Measuring physician practice site characteristics: A comparison of data from SK&A and a practice site survey.

Objective: To evaluate the comparability of commercially available practice site data from SK&A with survey data to understand the implications of using SK&A data for health services research.

Data Sources: Responses to the Comprehensive Primary Care Plus (CPC+) Practice Survey and SK&A data.

Study Design: Comparison of CPC + Practice Survey responses to SK&A information for 2698 primary care practice sites.

Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures.

Introduction: Current U.S. policy and payment initiatives aim to encourage health care provider accountability for population health and higher value care, resulting in efforts to integrate providers along the continuum.

A systematic review of vertical integration and quality of care, efficiency, and patient-centered outcomes.

Background: Small independent practices are increasingly giving way to more complex affiliations between provider organizations and hospital systems. There are several ways in which vertically integrated health systems could improve quality and lower the costs of care. But there are also concerns that integrated systems may increase the price and costs of care without commensurate improvements in quality and outcomes.

Changes in Hospital Quality Associated with Hospital Value-Based Purchasing.

Background: Starting in fiscal year 2013, the Hospital Value-Based Purchasing (HVBP) program introduced quality performance-based adjustments of up to 1% to Medicare reimbursements for acute care hospitals.

Methods: We evaluated whether quality improved more in acute care hospitals that were exposed to HVBP than in control hospitals (Critical Access Hospitals, which were not exposed to HVBP). The measures of quality were composite measures of clinical process and patient experience (measured in units of standard deviations, with a value of 1 indicating performance that was 1 standard deviation [SD] above the hospital mean) and 30-day risk-standardized mortality among patients who were admitted to the hospital for acute myocardial infarction, heart failure, or pneumonia.

Association Between Hospitals' Engagement in Value-Based Reforms and Readmission Reduction in the Hospital Readmission Reduction Program.

Importance: Medicare is experimenting with numerous concurrent reforms aimed at improving quality and value for hospitals. It is unclear if these myriad reforms are mutually reinforcing or in conflict with each other.

Objective: To evaluate whether hospital participation in voluntary value-based reforms was associated with greater improvement under Medicare's Hospital Readmission Reduction Program (HRRP).

Impact of Provider Incentives on Quality and Value of Health Care.

The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact.

Cost-effectiveness analysis of pneumococcal vaccination for infants in China.

Background: Although China has a high burden of pneumococcal disease among young children, the government does not administer publicly-funded pneumococcal conjugate vaccines (PCV) through its Expanded Program on Immunization (EPI). We evaluated the cost-effectiveness of publicly-funded PCV-7, PCV-10, and PCV-13 vaccination programs for infants in China.

Methods: Using a Markov model, we simulated a cohort of 16 million Chinese infants to estimate the impact of PCV-7, PCV-10, and PCV-13 vaccination programs from a societal perspective.

No hospital left behind? Education policy lessons for value-based payment in healthcare.

Value-based payment systems have been widely implemented in healthcare in an effort to improve the quality of care. However, these programs have not broadly improved quality, and some evidence suggests that they may increase inequities in care. No Child Left Behind is a parallel effort in education to address uneven achievement and inequalities.

Measurement scale influences in the evaluation of sight-word reading interventions.

Working with elementary students with disabilities, we used alternating treatment designs to evaluate and compare the effects of 2 computer-based flash card sight-word reading interventions, 1 with 1-s response intervals and another with 5-s response intervals. In Study 1, we held instructional time constant, applying both interventions for 3 min. Although students completed 6 learning trials per word during each 1-s session and 2 trials per word during each 5-s session, results showed similar acquisition rates for 1-s and 5-s words.

Re-examining the brain regions crucial for orchestrating speech articulation.

A traditional method of localizing brain functions has been to identify shared areas of brain damage in individuals who have a particular deficit. The rationale of this 'lesion overlap' approach is straightforward: if the individuals can no longer perform the function, the area of brain damaged in most of these individuals must have been responsible for that function. However, the reciprocal association, i.