MA PCMH Eval Week: Valerie Konar on Getting Evaluation Results through Project Management

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness. This blog post was posted to AEA365 during a week of posts featuring the team at the University of Massachusetts Medical School that helped to evaluate the Massachusetts Patient-Centered Medical Home Initiative

MA PCMH Eval Week: Valerie Konar, Carla Hillerns, and Michelle Landry on Comparison Groups in Evaluation Research – Never Trivial

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness. This blog post was posted to AEA365 during a week of posts featuring the team at the University of Massachusetts Medical School that helped to evaluate the Massachusetts Patient-Centered Medical Home Initiative

Association between Practice Participation in a Pediatric-focused Medical Home Learning Collaborative and Reduction of Preventable Emergency Department Visits by Publicly-insured Children in Massachusetts

Introduction: This study evaluates the impact of practice participation in a pediatric patient-centered medical home learning collaborative on preventable emergency department (ED) visits among children in MassHealth (Massachusetts Medicaid/Children\u27s Health Insurance Program). Methods: Claims and enrollment data were extracted for child MassHealth members (aged 3–18) comprising 2 groups: members enrolled in a group of 13 child-serving practices that participated in an intensive, 29-month long patient-centered medical home learning collaborative (intervention group), and members enrolled in a group of 12 comparison practices with roughly similar panel size, type, and geographic location (comparison group). Preventable ED visits were identified using a modified version of the New York University ED algorithm. Two analyses were then conducted: (1) a repeat cross-sectional analysis among children enrolled in intervention or comparison group practices during baseline (first half of 2011) and follow-up (second half of 2013) periods; and (2) a longitudinal analysis among a subset of children enrolled for the full study period (2011–2013). Both analyses tested whether the effect of the intervention differed for children with versus without chronic conditions (effect modification). Results: Preventable ED visits declined from baseline to follow-up among children in both intervention and comparison practices. In the cross-sectional analysis, the decrease was the same in both practice groups, and for children with versus without chronic conditions. The longitudinal analysis shows a statistically significantly greater decrease among children with chronic conditions enrolled in the intervention practices (P = 0.02). Conclusion: Children with chronic conditions might receive the greatest benefit from receiving care in a medical home setting

The Perioperative Surgical Home: A New Paradigm in a Surgical Episode of Care

An overview and review of a Perioperative Surgical Home (PSH) pilot developed using hte guiding principles of the patient-centered medical home. The PSH coordinates care and decisions from the decision to operate through return to primary care. The pilot demonstrated that a PSH improves efficiencies, decreases waste, improves patient and physician satisfaction and decreases care costs

Primary Care and the Perioperative Surgical Home

Our team partnered with UMass Memorial Medical Center’s Urology and Anesthesiology departments on a pilot patient-centered, physician-led, multidisciplinary team-based system of coordinated care for the surgical patient. The goals were to improve the patient experience, improve health care and reduce costs. Primary care physicians were surveyed to understand how surgical teams can better coordinate care with primary care. The results of the survey show that concise, useful communication about mutual patients is important to primary care physicians; there is no need for immediate follow-up appointments with primary care physicians unless necessary – appointments are recommended for two to four weeks after discharge; and defining the roles of primary care physicians and the surgeon is important

Paving the Way for Practice Success Under Value-Based Payments

A comprehensive look at The Southern New England Practice Transformation Network (SNE-PTN), which supports implementation of person-centered, high quality, efficient, and coordinated care. SNE-PTN is funded under the Centers for Medicare & Medicaid Services’ Transforming Clinical Practices Initiative. SNE-PTN is a complex, large-scale care transformation effort that requires a multi-faceted approach and alignment with state and national health care reform efforts. It is important to articulate the value proposition for clinicians

From Coarse to Fine? Spatial and Temporal Dynamics of Cortical Face Processing

Primary vision segregates information along 2 main dimensions: orientation and spatial frequency (SF). An important question is how this primary visual information is integrated to support high-level representations. It is generally assumed that the information carried by different SF is combined following a coarse-to-fine sequence. We directly addressed this assumption by investigating how the network of face-preferring cortical regions processes distinct SF over time. Face stimuli were flashed during 75, 150, or 300 ms and masked. They were filtered to preserve low SF (LSF), middle SF (MSF), or high SF (HSF). Most face-preferring regions robustly responded to coarse LSF, face information in early stages of visual processing (i.e., until 75 ms of exposure duration). LSF processing decayed as a function of exposure duration (mostly until 150 ms). In contrast, the processing of fine HSF, face information became more robust over time in the bilateral fusiform face regions and in the right occipital face area. The present evidence suggests the coarse-to-fine strategy as a plausible modus operandi in high-level visual cortex

Transformation Support Provided Remotely to a National Cohort of Optometry Practices

PURPOSE: We describe the results of a practice transformation project conducted within a national cohort of optometry practices participating in the Southern New England Practice Transformation Network. METHODS: Participants were 2,997 optometrists in 1,706 practices in 50 states. The multicomponent intervention entailed curriculum dissemination through a preexisting network of optometrists supported by specialized staff and resources, and data collection through a web portal providing real-time feedback. Outcomes included practices reporting data, urgent optometry visits for target conditions, and projected cost savings achieved by reducing emergency department (ED) use through increased provision of urgent care for conditions amenable to management in optometry practices. RESULTS: Over 13 months, 69.9% of practices reported data for a mean of 6.7 months. Beginning with the fourth month, the number of urgent optometry visits increased steadily. Among reporting practices, the total cost savings were estimated at $152 million (176,703 ED visits avoided at an average cost differential of$860 per visit). Monthly projected cost savings per optometrist were substantially greater in rural vs urban practices ($10,800 vs$7,870; P \u3c .001). CONCLUSIONS: Technical assistance to promote practice transformation can be provided remotely and at scale at low per-practice cost. Through the provision of timely, easily accessed ambulatory care, optometrists can improve the patient experience and reduce ED use, thereby reducing costs. The cost savings opportunities are immense because of the large volume and high expense of ED visits for ocular conditions that might otherwise be managed in ambulatory optometry practices