The faculty of the Department of Health Policy and Management (HPM) conducts research across a wide range of current health policy issues. Ours is a methodologically diverse department, and our research includes the application of rigorous analytic methods to evaluate specific health policy questions as well as the methods themselves. Our faculty members are engaged in multiple research areas, including...
- pharmaceutical policy
- financing Medicare and Medicaid
- long-term care
- organ donation and allocation
- technology assessment
- mathematical modeling and simulation
The following are profiles of standout funded faculty research in these areas.
HPM has substantial expertise in the analysis of large administrative and claims databases for the evaluation of the impact of various health policies. With the advent of Medicare Part D and health care reform, there is substantial interest in understanding the impact of medication reimbursement policies on health care spending and outcomes. Yuting Zhang, associate professor of health economics, has demonstrated recently that only 5 percent of seniors are enrolled in the most cost-effective Part D plan for their particular situations and that these patients overspend by several hundred to a thousand dollars per year. Using Medicare claims data, Associate Professor Julie Donohue found that a substantial amount of the variation in Part D spending arises from the regional differences in price rather than from different amount of prescription use.
Financing Medicare and Medicaid
The recent expansion of Medicaid in the Affordable Care Act prompted the Pennsylvania legislature to contract with the RAND Corporation and Donohue to predict the economic and coverage impact of Medicaid expansion in Pennsylvania, which would expand Medicaid roles by 350,000 people and bring nearly $2 billion in federal revenue to Pennsylvania.
HPM has had a longstanding interest in the measurement of and improvement in the quality of long-term care. Professor Nick Castle and colleagues at RAND are engaged in several projects, including examining staff turnover in long-term care settings (including nursing homes, assisted living facilities, and elderly high rises), use of the federal report card Nursing Home Compare, levels of job satisfaction among nursing home administrators, closure of nursing homes, staff injuries, and responses to disasters. Prior research has investigated how institutional factors can affect the outcomes of nursing home residents with mental illnesses, use of medications, and mortality rates of nursing home residents with mental illnesses. Studies through the department over the past 15 years have surveyed by mail more than 20,000 long-term care facilities; 15,000 family members of residents; and 30,000 nurse aides. The most recent survey conducted for the National Institute for Justice examined resident abuse in assisted living facilities.
Organ Donation and Allocation
Our department is conducting several research projects related to organ allocation and donation. Associate Professor Howard Degenholz conducts research aimed at improving organ donation in the United States, including through the Department of Motor Vehicles, as well as the development of an online video game designed to teach players the importance of organ donation in a successful transplantation program. Professor Mark Roberts and Associate Professor Cindy Bryce have long-standing work related to modeling the U.S. organ allocation system to evaluate different prioritization and allocation policies. Currently they are evaluating the impact of various strategies in the care of patients with pediatric acute liver failure.
HPM is conducting projects involving the evaluation of new health care technologies. For example, Assistant Professor Jagpreet Chhatwal is currently evaluating the complicated decision faced by patients with hepatitis C regarding whether to wait for newer, more effective drugs that are currently under development or to initiate therapy now with existing antiretroviral drugs, which may substantially reduce the effectiveness of the new drugs when they become available. Assistant Professor Julia Driessen is evaluating the impact on costs in clinical outcomes of the implementation of simple, open-source electronic health records in resource-poor environments in Africa.
Mathematical Modeling and Simulation
In collaboration with the Swanson School of Engineering Department of Industrial Engineering, the Public Health Dynamics Laboratory and multiple investigators in other institutions, Chattwal and Roberts are conducting research in the use of complex mathematical methods and the use of clinically realistic agent-based models to examine health policy decisions involving HIV, hepatitis C, and other diseases.