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Perspectives on Health Care Policy Presented at Chicago Federal Reserve Bank
On March 22-23, the Federal Reserve Bank of Chicago sponsored a conference titled “New Perspectives on Health and Health Care Policy” The conference brought leading researchers in health care policy together to discuss new perspectives on important policy topics. Conferences attendees included renowned health economists David Cutler (Harvard) and Mark Pauly (Pennsylvania) and Nobel Laureate James Heckman (Chicago). Among those presenting was Center health economist Mark Votruba, who discussed recent work titled “Unhealthy Insurance Markets: Search Frictions and the Cost and Quality of Health Insurance,” jointly completed with Randall Cebul, Center Senior Scholar James Rebitzer (Boston University), and Lowell Taylor (Carnegie Mellon). (posted 4/2010)

Votruba with Trivisonno "In the Air"
On March 26, Center health economist Mark Votruba represented MetroHealth Medical Center in a panel discussion of health care reform legislation on The Mike Trivisonno Show (WTAM 1100). You can listen to the entirety of the show here. Professor Votruba appears in hours 2-4. Joining Professor Votruba on the panel was insurance consultant Rick Kelly and Jason Koma of the Ohio State Medical Association.(posted 4/2010)

SIXTH CONSECUTIVE YEAR -Center Faculty Among Top Docs of 2010
In the March, 2010 Cleveland Magazine Center faculty, Alfred F. Connors, Jr., MD (Critical Care), Neal V. Dawson, MD (Internal Medicine), Patrick K. Murray, MD (Physical Medicine & Rehabilitation) and Irene Katzan MD (Neurology) were named among Northeast Ohio`s Top Doc`s. Congratulations to all! (posted 3/2010)

To Induce or Not to Induce?
With increasing numbers of expectant mothers choosing their delivery dates based on the convenience for family and the physician, Center Senior Scholar Jennfier Bailit, MD, MPH worked with the NIH to explore whether the type of delivery can impact motherand baby: in particular, whether elective inductions – performed for nomedical reason – provided an increased risk to mother or baby. The risks are increased for mom, according to Dr. Bailit, who is a high-risk obstetrician at MetroHealth. The study in the March issue of the American Journal of Obstetrics and Gynecology revealed that the chances of women needing a hysterectomy after giving birth were three times higher for women undergoing elective induction than for those who went into labor spontaneously.

The research also reinforced the data from recent smaller studies that neonatal outcomes are best at 39 weeks or later. “Given the advantages of an elective delivery are primarily social or logistical – whether Grandma can come in from out of town or when your OB is available and not on vacation – this study presents some hard data that an elective delivery has risks,” says Bailit. “At thevery least, women should be well-informed about the risks and benefits of the procedure.”

Thomas Love elected Chair of the Health Policy Statistics Section of the American Statistical Association for 2010 & Co-Chair of the 2011 ICHPS Meeting
Thomas E. Love, Ph. D. led two workshops (one on propensity methods, and the other on cluster randomized trials, with Center colleague Neal Dawson) at the recently completed 8th International Conference on Health Policy Statistics in Washington, D.C. Dr. Love also presided over the meeting`s plenary and awards session as Chair of the Health Policy Statistics Section of the American Statistical Association. He will serve as Co-Chair of the 9th ICHPS meetings, which will be held in Fall 2011 here in Cleveland.(posted 2/2010)

2009 Scholarship in Teaching Award
Thomas E. Love, Ph. D. was selected for a 2009 Scholarship in Teaching Award by CWRU`s School of Medicine, for his work in developing and leading the instruction of Statistical Thinking for Clinical Research, a semester course for post-doctoral physician-scientists in biostatistics as part of the Clinical Research Scholars Program. Dr. Love was also honored with this award in 2005, and with its predecessor, the Best Educational Contribution Award, in 2004.(posted 2/2010)

The Real Economics of the Health Insurance Market
Would the creation of a health insurance exchange benefit consumers? Recent research from Center investigators suggests that it would - by addressing an under-appreciated source of inefficiency in health insurance markets: the existence of “search frictions.” In economics jargon, “search frictions” refer to the difficulties consumers face when purchasing complicated goods. In the market for health insurance, where plans vary along numerous dimensions, consumers find it hard to meaningfully compare all their options. As a result, high-priced plans can remain profitable even when similar lower-priced plans are available. In search forthcoming in the American Economic Review, Drs. James Rebitzer, Lowell Taylor (Carnegie Mellon), Mark Votruba, and Randall Cebul estimate that the presence of search frictions enable insurers to set average premiums for employer-based insurance about 30% above competitive levels. This results in excessive administrative and marketing costs for the insurers and also undermines insurers’ incentive to efficiently finance care that could reduce future costs. By making comparison shopping easier, like Progressive insurance does in the car insurance market, a health insurance exchange would increase price competition among insurers. An earlier version of this work was published as a National Bureau of Economics Research working paper #14455.(posted 2/2010)

Better Health Greater Cleveland Partnership Highlighted in Medicus
Better Health Greater Cleveland’s partnership highlighted in Medicus. Distributed widely to School of Medicine faculty, staff and alumni, the Winter 2010 issue of Medicus featured a story on the Better Health alliance to improve outcomes among the region’s residents with chronic medical conditions. Future research opportunities using this electronic medical records-driven data warehouse also were highlighted.(posted 2/2010)

New Faculty Position in Health Informatics (posted 2/11/2010)
The Center for Health Care Research and Policy ofCase Western Reserve University (CWRU) at MetroHealth Medical Center (MHMC),seeks faculty with interest, experience and scholarship in Clinical Research Informatics. View the complete position description here.

Health Care Delivery: Repairing a Broken System
“Health Care Delivery: Repairing a Broken System” was the theme of the Health Policy Board’s Symposium at the 2009 annual meeting of the American Society of Nephrology in San Diego. Co-chaired by CWRU Professor of Medicine and Physiology and MetroHealth’s Vice President for Research John R. Sedor, M.D., symposium participants included Center director Randall D. Cebul, who presented “Care Fragmentation: Some Causes, Consequences, and Approaches to Remedy The Problem”. Other speakers included Alain C. Enthoven, PhD, Professor of Public and Private Management at Stanford University and Adeera Levin, M.D., Professor of Medicine at the University of British Columbia and Executive Director of the BC Provincial Renal Agency. (posted 11/2009)

Primary Care Grand Rounds - October 28th - Second in a Series
Better Health Greater Cleveland was pleased to present the second in a series of lectures on October 28th at the Intercontinental Hotel. John Tooker, MD, MBA, FACP, is the Executive Vice President & CEO of the American College of Physicians. His talk is titled “Health Care Reform: The End-game Strategies and Likely Outcome”.

An Economic Perspective on U.S. Health Care Reform -- September 10th
Mark E. Votruba, Ph.D. presented Medical Grand Rounds on September 10th at MetroHealth`s Scott Auditorium The topic: An Economic Perspective on U.S. Health Care Reform. [Slides] Dr. Votruba is Director of the Center’s Health Economics Research Unit and CWRU Associate Professor of Economics.

September 17th - First in a Series Lecture by Richard J. Baron, MD, FACP
Better Health Greater Cleveland was pleased to present the first in a series of lectures of particular interest to primary care physicians. Richard J. Baron, MD, FACP, spoke at MetroHealth`s Department of Medicine Grand Rounds on Patient-Centered Primary Care: Trends, Needs and Opportunities. Dr. Baron, of Greenhouse Internists P.C. in Philadelphia, and immediate past President of the American Board of Internal Medicine, transformed his four-physician primary care practice into a patient-centered medical home, which became one of the first to receive Level 3 NCQA accreditation. He is a pioneer in the use of electronic health records in small practices and founder and CEO of Philadelphia e-Quality, a non-profit company trying to accelerate EHR adoption in small practices. Dr. Baron`s PowerPoint Presentation.

Health Reform Debate on August 24th
The School of Medicine and its AMSA chapter sponsored a panel discussion about the President’s Plan for Health Care Reform on Monday, August 24th, from 6:00-7:00 p.m. at E301 Lecture Hall at the SOM. Mark Votruba, PhD, MA, director of the Center’s Health Economics Research Unit and CWRU Associate Professor of Economics, was joined by three other faculty members, including JB Silvers, PhD (Weatherhead), Joseph White, PhD (Political Science), and Mark Mayer, MD (Internal Medicine, Cleveland Clinic).

Center Director Receives Prestigious Maurice Saltzman Award from Mt. Sinai Healthcare Foundation
Center Director, Randall Cebul, was presented with the Mt. Sinai Health Care Foundation`s prestigious Maurice Saltzman Award for 2009. Dr. Cebul was recognized at the Foundation`s annual meeting on June 15 for establishing and leading Better Health Greater Cleveland, a community-wide collaboration that is dedicated to improving the health and health care for people in Northeast Ohio with chronic medical conditions. Posted 6/2009

FIFTH CONSECUTIVE YEAR -Center Faculty Among Top Docs of 2009
In the March, 2009 Cleveland Magazine Center faculty, Neal V. Dawson, MD (Internal Medicine), Patrick K. Murray, MD (Physical Medicine & Rehabilitation) and Irene Katzan MD (Neurology) were named among Northeast Ohio`s Top Doc`s. Congratulations to all! Posted 3/2009

Study selected for the Electrode Store Best Paper Presentation at AAP Annual Meeting
A study by Richard Wilson, MD, Steven Lewis, MS, and Patrick Murray, MD, MS was selected for the Electrode Store Best Paper Presentation for the annual meeting of the Association of Academic Physiatrists. The study, titled “Trends in Rehabilitation Therapist Workforce in Underserved Areas 1980 – 2000,” examines the supply of physical, occupational, and speech therapists in rural and medically underserved areas in the United States. The key findings are the size of the workforce of physical, occupational, and speech therapists grew at a slower rate in urban and medically underserved areas over the two decades 1980 – 2000 than the size of the workforce in the counterpart areas. This may represent a misallocation of supply given that demand is likely greater in rural areas where there is a greater representation of the elderly. Dr. Wilson will present the findings at the annual meeting of the AAP in Anaheim, California in February of 2008.(posted 1/2008)

Ongoing Work by Center Researchers Covered in Slate
A recent study by researchers from Case Western Reserve and Carnegie Mellon University explains that a culprit in inadequate preventive care and effective disease management programs may be the very high rate at which Americans switch among insurance plans. It takes several years for insurers to recoup their investment in early diabetes treatment, for example, and by then odds are that their customer has moved on to another health plan. Alas, says the Slate article, alot of this turnover may be built in to the way Americans get health insurance. And this may be the doing not of individual patients so much as their employers, who are always on the lookout to switch plans for lower-cost coverage. (posted 9/2007)

Visiting Professor Frank Harrell, PhD Held Seminar
Frank Harrell , Ph.D., founding Chair of the Department of Biostatistics at Vanderbilt University, visited on Tuesday, May 22 to give a seminar entitled "Presenting Regression Models to Clinicians". Dr. Harrell has devoted his career to the study of patient outcomes. In particular he has worked on accurate prognostic and diagnostic models. Dr. Harrell`s work has been applied to health services and outcomes research, technology evaluation, observational databases, and clinical trials. During his visit to Cleveland, Dr. Harrell gave a full-day short course for the Cleveland Chapter of the American Statistical Association regression modeling strategies.(posted 6/2007)

Center Member Sudano to Present Two Abstracts at IADR in New Orleans
Joseph Sudano, PhD, faculty will present two abstracts at the 85th General Session of the International Association for Dental Research to be held in New Orleans March 21-24, 2007. Co-author of both papers, Dr. Sudano will personally present: “Relationship Between Adult Oral Health, Depression, Pain and General Health”. (posted 3/2007)

Graduate of the Clinical Research Scholars Program to Receive Young Investigator Award
John Carey, M.D., M.S., a recent graduate of Case`s Clinical Research Scholars Program and Clinical Associate in the Department of Rheumatic and Immunologic Diseases at the Cleveland Clinic, has been selected to receive the International Society for Clinical Densitometry`s Young Investigator Award for his abstract (co-authored by Center faculty Thomas E. Love, Ph.D.) for his work: "The Impact of Subject Demographics on Young Adult DXA Z-Scores." Carey will present the work at the ICSD Annual Meeting in Tampa, Florida on March 15, 2007. (posted 2/2007)

Center Faculty Lead in Region-wide Partnership to Improve Quality of Care
The MetroHealth System led a region-wide partnership - of primary care physicians, employers, health plans, and public health agencies – in winning a $600,000 grant from the Robert Wood Johnson Foundation’s “Aligning Forces for Quality” program. Announced February 1st, the Northeast Ohio application was among 68 nationwide, of which 10 communities were awarded grants to measure and improve quality of outpatient care for patients with chronic conditions such as diabetes, heart disease, and asthma. Center Director Randall Cebul will serve as Project Director for the NEO Aligning Forces initiative, although he credits strong partnerships with others in the region – including the leadership of NEO’s primary care practices, the Center for Community Solutions, the Health Action Council, and NEO’s public health agencies – in producing the successful proposal. See coverage by the Plain Dealer and announcements by the RWJF and the Health Action Council. (posted 2/2007)

National Science Foundation Dissertation Improvement Grant Awarded
Constance Liu, a student in Case Western Reserve University`s MD/PhD in Health Policy Program, has been awarded a $12,000 Doctoral Dissertation Research Improvement Grant from the National Science Foundation. Her study, which is being carried out in collaboration with the Center for Health Research and Policy, focuses on geographic access to health care for a poor, diabetic population served by the MetroHealth System. The results will clarify the interpretation of studies that use distance as a measure of geographic access, and may additionally guide the selection of geographic measures in future studies carried out in an urban context. CHRP faculty member, Dr. Douglas Einstadter, is serving as a voting member of her dissertation committee. (posted 2/2007)

Henry Glick, PhD Presents Two Seminars on Economic Analysis of Research Trials, January 5th
Henry Glick, Ph.D. presented two special seminars concerning "The Economics of Obesity" and "The Economic Analyses in Clinical Trials"at MetroHealth Medical Center, Rammelkamp Research & Education Building. Professor Glick received his M.A. and Ph.D. in Public Policy Analysis from the University of Pennsylvania. He has more than 20 years of experience in conducting economic assessments of medical therapies. He specializes in economic assessments conducted as part of clinical trials. Henry is currently the chair of the Economics Committee for "Studies to Treat or Prevent Pediatric Type 2 Diabetes (STOPP-T2D) Prevention Study" and co-chair of the Economics Committee for the "Action for Health in Diabetes (LookAHEAD) Study", two large, randomized trials sponsored by the National Institute of Diabetes and Digestive and Kidney Disease. (posted 12/2006)

Bridges to Excellence National Coordinator Delivers 2006 Lecture on Health Care Economics and Policy
Francois de Brantes, BTE National Coordinator, spoke on: "Improving the Value of Health Care: Lessons Learned from Bridges to Excellence” at Cleveland`s Union Club on Friday November 10th. (posted 11/2006)

Rhoderick Machekano Guest Speaker at November ASA Meeting
Center faculty member, Rhoderick Machekano, Ph.D., MPH, spoke at the November 1, 2006 American Statistical Association meeting (held at MetroHealth). The topic of his talk was “Efficacy Studies of Malaria treatments in Africa: Efficient Estimation with Missing Indicators of Failure.” (posted 11/2006)

Dr. Katzan Honored for Work in Stroke Research
Irene Katzan, MD, MS, faculty member in the Center for Health Care Research and Policy and Director of the Northeastern Ohio Stroke Outcomes Research Program (SORP), was honored with the 2006 Pacesetter Award for Excellence in Stroke Research and Treatment at the American Heart Association’s annual Gala event in Cleveland on Saturday June 3rd. Others honored with this award were Anthony Furlan MD (Cleveland Clinic), Joseph Hanna MD (MetroHealth Medical Center), and Dennis Landis MD (University Hospitals of Cleveland), all of whom are members of SORP. The award recognizes physicians who have worked to advance the care of stroke patients regionally and nationally. (posted 6/2006)

Time of Day Caesarean Sections Performed does not Impact Complications
Concerns that sleep deprivation increases medical errors has led to increased scrutiny of the quality of medical care during night shifts. In a poster presented at the Society for Maternal Fetal Medicine in early February, Jennifer Bailit, MD, MPH from the Center for Health Care Research and Policy presented data from a study that compared complications from Caesarean sections by time of day. Data from over 18,000 Caesarean Sections at 13 medical Centers between 1999 to 2000 was reviewed. Caesarean births that occurred on the night shift did not have higher rates of complications from mother or newborn compared to births that occurred during the day. Data was adjusted for age, race, insurance status, medical conditions in the mother and the presence of preeclampsia. (posted 5/2006)

The Western Reserve Geriatric Education Center (WRGEC) received full funding for the next 5 year grant cycle, which will carry the WRGEC activities through to 2010.
The funding allows the WRGEC to pursue three themes of interest as determined by a needs assessment distributed last fall to past program participants. The three theme areas include geriatric palliative and end-of-life care, geriatric mental health care, and reducing disparities in geriatric care. Included within these themes are activities that will expand curriculum on cancer and aging, determination on capacity in mental health care, and a faculty development program on palliative care. An addition was also made to the consortium which consists of Case Western Reserve University (headquarters), Northeastern Ohio Universities College of Medicine, Ohio University College of Osteopathic Medicine, Miami University, and now Medical University of Ohio (formerly Medical College of Ohio). Congratulations to Dr. Julia Rose and her staff at the WRGEC!

Institutional Partnerships in Diabetes Research Featured in June 2005 Case Medlines
[See pages 4-5 here.]

David Cutler, Professor of Economics at Harvard`s Department of Economics and the Kennedy School of Government, delivered the Center`s Inaugural Lectureship in Health Economics and Policy on Friday, April 15th, at the Cleveland Union Club
The talk, entitled: "Prescriptions for Better Health Care: What Greater Cleveland Can Learn From Other Regions", was attended by over 75 representatives of business, provider organizations, government, and academia. Copies of slides are available from his Friday lecture as well as Thursday`s McMyler Lecture: "Your Money or Your Life: Strong Medicine for America`s Health Care System".

NIH "Roadmap" Grant Awarded to Re-Engineer Training in Clinical Research
Researchers at Case, the Cleveland Clinic Foundation, and MetroHealth`s Center for Health Care Research and Policy partnered to assemble a winning Multi-disciplinary Clinical Research Training Grant under the NIH Director`s new "Roadmap" initiative - one of seven awarded nationally in stiff competition. The $13.4 million project will emphasize the mutual benefits of scientists across the disciplinary spectrum working together to study and improve the public`s health. Project PI Richard Rudick, CCF`s Chairman of Clinical Research, will co-lead the training program with Center Director Randall D. Cebul, MD and Pedro Delgado, MD, Professor and Chairman of the Department of Psychiatry at University Hospitals. The program`s curriculum builds on the successful NIH-supported Clinical Research Scholars Program and will include important new seminars and courses to be developed in collaboration with key faculty throughout the medical school, Weatherhead School of Management, and the Bolton School of Nursing.

Center Faculty Receive Awards for Teaching Excellence
Congratulations both to Tom Love and Doug Einstadter whose teaching contributions at the School of Medicine were recognized. Both received awards for "Best Contributions" by the SOM Teaching Excellence Awards Committee in this first year of the annual awards process. Tom`s award is for his contributions and teaching of Biostatistics in the post-doctoral Clinical Research Scholars Program; Doug will be recognized for his leadership and teaching in Fundamentals of Medical Decision Making, in the School`s Core Academic Program. Well deserved recognition - congratulations!

Center Faculty Receive Award for Outstanding Short Course
Congratulations to Randall D. Cebul, M.D., Neal V. Dawson, M.D., and Thomas E. Love, Ph.D. on being presented with an award for "Outstanding Short Course" in recognition of outstanding development and teaching of Reducing Bias in Observational Studies: Propensity Methods. This course was presented at the Society of Medical Decision Making`s 25th Annual Meeting in Chicago, which ran from October 18-22, 2003. Course materials are available at http://www.chrp.org/propensity/.

CWRU School of Medicine Wins National AMSA Award for Activism
At the March 22nd national meeting of the American Medical Student Association in Washington, D.C., the CWRU School of Medicine was awarded the 2003 Paul R. Wright Award in Medical Education for its exceptional focus on activism in medicine and for the integration of advocacy skills training into the medical education curriculum [CWRU News story].

Mentioned prominently in the application by medical students Kyle Dinsio, Chris McCoy, Connie Liu, and Alexander Tsai were several Center-directed activities, including the course "Activism and Medicine" coordinated by Ashwini Sehgal, M.D., the AHRQ-supported MD-PhD Program in Health Services Research, led by Randall D. Cebul, M.D., and the Primary Care Track, led from 1999-2002 by past Center member Linda A. Headrick, M.D., and whose research curriculum is directed by Douglas Einstadter, M.D., M.P.H..

General Internist-Clinical Epidemiologist Ralph I. Horwitz, M.D. named CWRU VP for Medical Affairs and Dean of the School of Medicine.
Effective April 1st, Dr. Ralph Horwitz assumes his new posts as CWRU`s Vice President for Medical Affairs and Dean of the School of Medicine. Dr. Horwitz is known to many here at CWRU and the Center as the Co-Director of Yale`s Robert Wood Johnson Foundation Clinical Scholars Program (since 1978); as a researcher who has made major methodologic contributions in clinical epidemiology over the past 25 years; and, more recently, as Chair of Yale`s Department of Medicine. In a statement issued at the time of his recent appointment, Dr. Horwitz stated: "A particular passion of mine is the social contract linking the practice of medicine to the civic responsibility of the profession of medicine, and I see the embodiment of that in the affiliation with MetroHealth Medical Center." Needless to say, we are delighted that CWRU has attracted Dr. Horwitz to Cleveland! Link.

The Society for Medical Decision Making Helps CDC in Assessing Bioterrorism.
See story here.

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