Publications by authors named "Katherine Giuriceo"
In 2014, Maryland incorporated global budgets into its long-running all-payer rate-setting model for hospitals in order to improve health, increase health care quality, and reduce spending. We used difference-in-differences models to estimate changes in Medicare and commercial insurance utilization and spending in Maryland relative to a hospital-based comparison group. We found slower growth in Medicare hospital spending in Maryland than in the comparison group 4.
View Article and Find Full Text PDFObjective: To review the evidence of the association between performance in eight indicators of diabetes care and a patient's race/ethnicity and socioeconomic characteristics.
Data Source: Studies of adult patients with type 2 diabetes in MEDLINE published between January 1, 2000, and December 31, 2018.
Study Design: Systematic review and meta-analysis of regression-based studies including race/ethnicity and income or education as explanatory variables.
Background: Global budgets have been proposed as a way to control health care expenditures, but experience with them in the United States is limited. Global budgets for Maryland hospitals, the All-Payer Model, began in January 2014.
Objectives: To evaluate the effect of hospital global budgets on health care utilization and expenditures.
Importance: The Johns Hopkins Community Health Partnership was created to improve care coordination across the continuum in East Baltimore, Maryland.
Objective: To determine whether the Johns Hopkins Community Health Partnership (J-CHiP) was associated with improved outcomes and lower spending.
Design, Setting, And Participants: Nonrandomized acute care intervention (ACI) and community intervention (CI) Medicare and Medicaid participants were analyzed in a quality improvement study using difference-in-differences designs with propensity score-weighted and matched comparison groups.
Background And Objectives: Care coordination and palliative care supports are associated with reduced anxiety, fewer hospital admissions, and improved quality of life for patients and their families. Early palliative care can result in savings in the end-of-life period, but there is limited evidence that larger-scale models can improve both utilization and the cost of care. Three models that received Health Care Innovation Awards from the Centers for Medicare & Medicaid Services aimed to improve quality of care and reduce cost through the use of innovative care coordination models.
View Article and Find Full Text PDFArticle Synopsis
- Previous studies had conflicting results on whether patients receiving care from federally qualified health centers (FQHCs) used healthcare differently than those who did not.
- The study compared Medicare beneficiaries who primarily visited FQHCs with a large group of beneficiaries who received care elsewhere, analyzing their healthcare utilization patterns in 2013.
- The findings indicated that FQHC users had fewer visits to primary care or specialists but more emergency department visits, with hospitalization rates remaining similar between the two groups.
Article Synopsis
- From 2011 to 2014, a program helped 503 federally qualified health centers achieve advanced medical-home recognition, aimed at improving patient care and access.
- About 70% of these centers reached the highest recognition level, while only 11% of comparison sites did.
- Although some service utilization decreased overall, demonstration sites experienced a relative increase in certain services and tests, despite also seeing higher emergency visits and Medicare expenditures.
Article Synopsis
- Patient-centered medical home (PCMH) models in federally qualified health centers (FQHCs) can enhance access to care, improve health outcomes, and reduce costs for Medicare beneficiaries.
- A study analyzed 804 FQHCs and over 231,000 Medicare beneficiaries, finding that most FQHCs had varying levels of PCMH capabilities, which correlated with increased outpatient visits but also more specialist and emergency department visits.
- Advanced PCMH sites resulted in higher overall Medicare spending but no increase in hospital admissions, highlighting the need for balancing accessibility with cost considerations in primary care.
While studies of home-based care delivered by teams led by primary care providers have shown cost savings, little is known about outcomes when practice-extender teams-that is, teams led by registered nurses or lay health workers-provide home visits with similar components (for example, care coordination and education). We evaluated findings from five models funded by Health Care Innovation Awards of the Centers for Medicare and Medicaid Services. Each model used a mix of different components to strengthen connections to primary care among fee-for-service Medicare beneficiaries with multiple chronic conditions; these connections included practice-extender home visits.
View Article and Find Full Text PDFObjective: To identify roles physicians assumed as part of new health care delivery models and related strategies that facilitated physician engagement across 21 Health Care Innovation Award (HCIA) programs.
Data Sources: Site-level in-depth interviews, conducted from 2014 to 2015 (N = 672) with program staff, leadership, and partners (including 95 physicians) and direct observations.
Study Design: NORC conducted a mixed-method evaluation, including two rounds of qualitative data collected via site visits and telephone interviews.