Ambulatory Surgery Centers  Specialized ASCs more cost efficient than

Ambulatory Surgery Centers Specialized ASCs more cost efficient than multispecialty ASCs Supports focused factory model of delivery Interesting because opposite of SSH studies Readmissions HRRP is an Obamacare survivor CMS is expanding target conditions But new payment systems can have unintended consequences . . . Price Transparency CMS now reports hospital charges Who are the audiences? Is the market responding – Supply side? Demand side? SNH Financial Performance under the ACA New opportunities but also new challenges May affect SNHs differently Critics focusing on # insured, budget, mandates What about providers? Overall financial performance of SNHs Coming from where – Cost side? Revenue side? Bundled Payment Comprehensive Care for Joint Replacement Mandatory in 67 randomized MSAs Randomization has been done by CMS What are intended and unintended effects? More admissions? Up-coding? SNHs?

Research Stephanie Shimada, Interests PhD Implementation and Evaluation of Patient- Facing eHealth Technologies My HealtheVet Patient Portal and PHR Adoption and use Use of specific features to support effective self- management for chronic disease (e.g., diabetes) Annie text messaging system Addressing disparities in adoption and use Unintended consequences of eHealth technologies Intervention design (participatory design) and implementation

Nicole Huberfeld Center for Health Law, Ethics & Human Rights VT WA MT ME ND NH MN OR* SD ID MI WY NV* PA IA NE IL UT CO CA OH IN WV KS MO KY* OK NM* AK TX AL NJ DE MD DC SC AR* MS VA CT RI NC TN AZ MA NY WI GA LA FL HI State-based Marketplace and Adopted the Medicaid expansion (16 States including DC) State-based Marketplace and Not Adopting the Medicaid expansion at this Time (1 State) Federally-Facilitated or Partnership Marketplace and Adopted the Medicaid Expansion (16 States) Federally-Facilitated or Partnership Marketplace and Not Adopting the Medicaid Expansion at this Time (18 States) NOTES: *AR, KY, NM, NV, and OR are state-based Marketplaces using the federal healthcare.gov platform. SOURCE: State Decisions on Health Insurance Marketplaces and the Medicaid Expansion, KFF State Health Facts, updated January 1, 2017. http://kff.org/health-reform/state-indicator/state-decisions-for-creating-health-insurance-exchanges-and-expanding-medicaid/.

Gemmae M. Fix, PhD Applied Medical Anthropologist with postdoctoral training in Health Services Research Expertise – ethnographic methods, including interview & observation – patients’ illness experiences, including comorbidity management – patient & provider behaviors GMFix conducting fieldwork Teaching: PH844 Introduction to Qualitative Methods Research – patient-centered care initiatives; HIV care – VA funded Career Development Award (CDA 14-156) Design: ethnographic approach to understand the daily life context of aging Veterans with HIV & comorbidities [see figure] Next Steps – develop patient-centered interventions Life History Clinical Status Social Life Health & Behaviors HIV Status Daily Routine

Jack Clark, medical sociologist Interested in health practices: how people, as members of society, look after their health and the health of others Discovered “regret” as an outcome of prostate cancer treatment Recent, current research – Veterans’ decisions to seek care at the VHA – Coordinating health services provided by VHA and community clinics in rural areas – Assisting others: decisions to offer and accept HPV vaccination; communication and care planning with patients with advanced liver disease Teaching – PM 814: Contemporary Theoretical and Empirical Issues in Health Services – PM 826: Health, Illness, and the Use of Health Services – PM 755: Health Care Delivery Systems: Issues and Innovations (as needed)

Engagemen t Analysis Interactio n Organizati on Communicatio n

Mari-Lynn Drainoni, PhD, MEd Research Methods Expertise: – Implementation science – Qualitative methods – Program evaluation Full research funding - content areas: – Infectious Diseases (HIV, HCV, STIs, ASPs) – Substance use, mental health, disability, pediatrics Other Major BU Activities: – – – – – CIIS Co-Director Co-Director, HSR PhD Program Director, HSSR MS Program PI, NIDA T32; BU PI, AHRQ T32 Instructor, Implementation Science: Translating Research into Practice

CDC Federal Quarantine Regulations Firearm Regulations – Review Standard Individual can be held for 6 days before requesting a review No guarantee of an attorney No independent oversight Financial costs aren’t necessarily covered No compensation for lost wages No protection from discrimination Uncertainty how judges should review gun regulations Gun violence public health problem Standard for public health regulations is lenient Supreme Court will take a gun case soon NRA wants nationwide open carry

Megan Cole Research interests focus primarily on Medicaid and safety-net populations, and how state and federal health reform efforts affect health care coverage, quality, and equity for these populations. Teaching - Fall 17: PM 837: Evaluating Health Care Quality - Spring 18: MS paper writing course - Recent & Ongoing Research Impact of Medicaid expansion on community health centers Trends in comorbid conditions amongst Medicaid enrollees with HIV RI PCMH evaluation Evaluation of behavioral health integration into pediatric medical home in health centers BMC ACO Upcoming Research - Role of insurance in access to and equity in access to Rx & specialty care for safety net pts - Quality of care for HIV and non-HIV Medicaid enrollees - RI cost cap

School of Public Health Department of Health Law Policy & Management Lynn A. Garvin, PhD, MBA, Clinical Assistant Professor Research U.S. Department of Veterans Affairs (VA), Office of Rural Health Care Collaboration and Orientation to VHA for Rural Community Providers and Health Care Organizations. PIs: Jack A. Clark, PhD and Chris Miller, PhD (VA CHOIR) Collaborative Research of Boston University, Brandeis University and VA, Veterans and Consumers Health Informatics Office Veterans' Patient Engagement and User Satisfaction through Relational Coproduction with Providers Using VA's My HealtheVet Patient Portal. PI: Lynn A. Garvin Teaching PH 718: Leadership and Management in Public Health – Core MPH course that introduces leadership and management in U.S. and global public healthcare PH 825: Theory and Research on Organizations – Doctoral course that introduces perspectives for theory-based research on healthcare organizations (leadership, market and regulatory adaptation, teamwork, organizational learning and change) Service SPH Faculty Director, MPH-MBA Dual Degree Program – Advise and support understanding of the public health context, population health and implications for their coursework and internship experiences.

Steve Pizer Health Economist, returning to BUSPH from Northeastern Taught health economics and advanced causal inference Co-director of health services research doctoral program Focus on applied quantitative methods and “big data” Chief Economist for Partnered Evidence-based Policy Resource Center (PEPReC), located at VA Boston 3 investigators, 3 graduate students, 3 programmers, 2 support, and growing Randomized program evaluations, quality improvement projects 7 projects: opioid risk management, EMR modernization, workforce management, budget forecasting, HCBS, suicide, community care contracting

Barbara Bokhour, PhD PhD in Medical Discourse Studies (psychology, linguistics and cultural studies) Roles: Acting Director, VA Center for Healthcare Organization and Implementation Research, Bedford Campus Associate Professor, HLPM Other BU/ professional roles Participated in development of PhD program Led revision of PhD program curriculum Affiliate investigator – CIIS Medical Anthropology program advisory board member Member Academy Health Methods council Teaching (MSc, Doctoral program) Introduction to research methods Advanced qualitative research methods for HSR Research: Patient-centered care Patient perceptions of health and illness Patient-centered communication Systems of care and patient-centeredness in HIV care in VA Patient-centered care interventions Stories as an educational intervention Evaluating large scale transformation efforts to improve PCC Transformation of VA care towards Whole Health Leading evaluation of transformative efforts on patient reported outcomes, cost and utilization, employee experience of care. Disease areas Chronic illness management (hypertension, child asthma, HIV) Pain (new)

Marty Charns Research & Teaching Interests: How Organizational Factors Quality Affect Organizational change of Care Organizational factors affecting implementation of EBP Organizational factors affecting success of quality improvement projects Organizational transformation – changing the fundamental way a health care delivery organization functions Coordination of care Organization design, especially service line organizations Organizing around diseases and/or populations vs by discipline and profession

1. Species Altering 2. Species Endangering SCIENCE/PUBLIC HEALTH SECURITY/TERROR

Christine Gunn, PhD RESEARCH Pursuing a career development (K) award: Engaging Low Literacy Women to Develop Screening Decision Tools Topic areas: Cancer screening, risk communication, decisionmaking, women’s health Mixed methods research, with more emphasis on qualitative methods and community engagement Current partnerships: Health Care Disparities Unit (Medicine), Clinical Addiction Research & Education Unit (Medicine) TEACHING

Guneet K. Jasuja, PhD Research Assistant Professor Research Health Scientist, VA Areas of interest: Medication Prescribing (variation, overuse, underuse, inappropriate use, guidelineconcordance) Identification of Best Practices and De-implementation of Practices Hormone Therapy Mixed-methods Transgender population

Jon Kingsdale, Assoc Prof of the Practice Former health insurance executive Executive Director, Mass. Health Connector Worked with states/CMS implementing ACA Teach health policy & research consumer behavior

Bright Spots Program Quality Improvement Framework Conference Room Quality Frontline Staff Huddles Team Meetings How can we help nursing home staff make meanin provement gfuCBi-Directional lo,nltainsutoiuns in the ityCommunication of care ths ey provide? ,g im qual LOCK in Success Quality Improvement Cycles Plan Look for bright spots Observations by everyone Collaborate in huddles Keep it bite-size! Do Act Study

Pengsheng Ni, MD, MPH I have a medical degree from Shanghai Medical University and working as a Research Associate Professor at the School of Public Health, Boston University. I bring my extensive training in genetics, a strong mathematical, bio-statistical and computer science background to the development of contemporary patient-reported outcomes technology for health care. I have developed the algorithms to conduct Unidimensional and Multidimensional Computerized Adaptive Testing (CAT) models. I am the key person in developing several patient reported outcome assessments, including the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), Late Life Functioning Disability Instrument (LLFDI) and Activity Measure for Post Acute Care (AMPAC) etc. Current projects: Replenishing Work Disability Functional Assessment Battery (WD-FAB) item bank. WD-FAB is function assessment tool developed for the US Social Security Administration’s (SSA) disability determination process. In this project, we are trying to enrich the content of the existing item banks and increase the reliability of the score at higher and lower end of the scale. Collaborating with Dr. Cheville at Mayo Clinic to develop Computerized Adaptive Testing (CAT) to direct delivery of Hospital-Based Rehabilitation. We are applying Multidimensional CAT to score the instruments and using bookmarking method to create the staging. Developing pain assessment for patients with disorders of consciousness based on the behavioral and physical indicators.

Sara S. (Sally) Bachman, Ph.D. Schools of Social Work and Public Health Director, Center for Innovation in Social Work and Health Paul Farmer Professor at SSW, Research Professor at SPH Research Focus: Financing health care for people with disabilities and chronic illness Principal Investigator: National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs (CYSHCN); Improving Access to HIV Care Using Community Health Workers; Others Faculty Chair, Charles River Campus IRB Teaching at SSW and SPH: Research, Program Evaluation, Policy, CYSHCN

Ann Borzecki, MD, MPH Research Interests: Quality & Patient Safety Measurement; Validation of Performance Measures Completed: Identifying Heart Failure Patients at Highest Risk for Readmission (VA HSRD) Validating and Classifying VA Readmissions for Quality Assessment and Improvement (VA HSRD) Validating the Patient Safety Indicators in the VA (VA HSRD) Ongoing: Patient Safety Center of Inquiry on Measurement to Advance Patient Safety (VA National Center for Patient Safety ) Proposed: Do Facility-Level Avoidable Adverse Event Rates Reflect Differences in Patient Safety or Coding? (VA HSRD) 1

EXCHANGE POLITICS DAVID K. JONES

A. Rani Elwy Crisis and Risk Communication Effectiveness of Complementary and Integrative Health Treatments Dissemination and Implementation Science

Lewis Kazis, Sc.D. Professor of Health Policy and Faculty and Staff (11) Management Director, Health Outcomes Selected Research Projects Unit (HOU) LIBRE-CAT/BH-BIMS (NIDILRR) Quality and outcomes for burn patients (Shriners Hospitals for Children) WD-FAB CAT (NIH/SSA) Opioids and physical therapy in low back pain – (OptumLabs, APTA) VR-12/VR-36 methods and applications (NCI, NIA-RAND) – (SPRINT study) VA Safety Studies (Nursing Homes– CLCs) Large databases (Truven Analytics – MarketScan) - Quality of Care and Geography, Star Rating System-Nursing Homes, Medicare Advantage for profit and non-profit, Anti-depressants in Kids and Systems of Care.

Chris Sheldrick 1993: Cost/benefit B.A. in History (American foreign policy) Uncertainty on Limits ofNICHD rational R01HD072778 m) (Isla negative decision-making d 2004: Ph.D in R01 HD072778-01A1 u Clinical Psychology Feedback t loops 10% S ple Shared decision-making randomScreening sam 2004Department of Implications for packet W Figure. Visualizing threshold probability Figure 2. Policy decision to implement evidence- ostEBP based practice n Arrives for pediatric Frequency 3 B. National Survey of Children with Special 1 2 3 4 5 6 CSHCN), 2010 9 Mil d y 4 yrs Diagnost 7 Test 1: e s I 0.10 0.40% % Moderate n administered? o Decision node t d lic ain n o Median Mean Age Age Overall mean M sta negative e a p benefit – co 5.3 yrs s nt Screening result: SP Note. EBP Evidence-based practice; SP Standard practice TP se Decisi . org assessme Inter o n S c i e n c e FP 0 7 Screening instrument 1 Sever e U 2 Diagnosis TN result FN 3 4 5 6 8 10 9 Child age in 15 years 11 12 16 17 13 stSP EBP E i v d n e c e E www. www.theSWYC.org t h e S W Y C positive screening 0.00 % EBP fails d Pr c2 (compliance w/screener) s Policy Implementation Science ic 95% CI: upper bound Overall median 0.20 % 8 Risk for moderate ASD Risk for severe ASD benefitEBP – c n me PB le E 2017: Pediatrics A 0.50% Haza r 0 t Risk for mild ASD y EBP works as implemented Chance node Health Care Needs (NS- Pr c1 (compliance w/appt) (EBP) 14 Attend diagnostic Test 2: evaluation?C l i n i c y a l e Test 3: e x a negative n result o Pr c3 (compliance w/evaluation) .

Chris Louis Organizations & Management in the context of specific diseases or vulnerable populations Innovation Program Evaluation Policy Implications Multi-disciplinary Program Evaluation (specific to vulnerable populations) CHART NY DSRIP HRSA Future Work Mixed-methods examination of Breast Cancer Screening Centers in Appalachia Ways to mine, track and use large amounts of data in highly specialized services (e.g., NICU) Teaching – Competitive Strategy & Professionalism

Megan B McCullough, PhD Health Services Researcher, Anthropologist Expertise Current Projects Qualitative methodologist Implementation Science Clinical Pharmacy, medication studies & non-physician providers Past Research: Indigenous women’s reproductive health Areas: United VA Implementation of Clinical Pharmacy Specialists to Increase Access to Mental Health and Pain Management Care in Rural Areas De-Implementation of Antipsychotics in VA nursing homes BU Assisting/Team teaching PM 831 Guest Lecturing PM

David Rosenbloom Past PhD, MIT 1970 Political Science Chief of Staff, Boston Mayor 1975 Cmmr, Health and Hospitals 75-83 Various private health ventures BUSPH Faculty since 1991 Director, Join Together and NIAAA Youth Alcohol Center NIDA Council, 1998-2001 Interim Chair HLPM 2011-2016 Present Teach PH 719-HLPM Core Teach PM 740-Comp. Health Systm PI, VetChange Founder and Board, Police Assisted Addiction Recovery Initiative Recent Sabbatical looking at paths to universal health coverage Chair, Boston Foundation for Sight

Wendy Mariner E dw Professor of Health Law ard R. Utley

Mark Meterko Research Associate Professor, HPLM Was PI @ CHOIR until 10/15 – Interests: Coordination of Care, Organization Culture & Climate, Traumatic Brain Injury & PTSD Currently Senior Survey Methodologist, VA Patient Satisfaction Survey Program within Performance Measurement Office – VHA Office of Reporting, Analytics, Performance, Improvement and Deployment (RAPID – 10EA) Continued CHOIR involvement – Member of mentorship team for two HSR&D CDA recipients with survey-related components to their research Amy Linsky MD – Medication Deprescribing Varsha Vimalanada MD – Coordination of specialty care Continued HPLM involvement – Dissertation committee member Judy George Vanessa Merker – Member of grant-funded study team Development of measures of work-related physical and mental function, for SSA disability determination and broader rehabilitation applications (PI: Jette – Kazis) Overarching long-term interest – Survey research – Psychometrics

Julia Raifman Econometric methods Health equity Policy analysis: Health services research: How do unequal LGBT rights affect the disproportionate burden of HIV among men who have sex with men? How to increase primary care provider discussions about HIV pre-exposure prophylaxis (PrEP) with patients at high risk of HIV? Aim to help students pair quantitative skills with impactful research questions in their own areas of interest

Terri K. Pogoda, PhD Post-deployment health in Iraq and Afghanistan war Veterans, especially TBI and PTSD Community reintegration for Veterans with polytrauma/TBI, especially employment Interdisciplinary team care Vocational rehabilitation services Supported employment VA HSR&D IIR: Improving access to supported employment for Veterans with polytrauma/TBI

Keith McInnes Brought to you by the letter “H” HIV / Hep C / Health IT / Homelessness Research projects: 1. Access to and quality of hepatitis C care for veterans who are homeless 2. Text messaging to support disease self-management among homeless persons 3. Peer support intervention for veterans leaving incarceration 4. Supporting HIV self-management through personal health records (PHRs) Teaching: Digital Disruption in Healthcare

Jim Rothendler Background: Clinical cardiology, isotope imaging of the heart Medical Informatics More recent Interests: Working with large medical datasets Process of care, Outcomes of care, Quality of care Patient-reported outcomes

Alan Sager

Mary D. Slavin, PT, PhD Measuring Rehabilitation Outcomes Develop patient-reported outcome measures based on Item Response Theory (IRT) Solves measurement dilemma Used to assess persons with a wide range of abilities Compare outcomes across an episode of care Administered efficiently via computerized adaptive testing (a few well-selected items) Examples: Spinal Cord Injury Functional Index (SCI-FI), Pediatric Spinal Cord Injury (PEDI-SCI), Cerebral Palsy Profile (CP-PRO), Life Impact Burn Recovery Evaluation Profile (LIBRE) Knowledge translation activities Promote adoption and use of new measures in clinical practice and research (training materials, user-friendly platforms and score reports) Examples: SCI-FI included in the Spinal Cord Injury Model Systems national outcomes database CP-PRO included in a national database for children with cerebral palsy

STEIN: Technology-based Interventions (TBIs) using Behavioral Evidence -Reach, low expense, high fidelity, always accessible, point of service data gathering -Cell phones: ubiquitous, interactive, always “on call” -Fit & Sober - goal setting, monitoring -BetterOff – supporting withdrawal -Alcogait – passive sensing

Dr. Michael Teach: Grodin Health and Human Rights Ethical Issues in Medicine and PH Religion, Medicine and PH Mental Health Law, Ethics & Policy Jewish Bioethics & Holocaust Studies Research: Trade book on Health and Human Rights New edition of Health & Human Rights in a Changing World Service: Medical ethicist for BMC Consultation Liaison Psychiatry Advocacy: Global Lawyers and Physicians: Working Together for Human Rights