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Public Health Practice Program Office
| Title of Project: |
Impact of Managed Care on the Quality
of TB Laboratory Services and Reporting |
| Category |
Research |
| Objectives and Description |
While CDC recommends that laboratories use the
new, rapid technologies for M. tuberculosis smear, culture, and drug susceptibility
testing; older, slower technologies remain in wide use. Currently, there is little
information on how the rapid growth of the managed care sector is likely to affect the
adoption of CDC's TB testing recommendations. This study seeks to: (1) determine the
proportion of culture-confirmed TB patients whose testing is paid for via contracts with
managed care organizations; (2) assess the extent to which Medicaid and private managed
care contracts address CDC recommendations for TB testing; and (3) determine the impact of
managed care on both the quality of TB testing and the reporting of rest results. |
| Outcomes: |
An advisory panel meeting was convened in 1998
to provide the principal investigator with information and guidance on study design. Based
on the meeting input, the study design was revised to reflect the difficulties of
retrieving information from the types of managed care organizations which may provide care
for TB patients. The principal investigator is in the process of collecting laboratory
data and managed care status information on 300 TB patients from four California counties.
Fifty of 54 laboratories providing testing for these patients have agreed to participate
in this study. |
| External Institution/Principal Investigator |
Association of Public Health
Laboratories (APHL) Scott
Becker (202) 822-5227 California
Department of Health ServicesDavid Chin, MD, MPH (510) 540-2973 |
| CDC Project Officer |
John C. Ridderhof (770) 488-8076 |
| Other CIOs/Agencies Involved |
NCHSTP/DTBE |
| Annual Extramural Funding through 1998: |
FY 1997: $200,000 |
| Funding Mechanism: |
Cooperative Agreement with APHL |
| Project Status |
Ongoing |
| Special Populations |
Individuals covered by Medicaid managed care |
| Published Abstracts/Articles |
|
| Title of Project |
TennCare Study |
| Category |
Medicaid and Managed Care |
| Objectives and Description |
This project is evaluating how TennCare,
Tennessee's Medicaid managed care program, has affected Tennessee's public health agencies
and their ability to provide services. |
| Outcomes: |
This study examines public health practice
adaptations in Tennessee as a result of the introduction of capitated Medicaid managed
care (TennCare). It offers strategic insights and guidance to public health practitioners
in other states making the transition to Medicaid managed care. Strategies addressed
include: (1) integrating public health functions and services with managed care
operations; (2) restructuring public health operations based on both the opportunities and
the requirements of managed care health systems; and (3) preparing public health
professionals for a new practice environment. |
| External Institution: |
Tennessee Department of Health |
| CDC Project Officer/Principal Investigator: |
Michael Hatcher (770) 488-2530 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding through 1998: |
N/A |
| Funding Mechanism |
N/A |
| Project Status |
Completed / Report in development |
| Special Populations |
Tennessee Medicaid population |
| Published Abstracts/Articles |
"Are Public Health Roles Changing in the
Medicaid Managed Care Environment," presented at the 1998 American Public Health
Association Conference |
| Title of Project |
Development of an Effective Community
Report Card |
| Category |
Quality Assurance |
| Objectives and Description |
This project seeks to increase the
effectiveness of community health improvement efforts by enhancing the development and use
of community "report cards." Project objectives are to: (1) identify the best
community report cards and their common characteristics, (2) develop a case study protocol
for communities with high ranking community report cards, and (3) pilot test the protocol. |
| Outcomes: |
As a result of this project, a National
Directory of Community Report Cards and Technical Assistance Manual was produced for
communities looking for guidance developing effective community report cards. |
| External Institution/Principal Investigator |
UCLA School of Public Health
Jonathan Fielding, MD, MPH (310) 206-1141 |
| CDC Project Officer |
Pomeroy Sinnock, PhD (770-488-2469) |
| Other CIOs/Agencies Involved |
None |
| Annual Extramural Funding through 1998: |
|
| Funding Mechanism |
N/A |
| Project Status |
Completed |
| Special Populations |
None |
| Published Abstracts/Articles |
Characteristics of Community Report Cards -
United States, 1996. MMWR Vol. 46 (No. 28) p 647, July 18, 1997. |
| Title of Project |
Urban Health Systems Sentinel Network |
| Category |
Medicaid and Managed Care |
| Objectives and Description |
This project will establish and test a model
urban health systems sentinel network/study protocol to evaluate the impact of health
system restructuring on the delivery of essential public health services. |
| Outcomes: |
Case studies were developed describing how
Boston, Detroit, Columbus (OH), Los Angeles, Oakland, Birmingham, and San Antonio health
departments adapted to health system restructuring. A model urban health systems sentinel
network/study protocol was developed and data collected from six urban centers. A final
report has been prepared |
| Contractor/Project Manager |
MACRO International
Tom Chapel, PhD (404) 321-3211 |
| CDC Project Officer |
Pomeroy Sinnock, PhD (770) 488-4469 |
| Other CIOs/Agencies Involved |
EPO, NCIPC, NCCDPHP, NIP, NCID, ATSDR |
| Annual Extramural Funding through 1998: |
FY 1998 : $299,000 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
Medicaid, uninsured and underinsured |
| Published Abstracts/Articles |
|
| Title of Project |
A Computer-Based System for Evaluating
Preventive Health Interventions |
| Category |
Public-Private Partnerships |
| Objectives and Description |
This project supports the development of
PC-based simulation software for preventive health strategic planning. The software is
being designed to make the implications of the latest clinical, public health,
administrative, fiscal and community research and policy findings readily accessible to
planners and decision-makers. Public health, managed care, and community organizations
will be able to use it to simulate the health effects, costs and benefits of various,
preventive interventions on selected diseases. The current prototype uses Diabetes mellitus Type II as the disease-vehicle.
Future versions are envisioned for cancer, heart disease, stroke, hypertension, sexually
transmitted diseases, etc. Users will be able to customize resident data sets (e.g.,
health-care costs, utilization rates, intervention delivery costs, etc.) to reflect local
demographics, as well as project the costs and benefits of health education, case
management, health risk assessment and other interventions. The software will alert users
to potential political, social and policy issues that may affect program implementation or
feasibility. |
| Outcomes: |
Benefits include: 1) enhancing preventive
service advocacy, planning and evaluation; 2) providing guidance for program
implementation; 3) facilitating comparison of programs; 4) teaching clinicians and
epidemiologists about administrative, fiscal and community issues; 5) teaching
administrators, fiscal officers and policymakers about clinical and epidemiological issues
6) providing support for better-substantiated justifications for preventive intervention
budget requests |
| Contractor/Project Manager |
Engineering Management & Economics, Inc.
Robert Polster, DSc, Program Manager (301) 738-1045 |
| CDC Project Officer |
David E. Adcock, MBA (770) 288-2492 |
| Other CIOs/Agencies Involved |
National Library of Medicine, Rollins School of
Public Health at Emory University, Central Virginia Health Planning Agency, National
Association of Local Boards of Health, Chartered Health Plan, Inc., Virginia Hospital
& Healthcare Association, West Virginia Medical Institute |
| Annual Extramural Funding through 1998: |
FY 1996: $98,751; FY 1997: $325,969; FY 1998:
$325,969 |
| Funding Mechanism |
Small Business Innovation Research (SBIR) |
| Project Status |
Completion of SBIR Phase II by April 30, 1999 |
| Special Populations |
The modeled population can be adjusted to match
the community under study. |
| Published Abstracts/Articles |
Presentations: Society for Prospective Medicine
10/27/98, American Public Health Association 11/18/98, Prevention '99 3/19/99. Centers for
Disease Control & Prevention 5/7/99. |
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