Performance Improvement 1999. Health Policy

02/01/1999

TITLE: Enabling Services Methodology Workshop

ABSTRACT: This project seeks to address enabling services issues by: (1) exchanging information regarding what is known and unknown about enabling services in primary care settings, particularly in managed care environments, costs, efficacy, cost-effectiveness and new research efforts; (2) identifying key policy questions related to enabling services, particularly as used in managed care settings; (3) identifying major methodological questions that studies of these services present, both generally and in managed care settings, and strategies for overcoming them; and (4) developing a broad-based research agenda for consideration by the many public and private sector organizations which pay for, or otherwise have interests in, these services.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Caroline Taplin

PHONE NUMBER: 202-690-7906

PIC ID: 6750

PERFORMER ORGANIZATION: The Lewin Group Fairfax, VA

PROJECTED DATE OF COMPLETION: 10/1/98
 

TITLE: State Linked Data Meeting and Monograph

ABSTRACT: Data from a single source is frequently inadequate to examine effectively the relationships between and among costs, services and health outcomes. As a result of research and other efforts by the Federal government, foundations and States, a pool of experienced researchers and program administrators have created the linked data sets needed to examine the complicated relationships between and among programs. Sharing lessons learned in a meeting with the Federal research and data community will improve the Department of Health and Human Services (HHS) studies and help focus data initiatives. Sharing this information with the broader research and data community through a monograph will help encourage additional efforts, and may make such projects less daunting for those who follow.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Caroline Taplin

PHONE NUMBER: 202-690-7906

PIC ID: 6346

PERFORMER ORGANIZATION: MEDSTAT Group Cambridge, MA

PROJECTED DATE OF COMPLETION: 11/1/98
 

TITLE: Evaluating the Effects of Direct-to-Consumer Advertising on Consumers

ABSTRACT: The goal of this project is to improve our understanding of direct-to-consumer (DTC) advertising. The relation of this kind of advertising to aspects of public health will be examined through a survey of selected consumers and the Food and Drug Administration (FDA) Center for Drug Evaluation and Research's (CDER) analysis of that survey. This analysis will yield an initial broad description of some possible associations between DTC advertising and consumer knowledge, attitudes and behaviors. The survey and CDER's descriptive analysis will lay the foundation for the long- term task of determining what effects DTC advertising may have on overall consumer knowledge, attitudes and behaviors concerning prescription drugs and the overall effects of this practice on the public health.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Susannah Bruns

PHONE NUMBER: 202-690-7996

PIC ID: 6343

PERFORMER ORGANIZATION: Market Facts, Inc. McLean VA

PROJECTED DATE OF COMPLETION: 1/1/99
 

TITLE: Preventing Abusive Intimate Relationships Among Adolescents

ABSTRACT: The role of abusive relationships in the lives of adolescents is not as well researched or understood as either adult domestic violence or child abuse. A recent study found that 60 percent of young women who had sex before age 15 were involved in coercive sexual relationships. Apart from this study there is little research on coercive, controlling, or abusive relationships among teenagers. A new source of data in this area, the National Longitudinal Study of Adolescent Health (Add Health) has just been made available to the public. This project will examine the issue of abusive relationships among teenagers through a literature review, analysis of available data, identification of data needs, focused discussion groups, a summary of promising approaches to prevention and intervention and recommendations for further research and discussion.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Sandra Howard

PHONE NUMBER: 202-690-7778

PIC ID: 6751

PERFORMER ORGANIZATION: Research Triangle Institute Research Triangle Park, NC

PROJECTED DATE OF COMPLETION: 1/1/99
 

TITLE: Innovative Coverage of Health Promotion, Clinical Preventive Services, and Other Coverage Issues in the Private Sector

ABSTRACT: Despite the important private sector employers play in shaping the current health care market, the views of this group concerning the provision of a variety of clinical preventive services and what their health plans currently provide have not been adequately described. In addition, the factors which influence their decisions to include or exclude such services have not been characterized. In collaboration with the Office of Disease Prevention and Health Promotion (ODPHP), and the Office of the Assistant Secretary for Planning and Evaluation (ASPE), researchers are forming a partnership with Partnership for Prevention to support the commissioning of a set of expert papers on the clinical preventive service benefits offered by employer-sponsored health plans. These papers are intended to meet two objectives: (1) to characterize the trends and decision processes occurring within the private sector; and (2) to evaluate the impact of government information on this issue in the private sector. As the government is investing its resources in producing and disseminating information designed to encourage the appropriate use of clinical preventive services, it is important to know how its customers in the private sector perceive and use such information.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Caroline Taplin

PHONE NUMBER: 202-690-7906

PIC ID: 6347

PERFORMER ORGANIZATION: Partnership For Prevention, Washington D.C.

PROJECTED DATE OF COMPLETION: 1/30/99
 

TITLE: Analysis of Prescription-To-Over-The-Counter Switch Movement

ABSTRACT: There are now more than 600 over-the-counter (OTC) drugs which would have required a prescription only twenty years ago. These products are now available without a prescription because the Food and Drug Administration (FDA), determined that they could be used safely and effectively without a doctor's supervision. In the last few years alone, several important and widely used drugs have been switched to OTC status: Children's Motrin (ibuprofin), (2) Orudis KT (ketoprofen) for pain relief and fever reduction, (3) Femstat 3 (butoconazole nitrate) for vaginal yeast infection, and (4) several heartburn medications like Pepcid AC (famotidine). Consumers have responded enthusiastically, turning OTCs into a $19 billion a year industry, with the total retail market value of four billion dollars. Despite the far-reaching effects on the switch movement, there is a relatively sparse study of this trend. If it can be assumed that consumers will continue to self-medicate and that this trend will continue, factors determining the impact on public health need to be examined. This project will provide a comprehensive review and analysis of the prescription-to-over-the-counter switch movement, through several analytical methods, and with an overall emphasis on the impacts of the switches on public health, consumer information, choice and decision making, the doctor-patient relationship, pharmaceutical pricing, profits, health care costs and managed care policy.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Laina Bush

PHONE NUMBER: 202-205-5271

PIC ID: 6723

PERFORMER ORGANIZATION: Northwestern University, Center for Health Services and Policy Research, Evanston IL

PROJECTED DATE OF COMPLETION: 4/1/99
 

TITLE: An Inventory of Federal HIV-Related Databases

ABSTRACT: This project will develop an inventory of major Federally sponsored HIV-related databases. The inventory will describe the relevant databases and review their potential applications for administrative, clinical research, epidemiologic, financing, policymaking, or program administration purposes. It will also identify key research questions that could be addressed by these databases and identify opportunities for cross-agency collaboration in data collection or analysis. The project will produce a final report including an annotated inventory, as well as the relevant database assessments that point to key research issues and opportunities for interagency collaboration and cross-cutting analyses.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Leslie Hardy

PHONE NUMBER: 202-690-7858

PIC ID: 7146

PERFORMER ORGANIZATION: The George Washington University Medical Center Washington, D.C.

PROJECTED DATE OF COMPLETION: 6/20/99
 

TITLE: Statistical Linkage of Data Files for Evaluation: National Health Interview Survey and Survey of Income and Program Participation

ABSTRACT: This project, jointly sponsored by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the National Center for Health Statistics (NCHS), will establish analytical and modeling databases derived from statistical matches of the National Health Interview Survey (NHIS) and the Survey of Income and Program Participation (SIPP). The resulting analytical database will also be useful for analysis of inter-relationships between health status and health care use, socioeconomic factors and a range of income and program participation data from SIPP. The linked database will support sophisticated analyses to aid in understanding the interrelationships between health and human services variables. It will also support policy analyses through microsimulation modeling and other analytical techniques.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Joan Turek

PHONE NUMBER: 202-690-6141

PIC ID: 6419

PERFORMER ORGANIZATION: Urban Institute Washington, D.C.

PROJECTED DATE OF COMPLETION: 6/30/99
 

TITLE: Consequences and Cost of Intimate Partner Violence

ABSTRACT: This project will apply the methodology developed in "The Cost of Domestic Violence to the Health Care System" (PIC ID No. 4528) to prevalence and other data related to violence committed by adult intimate partners. The study will document the incidence of violence against women by intimate partners, estimate economic costs of related injuries and develop preliminary recommendations for reducing incidence and related injuries. It will form the basis for a report to Congress, authorized under the Crime Act. This project will be jointly funded by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Centers for Disease Control and Prevention (CDC). See also PIC 4528.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Sandra Howard

PHONE NUMBER: 202-690-7778

PIC ID: 4528.1

PERFORMER ORGANIZATION: University of California, San Francisco, Institute for Health and Aging, San Francisco CA

PROJECTED DATE OF COMPLETION: 7/1/99
 

TITLE: Evaluation of the Oregon Medicaid Reform Demonstration

ABSTRACT: The disability supplement to the existing Health Care Financing Administration (HCFA) evaluation of the Oregon Medicaid Reform Demonstration attempts to add a disability focus to the Statewide evaluation. This supplement will focus on the experiences of disabled children and adults (physically disabled, mentally retarded, or developmentally disabled) who are enrolled in the Oregon Health Demonstration. The disability supplement will examine cost and utilization data, and will link this data to functional data collected by State agencies and managed care plans. In addition, the supplement will conduct a survey of consumers and providers to examine issues of satisfaction, access, quality, health status and functioning. See PIC ID 6166 and the 6289 series.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Kevin Hennessy

PHONE NUMBER: 202-690-7272

PIC ID: 6166.1

PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA

PROJECTED DATE OF COMPLETION: 8/31/99
 

TITLE: The Changing Structure of Health Insurance Markets

ABSTRACT: This project will result in two research papers evaluating the following: (1) insurance market changes relating specifically to State laws complying with the Health Insurance Portability and Accountability Act of 1996, and (2) the relationship between health insurance market structure and health insurance coverage of the population. This study builds on an ongoing effort funded by the Robert Wood Johnson Foundation to compile an expanded and updated insurer database and to conduct several basic analyses of health insurance market structure, change and performance. State insurance markets are not well understood and have seldom been systematically studied in a manner that can inform public policy discussions and development. These products will contribute significantly to the public's understanding of how insurance markets are changing.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Stephen Finan

PHONE NUMBER: 202-690-7387

PIC ID: 7160

PERFORMER ORGANIZATION: Alpha Center Washington, DC

PROJECTED DATE OF COMPLETION: 9/20/99
 

TITLE: Developing a Framework for Domestic Infectious Diseases Surveillance

ABSTRACT: The purpose of this study is to develop an analytic framework that can be used to help create consensus on core capacities needed at each level of government for effective national infectious diseases surveillance. Emphasis will be placed on several areas including: (1) defining the relative roles of each level of government, and of the public and private sectors; (2) analyzing resource issues with particular attention to sources of funding, and to categorical versus integrated funding streams; (3) translating surveillance activities into meaningful public health responses; (4) evaluating surveillance activities; and (5) identifying training needs. The study will take into account the rapidly changing environment, especially the role of local health departments, and the changing nature of infectious diseases. The work will consist of: (1) collecting and analyzing data and information from the literature and from experts; (2) using this information to develop an initial framework describing what is needed for effective surveillance; and (3) establishing an expert panel which will use the framework as a tool to reach consensus on the minimum core capabilities needed at each level of government, and the relative roles of the public and private sector for more effective national infectious diseases surveillance.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Caroline Taplin

PHONE NUMBER: 202-690-7906

PIC ID: 7161

PERFORMER ORGANIZATION: The Lewin Group Fairfax, VA

PROJECTED DATE OF COMPLETION: 9/20/99
 

TITLE: Access and Utilization of New Antidepressant and Antipsychotic Medications

ABSTRACT: The proposed project involves a collaboration with the National Institute of Mental Health (NIMH). Very little is known about how and why decisions are made regarding insurance coverage for many of the newer antidepressant and antipsychotic medications. The proposed study will provide important insight and knowledge from multiple perspectives (and with regard to multiple programs) concerning the often complex processes related to access, utilization and coverage of newer psychotropic medications. This new knowledge will serve to inform the department in efforts to evaluate existing and proposed policies.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Kevin Hennessy

PHONE NUMBER: 202-690-7272

PIC ID: 7193

PERFORMER ORGANIZATION: The Lewin Group Fairfax, VA

PROJECTED DATE OF COMPLETION: 9/20/99
 

TITLE: Construction of an Integrated Measure of the Burden of Disease

ABSTRACT: The burden of disease in a population consists of the morbidity and disability experienced by its members, their psychological perception of the adequacy and effectiveness of the care they receive, and resources expended for health maintenance. The essence of medical care is to determine the balance among these components that will most enhance overall health. The objective of the proposed project is to develop and evaluate analytic techniques that will permit: (1) the construction of an integrated measure of the burden of disease based on the explicit assessment of what trade-offs are currently accepted; and (2) identify changes in strategies to optimize the mix.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Kevin Hennessy

PHONE NUMBER: 202-690-7272

PIC ID: 7142

PERFORMER ORGANIZATION: The Lewin Group Fairfax, VA

PROJECTED DATE OF COMPLETION: 9/27/99
 

TITLE: Safety Net Framework Project

ABSTRACT: The Nation's health care provider safety net consists of: (1) hospitals, (2) primary care facilities, (3) specialized service providers such as family planning clinics, HIV service providers, community mental health centers, drug and alcohol treatment clinics, and (4) individual practitioners. These providers operate under both public and private auspices. As a group they are diverse, with varied funding sources including: (1) Medicaid and Medicare patient revenues and other payments, (2) Federal grant support from multiple sources, (3) other grants, (4) State and local public funding, (5) limited private third party insurance, (6) patient fees (often sliding scale), and (7) private philanthropy. Federal policy affects these providers in several ways. Products from this project will include a series of working papers, a workshop summary and a final "framework" document. The project is intended to result in new ways of shaping the Department's views concerning safety net providers. In particular, the Department plans to have a structure which considers how Federal grant programs, payment policies and other Federal policies affect these providers as they interact among each other at the community level.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Caroline Taplin

PHONE NUMBER: 202-690-7906

PIC ID: 7156

PERFORMER ORGANIZATION: Northwestern University, Evanston IL

PROJECTED DATE OF COMPLETION: 9/28/99
 

TITLE: Impact of Medicare HMO Enrollment on Health Care Costs in California

ABSTRACT: The Office of the Assistant Secretary for Planning and Evaluation (OASPE) is supporting a time series study of the relationships between competition in hospital markets and the prices of hospital care, hospital revenues and hospital costs. The project began in the late 1980s and was extended in 1994 to investigate how health maintenance organization (HMO) enrollment affects changes in Medicare payments on behalf of beneficiaries. The project will collect time series data on California Hospitals (cost reports supplemented by a small survey on selective contracting by the hospital) to investigate whether competition continues to depress hospital prices, revenues and costs. In addition, several smaller projects are underway to investigate whether hospital mergers result in increased prices and a series of investigations (individual and county level) to determine if HMO enrollment leads to a decline in Medicare costs when other appropriate variables are held constant. California is particularly important in this study, because it tends to be a trend-setting State.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: George Greenberg

PHONE NUMBER: 202-690-7794

PIC ID: 6889

PERFORMER ORGANIZATION: RAND, Santa Monica, CA

PROJECTED DATE OF COMPLETION: 9/30/99
 

TITLE: Evaluation of the Projects for Assistance in Transition from Homelessness (PATH) Program

ABSTRACT: The proposed project involves a collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA) to conduct an evaluation of the Projects for Assistance in Transition from Homelessness (PATH) Program. The objectives of the proposed evaluation are to: (1) assess whether PATH-funded expenditures are consistent with the authorizing legislation; and the adequacy of program controls; (2) develop a typology for better understanding the delivery of local PATH-funded services and assess whether the typology adequately characterizes meaningful differences in process-level variables, such as outreach and engagement activities with clients; (3) provide background information useful in interpreting data collected to meet the Government Performance and Results Act (GPRA) requirements; and to suggest measures that may be used in conjunction with the GPRA mandate; and (4) examine, where possible in site visit programs, existing administrative or client-level data to describe relevant outcomes for a sample (albeit non-representative) of PATH program participants.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Kevin Hennessy

PHONE NUMBER: 202-690-7272

PIC ID: 7210

PERFORMER ORGANIZATION: Westat, Inc. Rockville, MD

PROJECTED DATE OF COMPLETION: 8/20/00