|
 |
National Center for Chronic Disease Prevention & Health
Promotion
| Title of Project |
Assessment of Hormone
Replacement Therapy Counseling and Colorectal Cancer Screening among Older Women |
| Category |
Research/Dissemination |
| Objectives and Description |
This project includes a series of
activities supporting the Prevention Center Special Interest Project, "Encouraging
Prevention in Older Women (EnPOWER)," conducted at Group Health Cooperative of Puget
Sound. Previous project activities include a validity study of colorectal cancer screening
methods and development of the EnPOWER intervention materials designed to guide women
through informed decision-making about hormone replacement therapy. Major tasks include
revising the EnPOWER workbook materials based on lessons learned from a six-month
intervention trial. The process will include seeking input from prevention/guideline
committees in managed care organizations, the public health community, and women's groups. |
| Outcomes: |
|
| Contractor/Project Manager |
Alliance of Community Health Plans
Michelle Tropper, MPH (732) 220-1388, Ext. 17 |
| Subcontractor/Principal
Investigator |
Group Health
Cooperative of Puget Sound Andrea
LaCroix, PhD (206) 287-2868
Katherine Newton, PhD (206) 287-2973 |
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Suzanne Smith, MD, MPH (770)
488-5464 Lynda Anderson, PhD (404)
639-8175 |
| Other CIOs/Agencies Involved |
CDC Office of Women's Health and
Office of HealthCare Partnerships |
| Annual Extramural Funding |
FY 1996: $100,000 FY 1997: $ 60,006
FY 1998: $ 99,998
FY 1999: $150,000 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
Women |
| Title of Project |
Feasibility Study for a Case-Control
Study of Prostate Cancer Screening and Mortality |
| Category |
Research |
| Objectives and Description |
This project will assess the feasibility of
conducting a case-control study in a managed care setting to compare the frequency of
prostatic-specific antigen (PSA) and digital rectal examination screening (DRE) among men
who died of prostate cancer and controls who did not; to determine if PSA and DRE
screening improves prostate cancer mortality. It has two phases. In Phase I, the
contractor will develop a medical record review form, determine sample size with adequate
power, conduct a policy review and prepare the Institutional Review Board (IRB) package.
In Phase II, the contractor will conduct a pilot study and refine the medical record
review form. |
| Outcomes: |
The data collection instrument has been
finalized and field tested. Data from the pilot study is currently being analyzed. |
| Contractor/Project Manager |
Alliance of Community Health Plans
Michelle Tropper, MPH (732) 220-1388, Ext. 17 |
| Subcontractor/Principal Investigator |
Kaiser Permanente Northwest
Sheila Weinmann (503) 249-3328Kaiser Permanente Northern California
Stephen VanDen Eeden (510) 450-2202
Kaiser Permanente Southern
California
Shelley Enger, PhD (626) 564-3201
Henry Ford Health System
Angela Blount (313) 874-6232 |
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Jean Shapiro, PhD (770) 488-3010 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding : |
FY 1999: $350,000 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
African American men |
| Published Abstracts/Articles |
None |
| Title of Project |
Development and Evaluation of
Performance Measures for Dental Practice |
| Category |
Quality Assurance |
| Objectives and Description |
The Agency for Health Care Policy and Research
(AHCPR) has funded the development, implementation and evaluation of a set of
outcomes-based, dental performance measures in two large, managed care dental plans.
However, the administrative data sets used in most dental clinics typically do not contain
all of the elements necessary to track these measures. The two elements most likely to be
missing are the diagnostic codes (or the reasons for treatment) and the formal risk
assessment. This project will test the use of a "surrogate" set of measures,
based upon more readily available data, in several public health settings. |
| Outcomes: |
|
| External Institution/Principal Investigator |
University of North Carolina at Chapel Hill
Sheps Center for Health Services Research
James D. Bader, DDS, MPH (919) 966-5727 |
| CDC Project Officer |
Barbara Gooch, DMD, MPH (770) 488-6068 |
| Other CIOs/Agencies Involved |
AHCPR |
| Annual Extramural Funding |
FY 1996: $156,551 (AHCPR) FY 1997: $ 50,000 (CDC)
$205,414 (AHCPR)
FY 1998: $275,416 (AHCPR) |
| Funding Mechanism |
Memorandum of Agreement with AHCPR |
| Project Status |
Ongoing |
| Special Populations |
None |
| Published Abstracts/Articles |
Bader J, White A, Olson O, Senft G, Shugars D.
Clinician Reliability in Classifying Disease Risk and Reasons for Treatment. J Dent Res
1999;78(IADR Abstracts):68. Abstract (No. 501).
Bader J, Shugars D. Development of a Prototype
Report Card for Managed Dental Care Plans. J Dent Res 1998;77(IADR Abstracts):652.
Abstract (No. 165). |
| Title of Project |
Cause of Death Among Men With Prostate
Cancer |
| Category |
Applied Research |
| Objectives and Description |
This project will investigate factors
associated with cause of death among men previously diagnosed with primary prostate
cancer. It is designed to identify clinical and demographic factors which are
independently associated with death from prostate cancer. Additionally, a set of clinical
factors will be identified which best predict death from prostate cancer. |
| Outcomes: |
|
| External Institution/Principal Investigator |
Prevention Research Center, University of
California Kaiser Permanente, Oakland, CA
William Satariano (510) 642-6641 |
| CDC Project Officer |
Irene Hall, PhD (770) 488-3001 |
| Other CIOs/Agencies Involved |
None |
| Annual Extramural Funding |
FY 1995: $99,856 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Completed |
| Special Populations |
|
| Published Abstracts/Articles |
Cause of Death in Men Diagnosed with
Prostate Cancer (in press) |
| Title of Project |
Comorbidity of and Prostate Cancer
Mortality |
| Category |
Applied research |
| Objectives and Description |
This study will investigate factors associated
with cause of death among black and white men previously diagnosed with primary prostate
cancer. It will determine whether demographic and clinical factors, in particular,
co-morbidity, as associated with cause of death (prostate cancer vs. other causes) among
black cases and whether such factors differ significantly from those associated with cause
of death among white cases. |
| Outcomes: |
|
| External Institution/Principal Investigator |
University of California Prevention Research
Center
Kaiser Permanente, Oakland, CA
William Satanano (510) 642-6641 |
| CDC Project Officer |
Irene Hall, PhD (770) 488-3001 |
| Other CIOs/Agencies Involved |
None |
| Annual Extramural Funding |
FY 1995: $154,919 FY 1996: $252,007 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Completed |
| Special Populations |
Kaiser plan members with prostate cancer |
| Published Abstracts/Articles |
|
| Title of Project |
Evaluation of Dental Treatment and
Health Status Differences Attributable to Water Fluoridation |
| Category |
Research/Medicaid and Managed Care |
| Objectives and Description |
This project will look for differences in the
dental treatment experiences and costs among beneficiaries of a group model dental HMO
(Kaiser Permanente Northwest) with and without access to fluoridated community water
supplies. Utilizing treatment data from a group model HMO will minimize the potential for
bias from differences in the supply of dentists, dental practice styles, and patient
care-seeking behaviors (including care-avoidance secondary to financial barriers); and
help control for other factors that bias ecological assessments (e.g., length of
participation in the dental HMO). This project will update older information, gathered at
a time when the prevalence of dental caries was far higher, and the diffusion of fluorides
far less than is currently the case. Six years of treatment data (1990-1995), stratified
by age and exposure to alternate sources of fluoride (e.g., fluoride supplements and
professional fluoride applications) will be evaluated. |
| Outcomes: |
This project compared the total dental costs
and frequency of restorative procedures over a six year period, stratified by age and
exposure to alternative sources of fluoride, for beneficiaries with and without access to
fluoridated water. Overall, a statistically larger proportion of members living in
non-fluoridated communities had at least one restorative procedure compared with members
from fluoridated communities. The magnitude of that difference was likely reduced by
greater use of alternative methods of fluoride delivery (e.g., school mouth rinse programs
and supplemental fluoride treatments) in non-fluoridated communities. |
| Contractor/Project Manager |
Alliance of Community Health Plans
Michelle Tropper, MPH (732) 220-1388, Ext. 17 |
| Subcontractor/Principal Investigator |
Kaiser Permanente Northwest B. Alexander White, MS, DDS, DrPH. (503) 335-6765 |
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Dolores Malvitz (770) 488-6065 |
| Annual Extramural Funding |
FY 1996: $134,400 |
| Funding Mechanism |
Contract |
| Project Status |
Completed |
| Special Populations |
Kaiser Permanente Northwest beneficiaries |
| Published Abstracts/Articles |
White, BA Little, SJ, and Martin, JA,
"Fluoridation and its impact on the use and cost of dental care." J Public
Health Dentistry 1999 (in press). |
| Title of Project |
Prostate and Colorectal Cancer
Screening Test Utilization in the Managed Care Environment |
| Category |
Research |
| Objectives and Description |
This study will determine the validity of
patient recall for prostate and colorectal cancer screening in a managed care environment.
Members of three HMOs will be surveyed regarding their most recent prostate and colorectal
cancer screening tests, and their medical records abstracted to determine the presence or
absence of these same tests (and their indications) within the past 5 years. |
| Outcomes: |
|
| Contractor/Project Manager |
Alliance of Community Health Plans
Michelle Tropper, MPH (732) 220-1388, Ext. 17 |
| Subcontractor/Principal Investigator |
Kaiser Permanente Northern California: Kaiser Permanente Georgia
HealthPartners, Minnesota
Steve K. VanDen Eeden, RN, PhD (510) 450-2202 |
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Irene Hall, PhD (770) 488-3001 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1997: $ 93,432 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
African American male HMO beneficiaries |
| Published Abstracts/Articles |
|
| Title of Project |
Feasibility of Linkage of Vital
Statistic with Claims Data for Reporting of the HEDIS Low Birth Weight Measure -
Massachusetts Experience |
| Category |
Quality Assurance |
| Objectives and Description |
The National Committee for Quality Assurance's
(NCQA's) Health Plan-Employer Data and Information Set (HEDIS) is a standardized set of
measures of health plan performance designed to evaluate quality of care in a managed care
environment. Low birth weight (LBW) is defined as the live birth of an infant weighing
less than 2500 grams. A measure of LBW prevalence (or LBW Measure) was added to HEDIS
because of this condition's adverse impact on infant morbidity and mortality, and its
sensitivity to preventive intervention. However, in 1996, NCQA placed the measure on
provisional status, citing problems with the use of administrative (claims-based) data for
reporting and a perceived need for risk-adjustment to improve comparability across plans.
This project will explore the feasibility of
linking claims birth data with vital statistics data for reporting of the HEDIS LBW
Measure. Researchers will 1) determine the validity of claims-based birth weights by
comparing them to birth records birth weights, 2) extract potential risk adjustors (like
race and ethnicity) from birth records, and 3) evaluate the effects of risk adjustment,
calculated according to the dictates of HEDIS, on absolute and relative rates of LBW.
Claims for 1994 live births in Massachusetts filed with six managed care organizations
(all members of the New England HEDIS Coalition) will be used in the study.
CDC and RAND (Elizabeth McGlynn and Associates)
are test sites for this project and will coordinate their activities. |
| Outcomes: |
Report on results of validity test/risk
adjustment will be submitted to the Massachusetts Department of Health and HEDIS Coalition
partners. |
| External Institution/Principal Investigator |
NCQA/New England HEDIS Coalition
Massachusetts Department of Health
Kathy Coltin (617) 731-8287 |
| CDC Project Officer |
Gail Janes, PhD (404) 639-4862 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
In kind |
| Funding Mechanism |
None |
| Project Status |
Ongoing |
| Special Populations |
|
| Title of Project |
Impact of the Diabetes Control and
Complications Trial on Diabetes Management |
| Category |
Prevention Effectiveness and Guidelines |
| Objectives and Description |
This project's main objective is to develop a
diabetes surveillance system which can be used by managed care organizations (MCOs) to:
(1) describe the epidemiology of diabetes, patterns of care, and health outcomes; and (2)
assess future changes in patterns of care in response to new guidelines and/or
developments in diabetes care. |
| Outcomes: |
Working with Batelle and three MCOs, we
demonstrated that the MCO data systems were sufficiently compatible to allow successful
surveillance across all three health plans.
We then developed a diabetes surveillance system
with an extensive set of surveillance indicators and proposed solutions to problems
establishing consistent data specifications across MCOs. We used the indicators to
describe the prevalence of diabetes, health service utilization, patterns of care, and
complications and co-morbidities in the three MCOs. |
| Contractor/Project Manager |
Battelle Centers for Public Health Research and
Evaluation
Diane Manninen, PhD (206) 528-3140 |
| Subcontractor/Principal Investigator |
MCOs: United Health Care Corporation
Lovelace Clinic Foundation
Group Health Cooperative of Puget Sound |
| CDC Project Officer |
Mary S. Moreman (770) 488-8188 |
| CDC Technical Monitor(s) |
Michael Engelgau, MD (770) 488-5024 Linda Geiss (770) 488-5024 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
$77,394 |
| Funding Mechanism |
Contract |
| Project Status |
Completed |
| Special Populations |
|
| Published Abstracts/Articles |
CDC Diabetes in Managed Care Work Group.
Utilization of Services by Diabetes Patients in Managed Care Organizations: Development of
a Diabetes Surveillance System. Published abstract for Health Services Research.
Paper published in Diabetes Care. |
| Title of Project |
The Prevalence of Health Risk Behaviors
among Families Served by an Inner City Clinic in Omaha, Nebraska |
| Category |
Partnerships; Medicaid and Managed Care |
| Objectives and Description |
Working in collaboration with health plans and
a physician-hospital organization, we will administer a brief behavioral risk survey,
patterned after the survey used by CDC's Behavioral Risk Factor Surveillance System
(BRFSS), to evaluate the prevalence of health risk behaviors among families served by an
inner-city clinic in Omaha, Nebraska. The results obtained from this survey will be
compared to results from the statewide BRFSS and used to plan prevention programs to
reduce the risk of diabetes and other chronic conditions in this population. |
| Outcomes: |
|
| External Institution/Principal Investigator |
|
| CDC Project Officer |
Robert D. Brewer, MD, MSPH (402) 471-0565 |
| Other CIOs/Agencies Involved |
NCCDPHP |
| Annual Extramural Funding |
$5,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
Medicaid clients and Medicaid managed care
enrollees |
| Published Abstracts/Articles |
|
| Title of Project |
Enhancing the Delivery of Clinical
Preventive Services in Managed Care |
| Category |
Research |
| Objectives and Description |
There is considerable evidence that the
distribution of published preventive service guidelines does not, by itself, increase
provider utilization/provision of clinical preventive services; and growing interest in
developing and evaluating strategies that will. The objectives of this project are to: 1)
develop a protocol for conducting and interpreting research syntheses (meta-analyses) that
assess the effectiveness of strategies to increase the adoption of preventive service
guidelines in clinical settings; and 2) test the feasibility of the protocol and database
structure by applying it to an example topic (e.g., hypertension management). Findings,
based on meta-analytic reviews of the pertinent literature, will be disseminated to key
individuals and groups in the public and managed care sectors concerned with strategies
for putting prevention into clinical practice. It is anticipated that this project will
form the foundation for the development of guidelines for designing and reporting on
behavioral intervention research. |
| Contractor/Project manager |
American Association of Health Plans
Barbara Lardy, MPH (202) 778-3229 |
| Subcontractor/Principal Investigator |
Johns Hopkins School of Hygiene & Public
Health Robert Lawrence, MD (410) 614-4590
Gail Daumit, MD |
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Lynda Anderson (404) 639-8175 Gail Janes (404) 639-4862 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1996: $100,000 FY 1997: $ 50,000 |
| Funding Mechanism |
|
| Project Status |
Manuscripts in progress |
| Special Populations |
|
|
|
| Title of Project |
Assessment of Using the Behavioral Risk
Factor Surveillance System for Risk Assessment of HEDIS Measures |
| Category |
Research |
| Objectives and Description |
In the face of the rapid expansion of the
managed care segment of the US health-care sector, consortia of purchasers, providers and
health plans have come together to develop standardized measures of health plan
performance. These include the National Commission for Quality Assurance's (NCQA's) Health
Plan Employer Data and Information Set (HEDIS) and the Joint Commission for Accreditation
of Health Care Organizations' (JCAHOs') ORYX Initiative. Many employers are requiring
health plans to participate in one of these programs as a prerequisite to bidding on
employee health- care contracts. The goal
of these measures is to inform the health plan choices of individual consumers and public
and private purchasers by making valid plan performance information available in an
understandable and useful format. However, health plans in any given local market
typically do not compete on a level playing field. Systematic selection of particular
health plans by certain groups (e.g., younger adults or older adults) can give rise to
differences in the underlying health risks of enrollees from one plan to the next.
Therefore, observed plan performance scores should be adjusted to remove the effects of
any resultant advantage ("favorable selection") or disadvantage ("adverse
selection"). This is known as "risk adjustment".
This study will: 1) determine the feasibility of
using aggregated data of personal risk behaviors collected by the Behavioral Risk Factor
Surveillance System (BRFSS) to risk adjust HEDIS data; 2) describe practical and
cost-effective methodologies for the collection and aggregation of BRFSS data for risk
adjustment, including required sample sizes and likely relationships of risk factors on
performance measures. |
| Contractor/Project Manager |
Alliance of Community Health Plans
Michelle Tropper, MPH (732) 220-1388, Ext. 17 |
| Subcontractor/Principal Investigator |
Kaiser Permanente Center for Health
Research
Group Health Cooperative-Puget Sound
Health PartnersMark C.
Hornbrook, PhD (503) 335-2400 |
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Gail R. Janes, PhD(404) 639-4862 |
| Annual Extramural Funding |
FY 1997: $98,150 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Title of Project |
Development of a Data Base to Examine
Medical Care and Costs for Women with Endometriosis or Uterine Leiomyoma in a Managed Care
Setting |
| Category |
Prevention Effectiveness |
| Objectives and Description |
This study will describe current
identification, treatment, and medical costs of endometriosis and uterine myoma in
selected managed care settings, based on actual records of utilization of services in a
sample of women from the population of interest. Beginning with January 1993 data,
existing automated data files in health maintenance organizations will be used to identify
a cohort of women with uterine myoma ("fibroid tumors") or endometriosis. A
sample of those files will be used to develop a database containing (1) patient
demographic and enrollment data; (2) provider utilization data covering all Plan physician
services as well as services from other non-institutional health- care providers; and (3)
prescription pharmaceutical utilization data. While the topic of main interest is
endometriosis and uterine leiomyoma, all utilization records for the selected patients
will be included in the database regardless of the diagnosis recorded (for inpatient and
ambulatory records) or the clinical objective of any prescription (where diagnoses are not
typically recorded). |
| Outcomes: |
|
| Contractor/Project Manager |
Battelle Centers for Public Health Research and
Evaluation
George Provenzario, PhD (703) 875-2946 |
| CDC Project Officer |
Mary S. Moreman (770) 488-8188 |
| CDC Technical Monitor(s) |
Robert Merritt (770) 488-5227 |
| Other CIOs/Agencies Involved |
EPO |
| Annual Extramural Funding through 1998: |
FY 1996: $141,650 |
| Funding Mechanism |
Contract |
| Project Status |
Completed |
| Special Populations |
Reproductive-aged women |
| Published Abstracts/Articles |
None |
| Title of Project |
Oral Health Module Special BRFSS |
| Category |
Research |
| Objectives and Description |
This project will use a modified Behavioral
Risk Factor Surveillance System (BRFSS) survey to describe tooth loss and use of oral
health services reported by about 1,000 low income/minority adults in each of two states -
Colorado and New York. Findings from this modified BRFSS, which includes a special module
with five oral health questions, will be compared with results from the ongoing BRFSS
survey among adults representative of each state's population. Differences in dental
visits, use of preventive services and the prevalence of tooth loss will be examined. |
| Outcomes: |
|
| External Institution/Principal Investigator |
Colorado / New York BRFSS Coordinators |
| CDC Project Officer |
Betsy Thompson, MD, MPH (770) 488-8187 |
| CDC Technical Monitor(s) |
Scott Tomar, DMD, DrPH (770) 488-6092 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1997: $35,000 |
| Funding Mechanism |
Memorandum of Agreement |
| Project Status |
Ongoing |
| Special Populations |
Low income/minority adults |
| Published Abstracts/Articles |
|
| Title of Project |
Diabetes Translational Research Data
Coordinating Center |
| Category |
Research |
| Objectives and Description |
The contractor for this project will provide
multi-center coordination and technical assistance to the Diabetes Translational Research
Centers in the establishment, analysis, and reporting of a collaborative program of
applied, population-based, diabetes research. |
| Outcomes: |
|
| Contractor/Principal Investigator: |
Klemm Analysis Group, Inc.
Rebecca Klemm, PhD (202) 667-5244 |
| CDC Project Officers: |
Venkat Narayan, MD (770) 488-1051
Bernice A. Moore, MBA (770) 488-1257 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1998: $662,779 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
Women, racial and ethnic minority populations,
and at least 5,000 people with diabetes receiving care in managed-care settings. |
| Published Abstracts/Articles |
|
| Title of Project |
Translational Research Centers for
Diabetes Control Within Managed Care Settings |
| Category |
Research |
| Objectives and Description |
This project will initiate a multicenter,
collaborative program of applied population-based, diabetes research and develop a
knowledge base through published research in scientific literature and handbooks for
professional associations to improve the process, delivery, and outcomes of diabetes
services in managed care settings. The knowledge base will include methods for
interventions and assessments of their effectiveness, cost-effectiveness,
generalizability, feasibility and sustainability; and will address a variety of activities
across the range of diabetes interventions (e.g., diabetes screening and diagnosis,
treatment approaches, glycemic control, CVD risk reduction and screening for diabetes
complications). This project should help
improve the availability, accessibility, quality of process, effectiveness,
cost-effectiveness and health outcomes of diabetes-related services in managed care
settings. |
| Outcomes: |
|
| External Institution/Principal Investigator |
Indiana University Translational Research
Center
David Marrero, PhD (317) 278-0907Kaiser Foundation Research Institute
Joe V. Selby, MD, MPH (510) 450-2106
Pacific Health Research Institute
J. David Curb, MD, MPH (808) 524-4411
University of California
Carol M. Mangione, MD (310) 794-7280
The Regents of the University of
Michigan
William H. Herman, MD (734) 936-8297
University of Medicine &
Dentistry of New Jersey
Robert Wood Johnson Medical School
David S Kountz, MD (732) 235-6383 |
| CDC Project Officer |
Bernice A. Moore, MBA (770) 488-1257 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1999: $1,716,985 |
| Funding Mechanism |
Cooperative Agreements |
| Project Status |
Ongoing |
| Special Populations |
Women, racial and ethnic minority populations,
and at least 5,000 people with diabetes receiving care in managed care settings. |
| Title of Project |
Assessment of Managed Care Environment
for Health Services Research Related to Preventive-Care Practices among People with
Diabetes |
| Category |
Research |
| Objectives and Description |
The contractor(s) will develop a written report
for submission to a peer-reviewed journal describing current status and research needs
related to diabetes care in managed care as assessed by a CDC-convened expert panel. This
report will describe the (1) current status of diabetes care in managed care settings, (2)
current strengths and barriers to conducting high quality epidemiologic and health
services research in managed care settings and (3) future research needs related to
diabetes care in managed care settings. |
| Outcomes: |
|
| Contractor/Project Manager |
Alliance of Community Health Plans
Michelle Tropper, MPH (732) 220-1388, Ext. 17 |
| Subcontractor/Principal Investigator |
|
| CDC Project Officer |
|
| CDC Technical Monitor(s) |
Venkat Narayan MD (770) 488-1051 Edward W. Gregg PhD (770) 488-1273 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
$35,000 |
| Funding Mechanism |
Contract |
| Project Status |
First draft completed and submitted to journal. |
| Special Populations |
None |
| Published Abstracts/Articles |
|
| Title of Project: |
Division of Diabetes Translation
Managed Care Seminar Series |
| Category |
Capacity Building in Public Health Agencies |
| Objectives and Description |
This lecture series, which began in June 1997,
will continue to offer informative presentations and discussions on diabetes and managed
care issues. |
| Outcomes: |
To date, this lecture series has provided
valuable training for Division of Diabetes Translation (DDT) staff, promoted understanding
of the goals shared by DDT and the managed care community, and facilitated collaboration. |
| External Institution/Principal Investigator |
Various organizations and individuals |
| CDC Project Officer |
Sabrina M. Harper, MS (770) 488-5004 |
| Other CIOs/Agencies Involved |
Various Centers, Institutes and Offices (CIOs) |
| Annual Extramural Funding |
|
| Funding Mechanism |
None |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project: |
National Diabetes Education Program
Business and Managed Care Ad Hoc Group |
| Category |
Partnership, Quality Assurance |
| Objectives and Description |
This group is developing publications and
products that will promote diabetes awareness and interventions aimed at reducing the risk
for diabetic complications and controlling health-care costs at work-sites and managed
care organizations |
| Outcomes: |
|
| External Institution/Principal Investigator |
Mutual of Omaha
Marcus Wilson, MD (402) 351-8621General Motors
Timothy McDonald (313) 556-9553 |
| CDC Project Officer |
Faye L. Wong, MPH, RD (770) 488-5037 |
| Other CIOs/Agencies Involved |
National Institutes of Health |
| Annual Extramural Funding |
|
| Funding Mechanism |
|
| Project Status |
Ongoing |
| Special Populations |
Health plan providers and individuals in
employer-sponsored health plans |
| Published Abstracts/Articles |
|
| Title of Project |
Innovative Practices in Diabetes Care |
| Category |
Medicaid and Managed Care, Partnerships,
Quality Assurance, Capacity Building and Case Management |
| Objectives and Description |
State Diabetes Control Programs (DCPs) assist
states in many activities including: convening stakeholders; providing resources; and
collaborating with state Medicaid programs, health maintenance organizations (HMOs), and
providers. They also provide resources and training as needed. Using a sample of six
programs, this study describes some of the innovative practices adopted by (DCPs) to
enhance the health and well being of people with diabetes across the United States. |
| Outcomes: |
The study report discusses, illustrates, and
categorizes key innovations, measures of success, barriers to success, and lessons
learned. |
| Contractor/Project Manager |
Birch and Davis Associates State Diabetes Control Programs and their organizational
partners in California, Maryland, Minnesota, New York, Texas, and South Carolina |
| Subcontractor/Principal Investigator |
Mary Clark (301) 589-6760 |
| CDC Project Officer |
Lois Voelker, MBA (770) 488-5405 |
| CDC Technical Monitor(s) |
Lois Voelker, MBA (770) 488-5405 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural: |
FY 1997: $235,000 |
| Funding Mechanism |
Contract |
| Project Status |
Completed |
| Special Populations |
All minority groups |
| Published Abstracts/Articles |
A Report: "Innovative Practices in
Diabetes Care" |
| Title of Project |
Flu Campaign Initiative Targeting
Persons with Diabetes |
| Category |
Quality Assurance, Capacity Building,
Partnerships |
| Objectives and Description |
This project, a collaboration between the
Division of Diabetes Translations (DDT) and National Immunization Program (NIP) aims to
reduce both the risk of influenza infection and the risk of dying from complications of
influenza infection among persons with diabetes. It features a focused public education
campaign to (1) increase awareness of influenza vaccination among persons with diabetes
aged 25 to 55 years and (2) educate persons with diabetes and their providers about the
importance of annual influenza vaccination. In concert with the public education campaign, State Diabetes Control Programs
(DCPs) are implementing interventions to increase the number of persons with diabetes who
receive influenza vaccination. These interventions demonstrate how to integrate high
influenza immunization rates into the standard-of-care for persons with diabetes in
managed care organizations, public health clinics, Federally Qualified Health Centers, and
other public and private health systems.
At the conclusion of the campaign, DCPs and
their partners will collect and analyze the data for evidence of increased in vaccination
levels among persons with diabetes. The impact of the national media campaign will be
assessed by tracking news coverage, the number/placement of public service announcements
and influenza-based stories, and by the quantity of brochures and posters distributed.
Planning is underway for the 2000 Flu Campaign. |
| Outcomes: |
Outcomes are still being assessed. |
| Contractor/Project Manager |
Prospect and Associates
Lynn Sokler (770) 216-9595 |
| CDC Project Officer |
Niki Keiser (404) 639-7280 |
| CDC Technical Monitor(s) |
Wendy Holmes (770) 488-5842 Lois Voelker, MBA (770) 488-5405 |
| Other CIOs/Agencies Involved |
National Immunization Program (NIP) |
| Annual Extramural Funding |
$365,000 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
African American and Hispanic persons with
diabetes aged 25 to 55 |
| Published Abstracts/Articles |
Two media awards for creativity have been
received. |
| Title of Project |
Establishment of a Diabetes Registry in
a Health Maintenance Organization (HMO) |
| Category |
Quality Assurance, Partnerships |
| Objectives & Description: |
The objective of this project is to develop a
model, internal, diabetes registry in an HMO setting which can be used to implement
initiatives to improve patient care. |
| Outcomes: |
The study HMO has established an internal
diabetes registry and plans to refine it over time. Collected data are being used to
identify areas for improvement in diabetes care. |
| External Institution/Principal Investigator |
Group Health Cooperative of South Central
Wisconsin
Michael Ostrov, MD (608) 251-4156 |
| CDC Project Officer |
Sabrina M. Harper, MS (770) 488-5004 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
Technical assistance only from the Wisconsin
Diabetes Control Program through a cooperative agreement with Centers for Disease Control
& Prevention |
| Funding Mechanism |
|
| Project Status |
Ongoing |
| Special Populations |
Health maintenance organization (HMO)
beneficiaries with diabetes |
| Published Abstracts/Articles |
|
| Title of Project: |
Development of Diabetes Guidelines for
Health Maintenance Organizations (HMOs), Other Health Systems, and Providers in Wisconsin |
| Category |
Prevention Effectiveness Guidelines,
Partnerships, Quality Assurance |
| Objectives & Description: |
For this project, a collaborative group of
stakeholders will be assembled to develop (and later participate in the statewide
implementation of) diabetes mellitus care guidelines with the goal of improving diabetes
health outcomes in Wisconsin. Expected deliverables include the guidelines, supporting
documents, references, sample flow sheets, surveillance and quality improvement tools, as
well as a wallet-sized version of the guidelines which will be used to promote patient
self-care. |
| Outcomes: |
The guidelines (including a wallet-sized
version), supporting documents, references, sample flow sheets, and surveillance and
quality improvement tools are completed. Most Wisconsin HMOs have adopted them and are
beginning implementation. Many individual clinics and health-care providers are also using
them. |
| External Institution/Principal Investigator |
Joseph Blustein, MD (608) 274-1940
Mary Bruskewitz, RN, CS, MS, CDE (608) 263-2657 |
| CDC Project Officer |
Sabrina M. Harper, MS (770) 488-5004 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
Technical assistance only from the Wisconsin
Diabetes Control Program through a cooperative agreement with Centers for Disease Control
& Prevention |
| Funding Mechanism |
|
| Project Status |
Completed |
| Special Populations |
Wisconsin residents with diabetes and their
providers, clinics, and health systems. |
| Published Abstracts/Articles |
Guidelines were printed in January 1998 |
| Title of Project |
Implementation of the "Essential
Diabetes Mellitus Care Guidelines" in Wisconsin - Development of a Consensus Approach
to Implementation |
| Category |
Prevention Effectiveness Guidelines, Quality
Assurance, Partnerships |
| Objectives & Description: |
For this project, a forum of key stakeholders
will be assembled to (1) examine the current status of diabetes guidelines implementation,
(2) address critical issues and barriers to implementation, and (3) appoint a workgroup
which will develop implementation strategies and guidelines-based quality improvement
projects. |
| Outcomes: |
|
| Contractor/Project Manager |
To be determined |
| Subcontractor/Principal Investigator |
|
| CDC Project Officer |
|
| CDC Technical Monitor(s) |
Sabrina M. Harper, MS (440) 488-5004 |
| Other CIOs/Agencies Involved |
Wisconsin Network for Health Policy Research |
| Annual Extramural Funding |
$30,000 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
Wisconsin residents with diabetes |
| Published Abstracts/Articles |
|
| Title of Project |
Project IDEAL (Improving Diabetes care
through Empowerment and Active collaboration and Leadership) |
| Category |
Partnerships, Research, and Quality Improvement |
| Objectives and Description |
Project IDEAL is a research initiative which
will demonstrate the effectiveness of a collaboration between a large managed care
organization (MCO), HealthPartners, and the Minnesota Department of Health's Diabetes
Control Program to improve diabetes care outcomes through a clinic-based quality
improvement program. |
| Outcomes: |
N/A |
| External Institution/Principal Investigator |
Minnesota Diabetes Control Program
Donald B. Bishop, PhD (651) 281-9839
HealthPartners Research Foundation
Patrick O'Connor, MD, MPH (612) 883-5034 |
| CDC Project Officer |
Cynthia K. Clark, MA (770) 488-5367 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1998-1999 approximately $140,000 annually |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
Solberg LI, et al. Using Continuous Quality
Improvement to Improve Diabetes Care in Populations: The IDEAL Model. Joint Commission
Journal on Quality Improvement, 23(11):581-92, 1997. |
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