What's New with HCFO - January 19, 2007 (Print All Articles)

The Evolution and Treatment of Disease Over Time

Over the last century, treatment and understanding of disease, has evolved and reconfigured in response to advances in medical technology as well as social and environmental changes.  The interplay among these factors has resulted in the development of different approaches to the organization of care at different points in time. 

Pasteur’s discovery of germs located disease as specific biological entities that exist outside of the body.  Germs, and the resulting medical abnormalities they caused, could therefore be isolated and treated. Development of technological instruments such as the thermometer, EKG, blood pressure cuff, and x-ray produced mechanisms for monitoring normal and abnormal states.¹  These technologies standardized not only states of the body but also indicated courses of universal care that would treat illness as discreet episodes. For the first time, the majority of care occurred in hospitals that possessed this highly technological equipment rather than in patients’ homes. Each of these shifts reinforced an organizational framework for care that viewed illness as episodic and distinct from other rhythms of life.  In addition, the ability to treat disease led to increased life expectancy.

Increased life expectancy and the ability to treat many acute illnesses effectively has resulted in the ability for individuals with chronic conditions such as heart disease and diabetes to live much longer with these conditions. As a result, many physicians have conceptualized both disease and its treatment within a more holistic approach.²  This framework for care focuses not only on the original condition but also the co-morbidities these diseases can cause. Treatment and care recognize the need for broad-based disease management and containment. Rather than viewing illness as episodic, these chronic conditions are viewed as entailing life long treatment through adjustments in diet, exercise, and medication. For those who are already sick, this view of illness moves care from the hospital out to all realms of life.

Currently, patients with chronic illnesses represent the largest consumers of health care dollars, despite attempts at cost containment.  Chronic diseases account for nearly 75 percent of total health care expenditures in the U.S., including 76 percent of all hospital admissions, 88 percent of all drug prescriptions, and 72 percent of all physician visits.³ As medical costs continue to rise, the public health community has focused on broad initiatives to reduce not only the incidences of chronic diseases such as heart disease, diabetes, and obesity, but to eliminate the root causes of these conditions at a population level. The New York City Board of Health’s recent decision to phase artificial trans fats off the city’s restaurant menus is symbolic of this shift in understanding chronic conditions and embodies a movement toward addressing environmental as well as epidemiological concerns.

Beginning on July 1, 2007, New York City Restaurants will be required to remove all artificial trans fat within their food over the next 18 months.⁴  By banning trans fat from the cities eateries, the New York City Board of Health hopes to decrease the risks of obesity, diabetes, and cardiac conditions in a town where dining out has increasingly become the norm and heart disease is the leading cause of death.⁵

Several HCFO grantees have explored how treatment for chronic conditions is both conceptualized and delivered. Paul Herbert, Ph.D., of Mt. Sinai School of Medicine, researched whether increased managed care market penetration in a metropolitan area had an effect on the medical care provided for fee-for-service Medicare beneficiaries with diabetes. Herbert found little evidence to suggest a “spillover” effect of managed care market penetration on the quality of care for these beneficiaries. However, he did find that some evidence that quality of care decreased for beneficiaries who remained in fee-for-servicve when the majority switched to managed care.
         
In another HCFO grant, Mark Doescher, M.D., of the University of Washington examined the relationship between prescription drug coverage and health care costs in a sample of elderly Medicare+Choice enrollees with common chronic health conditions. They found that seniors who lacked prescription drug coverage faced significantly greater non-pharmaceutical-related costs of care than seniors who had drug coverage. In addition, the savings in inpatient (hospital) and emergency department costs approximately offset the costs to the plan of medications for those with a benefit.

Currently, three HCFO grantees are conducting research in this area. Amira El Bastawissi, Ph.D , of the University of Washington is investigating how a Washington State Diabetes Collaborative influences the health and economic outcomes of diabetic patient. David Blumenthal, Ph.D., at Massachusetts General Hospital is researching consumer tools to select high performing physicians within consumer-driven health plans (CDHPs). Specifically, Blumenthal will focus on testing the effectiveness of tools to assist people with chronic conditions to make an informed choice of primary care physician. Marissa Domino, Ph.D., University of North Carolina is studying the impact of supply restrictions for pharmacy benefits in the Medicaid program in North Carolina on medication adherence, health service use, and the cost impact of the change on the Medicaid program.  This work is focusing on individuals who use medications for chronic conditions. Additionally, newly funded research from the Public Health Systems Research special topic solicitation considers a range of complex issues related to protecting the population’s health.

HCFO Funded Research
Grant No: 58064
Title: Impact of the Washington State Diabetes Collaborative on Patient Health and Economic Outcomes
Institution:  Washington State Department of Health
Principal Investigator: Amira El-Bastawissi, Ph.D.
Grant Duration: July 1, 2006 to February 29, 2008
How do the clinics and primary care physicians participating in Collaborative III of the Washington State Diabetes Collaborative affect the health and economic outcomes of diabetic patients? The collaborative combines elements from Collaboratives of the Institute for Healthcare Improvement and the Chronic Care Model developed by Edward Wagner and colleagues. The researchers will capture the later-stage results of the collaborative, “thus offering an impact evaluation of a mature system-change model.” In particular, the researchers will explain how different components of the collaborative approach to diabetes care management directly affect health and economic outcomes (utilization and costs). The objective of the study is to better inform health plans, public payers, health care providers, and employers about the economic impact of the collaborative, to inform their quality improvement, benefit design, and payment decisions for diabetic patients.
 

Grant No: 56527
Title: Involving Consumers in Physician Choice: Making Data into Useable Information for Chronically Ill Patients in Consumer-Directed Health Plans
Institution:  Massachusetts General Hospital
Principal Investigator: David Blumenthal, M.D.
Grant Duration: March 01, 2006 - August 31, 2007
What tools will consumers need to help select high performing physicians, within CDHPs? Physician performance data is one of the tools that can be used to help consumers make these decisions. However, there are important opportunities and challenges facing consumer-directed health plans (CDHPs) trying to engage consumers in using physician performance data (PPD). The specific aims of the project are: 1) to develop methods for informing consumers about physician clinical performance; 2) to test the effectiveness of these methods in helping consumers with chronic conditions in CDHPs to make an informed choice of primary care physician (PCP); 3) to explore how consumer characteristics affect their ability to understand PPD and their response to that data. The objective of this study is to understand how and whether PPD can be appropriately and effectively used in CDHPs.

Grant No: 40540
Title: Prescription Benefit Comprehensiveness and Costs of Care in Elderly Persons with Chronic Illness: The Medicare Enrollee Drug Study (MEDS)
Institution:  University of Washington
Principal Investigator: Mark P. Doescher, M.D.
Grant Duration: November, 2000 - April, 2003
Is the cost of adding a prescription drug benefit to Medicare offset by a decrease in costs for other health care services? Researchers at the University of Washington examined this question by looking at the effects of prescription drugs on more resource-intensive care. Using a sample of enrollees in a Medicare HMO administered by the Group Health Cooperative of Puget Sound, they tested the following hypotheses: 1) as pharmaceutical benefit comprehensiveness increases, Medicare enrollees will engender higher outpatient pharmacy costs, but lower costs for other outpatient and inpatient services; and 2) that the effects of increasing prescription drug benefits generosity will be amplified for low-income individuals. Their goal was to inform the current debate on Medicare prescription benefits on the possible cost off-setting that could be associated with improving pharmaceutical coverage for the elderly.

Grant No: 56109
Title: Duration Limitations and Adherence to Chronic Medication
Institution:  University of North Carolina at Chapel Hill
Principal Investigator: Marisa Domino, Ph.D.
Grant Duration: January 1, 2006 – December 31, 2006
What is the impact of supply restrictions for pharmacy benefits in the Medicaid program in North Carolina on medication adherence, health services use, and the cost impact of the change on the Medicaid program? (North Carolina Medicaid introduced a 34 days supply limit in July 2001.) Experience in North Carolina will be compared with the experience in Georgia, where there was no change in the days supply requirements. The study will focus on individuals who use medications for chronic conditions in the following categories: anti-hypertensives, anti-diabetic medications, lipid-lowering drugs, anti-psychotics, anti-depressants, and seizure-disorder medications. The objective of this study is to inform state-based and private sector initiatives to constrain pharmaceutical costs, and suggest directions for future research to advance the understanding of how prescription drug policies may affect patient behavior, care processes, and costs in Medicaid beneficiaries and other insured populations.

Grant No: 44201
Title: Managed Care’s Spillover Effects on the Quality of Diabetes Care for Medicare Patients
Institution:  Mount Sinai School of Medicine
Principal Investigator: Paul L. Hebert, Ph.D.
Grant Duration: January 1, 2002 to July 31, 2003
How does increased managed care penetration affect quality of care in the non-managed care sector? Paul L. Herbert, Ph.D., at Mount Sinai School of Medicine used data from the Physician Survey of the CTS and the National Diabetes Cohort to examine whether efforts to monitor the quality of care in managed care organizations (MCOs) have had similar spillover effects on the non-managed care market – particularly for chronic conditions such as diabetes. Specifically, the researchers examined whether: 1) increased managed care market penetration affects the provision of diabetes-specific preventive care to Medicare beneficiaries in the non-managed care sector; and 2) increased managed care market penetration affects the provision of high-cost medical services to Medicare beneficiaries with diabetes in the non-managed care sector. The study also examined whether managed-care-induced changes in health care use have implications for “avoidable” hospitalizations for persons with diabetes. This study better informs policymakers of the system-wide consequences of health care cost-containment policies that encourage expanded use of managed care.

¹ Rosenberg, Charles E. "The Tyranny of Diagnosis: Specific Entities and Individual Experience,"
Milbank Quarterly 80, No. 2, (Summer 2002), pp.237-260.
²  Rosenberg, Charles E."Holism in Twentieth Century Medicine," In Christopher Lawrence and George Weisz, eds. Greater than the Parts. Holism in Biomedicine, 1920 1950 (New
York and Oxford: Oxford University Press, 1998), pp. 335 55.
³ Tu, Ha T. “Rising Health Costs, Medical Debt and Chronic Conditions” HSC Issue Brief No. 88, September 2004.
⁴ NYC Board of Health Votes To Phase Out Artificial Trans Fat From New York City’s Restaurants, December 5, 2006 (Press Release).
⁵ Childs, Dan. “Experts : NYC Trans Fat Ban a Healthy Move : Proposal Could Save Lives, and Other Cities May Follow Suit.” ABC News, December 5, 2006.

Grantee Spotlight - Michael Stoto, Ph.D.

Michael Stoto is a professor of health services administration and population health at the Georgetown University School of Nursing and Health Studies. He also serves as an Adjunct Professor of Biostatistics at the Harvard School of Public Health. Currently, Stoto is researching regionalization in local public health systems, and other aspects of public health preparedness. He is also conducting research on methodological topics in epidemiology, statistics, community health assessment, risk analysis, and performance measurement.

After receiving an A.B. in statistics from Princeton University, Stoto went on to receive both his A.M. and doctorate in statistics from Harvard. He served on the faculty at Harvard’s John F. Kennedy School of Government, the George Washington University School of Public Health and Health Services, and the Georgetown University Public Policy Institute. Most recently, Stoto was a senior statistician at the RAND Corporation and the associate director for Public Health in the Center for Domestic and International Health Security.

Dr. Stoto has broad knowledge in the development of statistical and epidemiological methods and their application to guide public health policy. He has developed expertise in the use of systematic review and meta-analytic methods to assess the evidence about health risks. He is also a leader in the application of syndromic surveillance and related statistical methods in public health surveillance for analyzing large health databases to identify early disease outbreaks.

Under his HCFO grant, awarded in 2006 under a special Public Health Systems Research solicitation, Stoto is analyzing the justification for creating regional local public health systems. He and his colleagues conducted four comparative case studies to document the variation in justification for creating regional public health structures; understand how these structures have been organized, implemented, and governed; and assess the current impact of regional structures on public health preparedness. The case studies address surge capacity, coordination, workforce issues, and standardization in Massachusetts, Northern Illinois-Chicago, the Washington Metropolitan area, and Nebraska.

For more information on Michael Stoto and a list of selected publications please go to http://www.nhsresearch.net/faculty/nhs.html#HSA.

New HCFO Grant Announced

Grant No.: 58731   
Title: Impact of MMA Part D on Medicare Residents in Nursing Homes   
Institution: University of Massachusetts Medical School   
Principal Investigator: Becky Briesacher, Ph.D.   
Grant Duration: January 1, 2007 - June 30, 2008   
Paragraph Summary: The applicants will evaluate the impact of the transfer of prescription drug coverage for dual-eligibles (Medicare and Medicaid) living in nursing homes from Medicaid to Medicare Part D, as required by the MMA. In particular, they will: 1) measure the rates of enrollment into Medicare Part D for nursing home residents from 2005 to 2007; 2) assess the impact of Medicare Part D on overall prescription drug utilization patterns; 3) identify the major drug classes most affected by the program, including an examination of benzodiazepines and their exclusion from Part D coverage; and 4) determine the impact of Medicare Part D on overall rates of hospitalizations and falls, as indicators of quality care. The objective of the project is to better inform state and federal policymakers about the impact of Medicare Part D on drug utilization, as well as quality (measured by hospitalizations and falls). 

New HCFO Special Solicitation in Public Health Systems Research Grants Awarded

The HCFO program is pleased to announce nine new grants under the Robert Wood Johnson Foundation Special Solicitation in Public Health Systems Research. The proposals cover the use of data to inform policy, the organization of rural health systems, the training of financial managers, the intersections of public health partnerships, surge capacity, enhancements of CTS to analyze workforce needs, and the connection between local public health expenditures and health disparities. Taken together, these proposals offer a portrait of some of the most complex, vexing, and important issues in Public Health Services and Public Health Systems Research.

Title: Assessment of Training Needs for Public Health Financial Managers
Institution: University of Kentucky
Principal Investigator: Julia F. Costich, Ph.D., J.D.
Grant Duration: January 1, 2007 – June 30, 2008

The researchers will examine competencies of financial managers in state and local public health departments.  A national sample of public health finance officers, and the senior public health officials to whom they report, will be surveyed.  The survey will gather information on their self-assessment of current knowledge and performance in relation to public health finance competencies, as well as their preference for educational formats.  Using newly issued competencies in public health financial management as benchmarks, the researchers will identify areas of need, mechanisms for delivering training, and potential funding sources.  The objective of this project is to identify professional development needs for financial officers in state and local public health agencies.

Title: Public Health System Organization and Performance in Rural Communities
Institution: University of Minnesota
Principal Investigator: Douglas R. Wholey, Ph.D.
Grant Duration: January 1, 2007 – June 30, 2008

The researchers will examine public health system organization and public health performance in eight rural communities through a comparative case study.  Their particular focus is on rural communities, since the scarcity of resources there increases the importance of integrating public and private resources optimally.  In particular, they will:  1) describe the organization of key essential services networks within each rural community; 2) describe the structures and processes that integrate activities across the essential services networks; and 3) compare public health system performance.  The objective of this project is to illuminate the relationship between local public health systems and public health outcomes.

Title: Incorporating Disparities into State Strategies to Monitor and Improve Health Status
Principal Investigator: Marcia Gold, Sc.D.
Institution: Mathematica Policy Research, Inc.
Grant Duration: January 1, 2007 – March 31, 2008

The researchers will examine state capacity to develop the 10 leading indicators defined in Healthy People 2010, both overall and by geographic group.  In particular, they will study: 1) the strengths and weaknesses of data available within states to adequately assess the health of a population that includes diverse groups; and 2) the organizational, political, and other forces that promote or impede use of such data to intervene in ways that improve the health of the state’s population.  The three part study includes:  1) an inventory of state practices with respect to available data on leading indicators; 2) case studies of four states to learn about how the indicators and disparities in the indicators across subgroups are viewed in developing initiatives to improve public health; and 3) a dissemination plan for translating information in ways that would be useful to diverse audiences.  The objective of this project is to further the vision articulated in Healthy People 2010, setting health goals that explicitly link overall improvements in public health to reduced disparities in health status across diverse subgroups of the population.

Title: Local Community Strategies to Develop their Public Health Surge Capacity to Handle Emergencies Affecting Many People
Principal Investigator: Laurie Felland
Institution: Center for Studying Health System Change
Grant Duration: January 1, 2007 – July 31, 2007

The researchers will examine local community strategies to develop their public health surge capacity.  They note that following Hurricane Katrina, public health agencies recognize an urgent need to ensure that they can meet increased volume in times of high demand.  The researchers plan to build on the Community Tracking Study site visits, conducting more focused, in-depth case studies on the surge capacity in six selected communities.  The objective of the study is to identify key strategies that selected communities have used to develop surge capacity, pinpointing lessons that can be drawn from each community’s experience.

Title: Public Health Funding and Population Health
Principal Investigator: David E. Grembowski, Ph.D.
Institution: University of Washington
Grant Duration: January 1, 2007 – December 31, 2007

The researchers will examine the relationship between local health department expenditures and county-level disparities in mortality and infant mortality rates for African American and Caucasian racial/ethnic groups.  They will also estimate whether changes in expenditures are associated with changes in those rates over time.  The objective of this project is to inform the debate about the level of resources that should be allocated to public health systems rather than to medical care or other determinants of population health.

Title: Effective Strategies that Local Communities Have Used to Meet Expanded Public Health Workforce Needs
Principal Investigator: Robert Hurley, Ph.D./Debra Draper, Ph.D.
Institution: Center for Studying Health System Change
Grant Duration: January 1, 2007 – July 31, 2007

The researchers will examine local communities’ effective strategies for meeting expanding public health workforce needs.  They plan to study six of the twelve Community Tracking Study (CTS) communities that have faced particularly unique and/or challenging situations.  They will also conduct interviews with key public health stakeholders, covering topics such as local factors that have an impact on the public health workforce, current public health workforce needs and areas of severe shortages, current recruitment and retention challenges and strategies to overcome them, and resource and other needs that might facilitate recruitment and retention.  The objective of this project is to better understand how local agencies are dealing with the public health workforce shortages identified in the 2005 CTS site visits.

Title: Comparison of Public Health Organizational Structures Using Dynamic Network Analysis
Principal Investigator: Jacqueline Merrill, D.N.Sc.
Institution: Columbia University
Grant Duration: January 1, 2007 – December 31, 2008

The researchers will examine how intra-organizational public health networks are linked to process and outcomes.  Using dynamic organizational analysis, they will study several agency networks.  They will determine baselines for public health organizational networks, identify common elements, and relate common elements identified to performance.  The researchers will also compare the public health networks to similar networks in the private sector, allowing their findings to be interpreted in that context and theory.  The objective of this project is to provide public health managers with a better understanding of the dynamics and impact of intra-organization networks, so that they can better plan for and justify allocating limited resources.

Title: An Academic Health Center and Public Health Practice Collaboration: Disseminating Continuous Quality Improvement Capability to Local and State Public Health Agencies
Principal Investigator: William J. Riley, Ph.D.
Institution: University of Minnesota
Grant Duration: January 1, 2007 – December 31, 2008

The researchers will develop a pilot program to expand the use of continuous quality improvement (CQI) principles to public health agencies, with a focus on reducing health disparities. They intend to implement CQI through collaboration among the School of Public Health at the University of Minnesota and local and state public health agencies.  They will create a coordinated academic curriculum in CQI, preparing personnel to lead CQI efforts, and they would implement CQI capabilities into eight separate public health agency projects.  The objective of this project is to demonstrate that CQI can be used in public health organizations to improve performance of core processes.

Title: Understanding and Assessing Partnership Connections in Public Health Departments
Principal Investigator: Danielle M. Vogenbeck, Ph.D.
Institution: RAND Corporation
Grant Duration: January 1, 2007- December 31, 2007

The researchers will examine partnerships, designed to leverage limited resources and fulfill common missions, among state and local public health agencies and other organizations, agencies, and groups.  In particular, they intend to:  1) define what good connectivity means in a public health partnership; 2) quantify good connectivity as percentile score measured against a standard; and 3) develop a tool to measure connectivity and document the analytic process through which the tool produces a connectivity score.  The objective of this project is to develop a tool to allow public health partners to measure their multi-agency collaborations in order to strengthen them.

Spotlight on Grantee Publication

Susan H. Busch, Ph.D., associate professor with the Department of Epidemiology and Public Health, Yale University School of Medicine, is the co-author of an article titled, “Do State Parity Laws Reduce the Financial Burden on Families of Children with Mental Health Care Needs?” that appeared in an early online issue of HSR. The article describes HCFO-sponsored research examining the financial impact of state parity laws on families of children in need of mental health services

Current HCFO grantee publications and recent grant findings will be regularly featured in the results section of our Web site. 
 

This Month in the News

Judith Hibbard, Dr. P.H., professor of health policy at the University of Oregon, was quoted in a December 10, 2006 article in the Charlotte Observer that examined the role of state medical boards in overseeing physicians. The article details information provided about physicians to patients by state medical boards.  Hibbard states that the state medical boards, “are not doing enough since we have such large concerns about the quality of care.” 

Michael A. Morrisey, Ph.D., professor in the Department of Health Care Organization and Policy, University of Alabama at Birmingham (UAB) School of Public Health, was featured in a Yahoo! Finance article summarizing the latest issue of the Journal Inquiry. Morrisey is the a co-author of an article describing HCFO funded research on the effects of tort law and insurer investment returns on physician malpractice insurance premiums that was featured in this issue. 

Lawrence P. Casalino, M.D.,  Ph.D., physician and health services researcher at the University of Chicago, was featured in a December 12, 2006 Healthcare IT News article that examined quality improvement efforts in physician practices.  The article details a recent study released from the University of Pittsburgh School of Medicine which attributed quality improvements to practice structure rather than investment in healthcare information technology.  Casalino cautioned that the study “does not capture the extent of EMR use in an organization,” because “the quality improvement measures do not distinguish intensive use from minimal use of quality improvement processes.” 

New HCFO Findings Briefs

“Design of a Pharmacy Benefit for Low-Income Seniors: Lessons from State Pharmacy Assistance Programs”

There is limited research in understanding how poor and near-poor elderly and the disabled respond to different drug cost-sharing approaches in the current environment. In order to bridge this gap, researchers at Brandeis University used data from two state programs (Medicaid Pharmacy Plus Medicaid 1115 waiver programs administered by Illinois and Wisconsin) providing pharmacy benefits to low-income seniors prior to Medicare Part D.

“A Sustainable Future? The Role of Premium Subsidies in Medicare Prescription Drug Plans“

In July 2004, HCFO funded research to provide early and timely information on entry, enrollment, and risk selection of Medicare prescription drug plans and regional PPOs. A research team based at Boston University School of Public Health explored adverse selection in PDPs, the entrance of PPOs into regional markets where health maintenance organizations (HMOs) already exist, and the introduction of PDPs and PPOs in markets where HMOs did not have a presence.  Simulation models show that in general, PDPs will be stable, regardless of adverse selection, and that premium support of these programs will ensure viability.

New NCHS Data on Medication Therapy

The National Center for Health Statistics (NCHS) is pleased to announce the release of a new report that highlights a unique data resource for studying medication therapy in ambulatory care.   The report, entitled “Medication therapy in ambulatory medical care settings: United States 2003-2004, presents estimates of medications prescribed, provided, or continued at visits to physician offices and outpatient and emergency departments in 2003-2004. The report provides detailed drug characteristics separately for primary care offices, surgical specialty offices, medical specialty offices, outpatient departments, and emergency departments.  It can be accessed on the NCHS website at http://www.cdc.gov/nchs/data/series/sr_13/sr13_163.pdf.

Among the report findings:
• Medications were mentioned at approximately two-thirds of encounters.
• A total of 1.9 billion medications, including prescriptions, injections, and over-the-counter preparations, were reported for these visits.  
• Pain relievers, cardiovascular-renal agents, respiratory tract drugs, central nervous system drugs, hormonal agents, and antimicrobials were reported most frequently. 
• Anti-depressant prescribing rates per 1,000 persons were higher for females than males and for whites than blacks.

The detailed drug data upon which this report is based are available for public use as part of the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS).  NAMCS and NHAMCS collect data on ambulatory medical care providers, their patients, and the care delivered during visits to physician offices, hospital outpatient departments, and emergency departments.  Medication therapy has been included on the NAMCS and NHAMCS data collection forms since 1980.  The 2003 and 2004 data collection forms permitted up to eight drugs to be recorded by name and therapeutic class for each visit.  To access the micro-data files, visit http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm.

NAMCS and NHAMCS are part of a larger group of surveys known collectively as the National Health Care Surveys.  For information on long term care, inpatient care, and ambulatory surgery components of the National Health Care Surveys, please visit www.cdc.gov/nchs/nhcs.htm.

Workforce Takes Center Stage at NHPC

National Health Policy Conference (NHPC)
February 12-13, 2007, Capital Hilton, Washington, DC

Workforce Takes Center Stage at NHPC

Attend the National Health Policy Conference February 12-13, at the Capital Hilton, Washington, DC and join leading health policy experts as they examine the issues associated with strengthening the health care workforce.

The workforce plenary session will provide insight from experts such as administration officials, senior congressional staff, state officials, executives from the health care industry, and political commentators while two breakout meetings will tackle the topic in greater depth. The following sessions and meetings will be offered:

* Macro Views on Strengthening the Health Care Workforce (Plenary session)
* The U.S. Physician Workforce: Beyond the Numbers
* RN Rx: A Prescription for the National Nursing Workforce Crisis

Don’t miss all this and more from leading experts in the field including:

* Ann Bokelman, Southside Regional Medical Center
* Colleen Conway-Welch, Vanderbilt School of Nursing
* Richard Cooper, University of Pennsylvania
* David Goodman, Dartmouth College
* Chuck Kilo, Greenfield Health
* Bruce Morrison, Former Member of U.S. Congress
* Fitzhugh Mullan, The George Washington University 
* Kevin Sexton, Holy Cross Health

In addition to workforce issues, the 2007 National Health Policy Conference will feature three additional topic tracks:
* Addressing Coverage Issues and Evolving Strategies
* Driving Quality Improvement
* Advancing Public Health

Registration is now open!

Building Bridges: Making a Difference in Long-Term Care 2007 Policy Seminar

Wednesday, February 14, 2007
8:30 am to 12:30 pm
Capital Hilton

The Building Bridges 2007 Policy Seminar will be held in conjunction with AcademyHealth's National Health Policy Conference, in Washington, DC. Separate registration is required.

2007 Annual Research Meeting (ARM)

2007 Annual Research Meeting (ARM)
June 3–5 * Walt Disney World Swan and Dolphin * Orlando

Abstracts submitted for the 2007 ARM are under review. Notifications will be sent by March 23.

Additional Presentation Opportunities Available
Five AcademyHealth Interest Groups have issued a call for abstracts with a submission deadline of February 1. Abstracts submitted for the ARM may also be submitted to an interest group. The five interest groups are:

- Child Health
- Health Workforce
- Interdisciplinary Research Group on Nursing Issues
- Public Health Systems Research
- State Health Research and Policy 

ARM Preliminary Agenda Available Online
So far, about half of the program has been identified and is available online. The call for abstracts peer review process will determine the content of the remaining sessions. Check out the agenda-at-a-glance and session schedule.

Keynote Speaker
David Cutler, Otto Eckstein Professor of Applied Economics and Dean for the Social Sciences at Harvard University, and author of Your Money Or Your Life: Strong Medicine for America's Health Care System will be this year’s keynote speaker.