' chief executive officers' compensation related to clinical performance?

Background: Most research of chief executive officer (CEO) compensation in the health care industry has been limited to hospitals. This study expands our knowledge of CEO compensation into the nonhospital areas of the industry, specifically community health centers (CHCs). CHCs are safety-net providers that are an integral part of the U.

Implementing Two Randomized Pragmatic Trials of HPV Self-sampling among Underserved Women: Challenges and Lessons Learned.

Background: Haitian and Hispanic immigrant women experience substantial disparities in cervical cancer screening. Recently, our team completed two randomized trials of human papillomavirus (HPV) self-sampling as a cervical cancer screening strategy among Haitian and Hispanic women, using a community-based participatory research (CBPR) approach.

Objective: To reflect on lessons learned in the process of completing two large randomized cancer screening trials within underserved communities.

Health Information Technology Adoption and Clinical Performance in Federally Qualified Health Centers.

A national sample (N = 982) of federally qualified health centers (FQHCs) for the period 2011-2016 was examined regarding the relationship between the age and extent of health information technology (HIT) use and clinical performance. We found that each additional year of HIT use was associated with an approximate 4 percent increase in both process and outcome measures of clinical performance. Furthermore, FQHCs that fully adopted HIT had 7 percent higher clinical performance on hypertension control than those that did not adopt HIT.

Not so implausible: impact of longitudinal assessment of implausible anthropometric measures on obesity prevalence and weight change in children and adolescents.

Purpose: Implausible anthropometric measures are typically identified using population outlier definitions, conflating implausible and extreme measures. We determined the impact of a longitudinal outlier approach on prevalence of body mass index (BMI) categories and mean change in anthropometric measures in pediatric electronic health record data.

Methods: We examined 996,131 observations from 147,375 children (10-18 years) in the ADVANCE Clinical Data Research Network, a national network of community health centers.

A randomized trial of mailed HPV self-sampling for cervical cancer screening among ethnic minority women in South Florida.

Purpose: HPV self-sampling has previously been shown to increase cervical cancer screening among ethnic minority and immigrant women. We conducted a randomized pragmatic trial to examine the effectiveness of HPV self-sampling delivered via in-person versus by US mail for medically underserved Hispanic, Haitian, and non-Hispanic Black women living in South Florida.

Methods: We randomized women aged 30-65 who had not completed Pap smear screening in the past 3 years into two groups: (1) HPV self-sampling delivered in-person (IP) by a community health worker (CHW; IP + SS) or (2) HPV self-sampling delivered via US mail (SS + Mail).

Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida.

Objective: Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care.

OneFlorida Clinical Research Consortium: Linking a Clinical and Translational Science Institute With a Community-Based Distributive Medical Education Model.

Problem: Developing a national pragmatic clinical trial infrastructure is central to understanding the effectiveness of interventions applied under usual conditions and where people receive health care. To address this challenge, three Florida universities-the University of Florida Clinical and Translational Science Institute, Florida State University (with its community-based distributive medical education model), and the University of Miami-created (2010-2013) a statewide consortium, the OneFlorida Clinical Research Consortium, to support the conduct of pragmatic clinical trials and provide mentored research experiences for medical and graduate students in real-world practice settings.

Approach: OneFlorida has four programs, which report to a steering committee with membership from each partner, community members, and the state Medicaid agency and Department of Health to ensure shared governance.

Oversight on the borderline: Quality improvement and pragmatic research.

Pragmatic research that compares interventions to improve the organization and delivery of health care may overlap, in both goals and methods, with quality improvement activities. When activities have attributes of both research and quality improvement, confusion often arises about what ethical oversight is, or should be, required. For routine quality improvement, in which the delivery of health care is modified in minor ways that create only minimal risks, oversight by local clinical or administrative leaders utilizing institutional policies may be sufficient.

The ADVANCE network: accelerating data value across a national community health center network.

The ADVANCE (Accelerating Data Value Across a National Community Health Center Network) clinical data research network (CDRN) is led by the OCHIN Community Health Information Network in partnership with Health Choice Network and Fenway Health. The ADVANCE CDRN will 'horizontally' integrate outpatient electronic health record data for over one million federally qualified health center patients, and 'vertically' integrate hospital, health plan, and community data for these patients, often under-represented in research studies. Patient investigators, community investigators, and academic investigators with diverse expertise will work together to meet project goals related to data integration, patient engagement and recruitment, and the development of streamlined regulatory policies.

Diagnostic inconsistency: a marker of service utilization in bipolar disorder.

Community outcomes for the treatment of bipolar disorder remain poor, including frequent hospitalization. Recent small-scale studies suggest that hospitalization may be tied to poor recognition and medication management. This paper examines the health care charges associated with poor recognition of mania.

Association of utilization management and treatment plan modifications among practicing U.S. psychiatrists.

Objective: This study examined the relationship between utilization management techniques and psychiatrists' treatment plan modifications.

Method: Nationally representative data on 1,843 patients treated by 615 psychiatrists participating in the American Psychiatric Institute for Research and Education's Practice Research Network were used to examine the demographic and clinical characteristics of patients whose care was subjected to utilization management and to assess the association between utilization management and psychiatrists' treatment plan modifications.

Results: Approximately half of all patients had treatment that was subject to utilization management (52.

Risk factors for psychosocial dysfunction among enrollees in the State Children's Health Insurance Program.

Objective: The authors studied enrollees in the State Children's Health Insurance Program (SCHIP) (Title XXI) to characterize risk factors for psychosocial dysfunction among children of the working poor.

Methods: Medical and psychosocial variables were included in a survey completed by 393 parents of children enrolled in SCHIP. Regression analysis was used to examine the relationship between these variables and scores on the Pediatric Symptom Checklist, a measure of psychosocial dysfunction among children.