Quality improvement teams, super-users, and nurse champions: a recipe for meaningful use?

Objective This study assessed whether having an electronic health record (EHR) super-user, nurse champion for meaningful use (MU), and quality improvement (QI) team leading MU implementation is positively associated with MU Stage 1 demonstration

Trends in Asset Structure Between Not-for-Profit and Investor-Owned Hospitals

The delivery of health care is a capital intensive industry and thus hospital investment strategy continues to be an important area of interest for both health policy and research. Much attention has been given to hospitals’ capital investment policies with relatively little attention to investments in financial assets, which serve an important role in NFP hospitals. This study describes and analyzes trends in aggregate asset structure between NFP and IO hospitals during the post-capital based PPS implementation period, providing the first documentation of long-term trends in hospital investment. We find hospitals’ aggregate asset structure differs significantly based on ownership, size, and profitability. For both NFP and IO hospitals, financial securities have remained consistent over time, while fixed asset representation has declined in IO hospitals

Performance-Based Contracting and the Moderating Influence of Caseworker Role Overload on Service Provision in Child Welfare

Although performance-based contracts have become increasingly popular in child welfare, administrators are developing these contracts with little empirically guided information about how internal work conditions may influence the services families receive. This study examines how child welfare caseworker role overload moderates associations between child welfare agencies’ use of performance-based contracting and services provided to families. Analyses using data from the National Survey of Child and Adolescent Well-Being suggest that when caseworkers experience high role overload, use of performance-based contracts may decrease caregivers’ likelihood of receiving necessary social and behavioral health services. These findings and their implications are discussed

Facing the Recession: How Did Safety-Net Hospitals Fare Financially Compared with Their Peers?

To examine the effect of the recession on the financial performance of safety-net versus non-safety-net hospitals

The Cost to Successfully Apply for Level 3 Medical Home Recognition

The NCQA Patient Centered Medical Home (PCMH) recognition program provides practices an opportunity to implement Medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work

The strategic case for establishing public-private partnerships in cancer care

Abstract Background In 2007, the National Cancer Institute (NCI) launched the NCI Community Cancer Centers Program (NCCCP) as a public-private partnership with community hospitals with a goal of advancing cancer care and research. In order to leverage federal dollars in a time of limited resources, matching funds from each participating hospital were required. The purpose of this paper is to examine hospitals’ level of and rationale for co-investment in this partnership, and whether there is an association between hospitals’ co-investment and achievement of strategic goals. Methods Analysis using a comparative case study and micro-cost data was conducted as part of a comprehensive evaluation of the NCCCP pilot to determine the level of co-investment made in support of NCI’s goals. In-person or telephone interviews with key informants were conducted at 10 participating hospital and system sites during the first and final years of implementation. Micro-cost data were collected annually from each site from 2007 to 2010. Self-reported data from each awardee are presented on patient volume and physician counts, while secondary data are used to examine the local Medicare market share. Results The rationale expressed by interviewees for participation in a public-private partnership with NCI included expectations of increased market share, higher patient volumes, and enhanced opportunities for cancer physician recruitment as a result of affiliation with the NCI. On average, hospitals invested resources into the NCCCP at a level exceeding $3 for every$1 of federal funds. Six sites experienced a statistically significant change in their Medicare market share. Cancer patient volume increased by as much as one-third from Year 1 to Year 3 for eight of the sites. Nine sites reported an increase in key cancer physician recruitment. Conclusions Demonstrated investments in cancer care and research were associated with increases in cancer patient volume and perhaps in recruitment of key cancer physicians, but not in increased Medicare market share. Although the results reflect a small sample of hospitals, findings suggest that hospital executives believe there to be a strategic case for a public-private partnership as demonstrated through the NCCCP, which leveraged federal funds to support mutual goals for advancing cancer care and research

Why providers participate in clinical trials: Considering the National Cancer Institute's Community Clinical Oncology Program

The translation of research evidence into practice is facilitated by clinical trials such as those sponsored by the National Cancer Institute’s Community Clinical Oncology Program (CCOP) that help disseminate cancer care innovations to community-based physicians and provider organizations. However, CCOP participation involves unsubsidized costs and organizational challenges that raise concerns about sustained provider participation in clinical trials

Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals

To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance

CEO Compensation and Hospital Financial Performance

Growing interest in pay-for-performance and the level of CEO pay raises questions about the link between performance and compensation in the health sector. This study compares the compensation of non-profit hospital Chief Executive Officers (CEOs) in Ontario, Canada to the three longest reported and most used measures of hospital financial performance. Our sample consisted of 132 CEOs from 92 hospitals between 1999 and 2006. Unbalanced panel data were analyzed using fixed effects regression. Results suggest that CEO compensation was largely unrelated to hospital financial performance. Inflation-adjusted salaries appeared to increase over time independent of hospital performance, and hospital size was positively correlated with CEO compensation. The apparent upward trend in salary despite some declines in financial performance challenges the fundamental assumption underlying this paper, that is, financial performance is likely linked to CEO compensation in Ontario. Further research is needed to understand long-term performance related to compensation incentives

The Effect of Minimum Nurse Staffing Legislation on Uncompensated Care Provided by California Hospitals

This study assesses whether California’s minimum nurse staffing legislation affected the amount of uncompensated care provided by California hospitals. Using data from California’s Office of Statewide Health Planning and Development, the American Hospital Association Annual Survey and InterStudy, we divide hospitals into quartiles based on pre-regulation staffing levels. Controlling for other factors, we estimate changes in the growth rate of uncompensated care in the three lowest staffing quartiles relative to the quartile of hospitals with the highest staffing level. Our sample includes short-term general hospitals over the period 1999 to 2006. We find that growth rates in uncompensated care are lower in the first three staffing quartiles as compared to the highest quartile; however, results are statistically significant only for county and for-profit hospitals in quartiles one and three. We conclude that minimum nurse staffing ratios may lead some hospitals to limit uncompensated care, likely due to increased financial pressure