Studying incentives and payment models that can support integrated care

Presentations from SIREN 2019 National Research Meeting

Day 2 (2/5) 10:30 - 11:45am

Session Description

This session will showcase recent research conducted on health policies designed to facilitate social health interventions, including from Massachusetts, Oregon, California, and Washington State. Group discussion will engage participants around opportunities for new policy research that could strengthen implementation and dissemination efforts in this field.

Moderator

Pamela Riley, MD, MPH, Medical Director, DC Medicaid

Dr. Pamela Riley joined the District of Columbia Department of Health Care Finance in August 2018, serving as Medical Director for the DC Medicaid program. In this capacity, she oversees medical administration and quality of care in the District of Columbia’s Title XIX (Medicaid), SCHIP and Alliance Programs. Dr. Riley was most recently vice president for Delivery System Reform at The Commonwealth Fund.

Speakers

Erika Cottrell, PhD, MPP, Assistant Professor, OHSU Family Medicine; Investigator, OCHIN

Dr. Cottrell is a Research Assistant Professor in the Department of Family Medicine at Oregon Health and Science University (OHSU) and an Investigator at OCHIN, a nonprofit health innovation center committed to conducting research to improve the health of underserved populations. She earned her PhD in Sociology from the University of Wisconsin-Madison, her Masters in Public Policy from Harvard University, Cambridge, MA, and her BA in Anthropology from Luther College, Decorah, IA. Dr. Cottrell has an active portfolio of research focused on identifying and addressing social determinants of health in primary care; understanding and disseminating patient health experiences; and evaluating the impact of payment and policy changes on health care access, utilization, and outcomes.

Presentation: "Studying Oregon’s Alternative Payment Methodology Pilot"

Arlene Ash, PhD, Professor, University of Massachusetts

Arlene Ash, PhD, is Professor and Division Chief for Biostatistics and Health Services Research, Department of Population and Quantitative Health Services, University of Massachusetts Medical School. She has developed risk adjustment models for health care delivery systems, including those now used by the US Medicare program. Since 2014 she has worked with MassHealth to develop risk models for paying and monitoring quality for Medicaid ACOs that account for social as well as medical risk.

Presentation: "Using SDoH Data in Rate Setting: MassHealth Risk Adjustment Model"

Hugh Alderwick, Assistant Director of Policy and Strategy, The Health Foundation

Hugh Alderwick is Assistant Director of Policy and Strategy at the Health Foundation in London--an independent foundation committed to improving health and health care through research and policy analysis. In England, Hugh's work focuses on national health system reforms, health and social services integration, and opportunities to improve population health. In 2017-18, Hugh was a Harkness Fellow at the University of California, San Francisco (UCSF). Hugh's research in the US focuses on health system policies and approaches to address patients' social needs.

Presentation: "Understanding Medicaid investments to address patients’ social needs"

Bill Wright, PhD, Director, CORE, Providence Health & Services

Bill J. Wright, Ph.D., is the Director of CORE – the Center for Outcomes Research & Education at Providence St Joseph Health. Dr. Wright is a sociologist with a principal focus on social research methods; he specializes in longitudinal research with low-income and vulnerable populations. His research focuses primarily on the intersection between health policy, health systems design and the social determinants of health. Dr. Wright has led numerous studies in this arena, and he was a principal investigator on the Oregon Health Insurance Experiment, the first-ever randomized trial on the effects of having health insurance vs. not having health insurance. His current research examines the social determinants of health and the impacts that accountable communities of health and similar cross sector initiatives play in helping address them to improve health and health equity outcomes.

Presentation: "Evaluating Clinical-Community Integration through a Systems & Policy Lens: Washington's ACH Model"