The mission of the Center for Health Care Research and
Policy is to: (1) improve the health of the public by conducting
research that examines access to health care, increases the quality of
health care services, and informs health policy and practice; and (2)
lead educational programs that promote these goals.
Director's Report, 2014,
CHRP Grants and Contracts
|New Study Shows Prepared Safety Net Improves Care, Saves Money In Medicaid Expansion Population |
A new study published July 7 in Health Affairs found that poor, uninsured patients who enrolled in a Medicaid-like insurance plan had better care and health outcomes than those who remained uninsured -- all achieved with total costs of enrollees` care that were 28.7 percent below the spending cap allowed by the federal government. The study examined the impact of MetroHealth Care Plus, which extended Medicaid coverage to 28,295 Cuyahoga County residents before the expansion of Medicaid took place in Ohio. “The results challenge recent reports and contribute to the ongoing debates on the value of expanding health care coverage to more poor Americans,” said Randall Cebul, MD, president and CEO of Better Health Partnership and lead author of the study. Read the news release.
|Better Health Featured at WCPN 90.3 Ideastream|
WCPN 90.3 Ideastream recently featured the improving care of diabetes and high blood pressure reported by the Better Health Partnership. Visit here for more on Better Health Partnership (formerly Better Health Greater Cleveland) and its Summer 2015 report.
|Thomas Love Giving Six Traveling Courses on Propensity Methods This Summer & Fall|
In the summer and fall of 2015, Thomas E. Love, Ph.D., is giving a set of six one-day traveling courses for the American Statistical Association, entitled "Using Propensity Scores to Effectively Design and Analyze Observational Studies." The first workshop was May 29, 2015 for the Northeastern Illinois chapter, in the Chicago area. Subsequent workshops will be held this Fall in Pittsburgh, Little Rock, Charleston, Atlanta and Cleveland. Love is a Fellow of the American Statistical Association.
|Disentangling Multiple Sclerosis and Depression for Better Care|
Due to the overlap of symptoms in clinical depression and multiple sclerosis, clinicians and researchers can be misled when caring for patients with MS who report fatigue and functional or cognitive impairment. Seeking to disentangle these complex relationships to improve care, Center faculty Douglas Gunzler, PhD, Adam Perzynski, PhD, Steven Lewis, MS, MBA, along with others at Case Western Reserve University and the Cleveland Clinic Mellen Center for Multiple Sclerosis, recently studied 3,507 patients with MS who also completed a self-reported depression screening tool (PHQ-9). Using a sophisticated causal modeling approach, the team found that overlap in symptoms was especially large for symptoms of fatigue. The team is developing an adjusted PHQ-9 screening tool for MS patients, as reported in the June 2014 issue of the Journal of Behavioral Medicine. Dr. Gunzler is a KL2 Scholar in the Cleveland CTSC’s Multidisciplinary Clinical Research Training Program.
|Engaging Patients in Care Improves Blood Sugar Control in Patients with Diabetes|
Center member Shari Bolen, MD, MPH and colleagues recently performed a systematic review of over 100 studies of “patient activation” strategies for adults with diabetes, and found that these programs improve blood sugar control almost as much as taking a diabetes medication. The study team also found improvements in cholesterol, blood pressure, and weight. Interventions often were relatively simple - such as diabetes group visits, use of pedometers and activity journals, or use of a portion-controlled plate at meal time in conjunction with nutrition visits. Programs that lasted longer, incorporated clinical pharmacists, and enrolled patients with higher blood sugars had greater improvements. While many patient activation programs exist to help adults with diabetes improve their health, about 50% of insurers do not yet support these programs. Study findings provide evidence for insurers who do not yet cover these programs. This study should revolutionize care by encouraging primary care providers and their staff to offer these programs consistently to engage patients in improving their health. Also participating in the current study were MetroHealth researchers Dr. Corinna Falck-Ytter; Adam Perzynski and Steven Lewis of the Center for Health Care Research and Policy; Cleveland Clinic family medicine physician Carl Tyler, and two Clinic Lerner College of Medicine students. The article was published recently in the Journal of General Internal Medicine and was highlighted in the May 15 issue of the Cleveland Plain Dealer.