Our Publications

In this article by Yuvaram Reddy, Sri Lekha Tummalapalli, and Amol Navathe, the authors cover the state of Alternative Payment Models (APMs) and the value they provide towards the goal of controlling Medicare costs, in relation to a recent publication by Keating et al.

In this paper from The Parity Center and in collaboration with Dr. Joshua Liao, the authors compared two definitions of ambulatory safety net and investigated the extent to which those definitions of safety-net practices overlap. The authors found that alternative definitions of the ambulatory safety-net yielded nonoverlapping groups of practices, which may complicate efforts to target these practices for funding purposes.

In this Viewpoint from JAMA Internal Medicine, Deputy Director Austin Kilaru along with his coauthors discuss the future of the Hospital at Home program, potential directions the program can be taken, and what pitfalls to avoid in the programs renewal.

In this Health Affairs Forefront, authors Joshua Liao and Amol Navathe discuss the upcoming Ambulatory Specialty Model (ASM) which seeks to address specialist engagement in accountable care models.

In this Health Affairs Perspective article,  authors Sita Kottilil and Amol Navathe investigate the tension between input-based prices and outcome-based care by comparing and contrasting payment for AI with the approach for prescription drug pricing and propose a classification system to distinguish between the types of AI that differ in their implications for clinician time and cost. 

In this randomized clinical trial of 80 039 patients across 48 clinics, the multicomponent nudge to clinicians and patients resulted in a 5.1–percentage point increase in vaccine completion.

This cohort study of IOTA and ETC/IOTA ‘overlap’ centers analyzed differences between the two groups. Through their findings the authors argue that more dedicated research is needed to understand whether overlapping payment structures are beneficial for kidney treatment.
 

In this cohort study of health care organizations voluntarily transitioning to risk-based payment contracts, contract transition was not consistently associated with differential changes in utilization or low-value service use relative to organizations that did not change contract type.

In this study, the authors investigated how related HCC scores are to mortality, a more objective indicator of clinical risk state, and whether that relationship differs between rural and urban populations. They examined calibration of the HCC spending model by calculating the predicted-to-observed spending ratio within deciles of the HCC score. They then compared urban and rural beneficiaries’ clinical risk by comparing observed mortality rates within deciles. Our results demonstrate that the HCC model underpredicts mortality, while overpredicting spending, for rural beneficiaries. In contrast, it is well-calibrated for urban beneficiaries. These findings suggest that risk models based on HCCs may systematically disadvantage rural beneficiaries because HCC-based risk-adjusted spending may not fully account for baseline clinical risk.

In this paper the authors provide a comprehensive review of the staggered adoption setting and a selection of DiD methods suitable for the context of a payment program implemented by a healthcare provider in Hawaii. They begin with a theoretical overview of these methods, followed by a simulation study designed to resemble the characteristics of their application, where the intervention is implemented at the cluster level. Their results show that the current methods tend to under-perform when the number of clusters is small, but improve as the number of clusters increases. They then applied the methods to evaluate the real-world payment program intervention and offer practical recommendations for researchers implementing DiD methods for staggered adoption settings. Finally, they translate their findings into practical guidance for applied researchers choosing among DiD methods for staggered adoption settings.