PE Fellow and Alumni Accomplishments
Dr. Bradford Greening and Dr. Caresse Campbell
Research: Dr. Keith Branham co-authored a January 2017 policy brief entitled, Medicaid Expansion Impacts on Insurance Coverage and Access to CareExternal while assigned to the Department of Health and Human Services, Assistant Secretary for Planning and Evaluation. This brief examined the availability and affordability of plans available through Marketplace for the 2017 Open Enrollment period. He also co-authored an October 2018 landscape brief titled 2019 Health Plan Choice and Premiums in Healthcare.Gov States Cdc-pdf[PDF – 44 pages]External. This brief found increased numbers of insurers operating in healthcare.gov states and documented substantial increases in premiums in those states.
Dr. Branham completed an analysis of various repeal and replace models by applying the RAND COMPARE model to identify research questions and using the tool to support a predictive analyses of options. He currently works for the Data and Systems Group, Division of Business and Data Analysis, at the Centers for Medicare and Medicaid Services.
Public Health Impact: Medicaid Expansion Impacts on Insurance Coverage and Access to CareExternal has been highly influential within policy circles at HHS as ASPE’s role includes ascertaining the economic impacts of Medicaid expansion including the impact on the cost of uncompensated care.
PE Fellowship Class of 2014
Research: In The Lancet article “Preventive malaria treatment for contacts of patients with Ebola virus disease in the context of the west Africa 2014–15 Ebola virus disease response: an economic analysis,” Dr. Bradford Greening and Dr. Caresse Campbell shared study findings centered around administering malaria treatment to contacts of Ebola patients.
Public Health Impact: Their study found that administration of malaria treatment to contacts of patients with Ebola virus disease was cost saving for contacts of all ages in Liberia, Sierra Leone, and Guinea, in both seasons, from a health-care provider perspective and should be considered by public health officials when addressing Ebola virus disease outbreaks in countries and seasons where malaria reaches high levels of transmission.
Dr. Gabi Miller
PE Fellowship Class of 2014
Research: In an October 2016 article titled “Cost and Prevalence of Five Chronic Conditions in School Children” in the Journal of School Nursing, Dr. Gabi Miller used 2005-2012 Medical Expenditure Panel Survey data to calculate the prevalence of asthma, epilepsy, hypertension, food allergies, and diabetes in children aged 0-18 years. Prevalence rates varied by race and ethnicity across conditions. Females had higher prevalence of all chronic conditions except epilepsy. An additional $1,378–$9,059 were spent annually per child with these conditions.
Public Health Impact: This is the first study to examine the costs and prevalence of chronic health conditions in children and adolescents using a single data set.
Dr. Yao-Hsuan Chen
PE Fellowship Class of 2013
Research: Dr. Yao-Hsuan Chen, an Operations Research Analyst in CDC’s Division of HIV/AIDS Prevention, has collaborated with experts in the Division and in the Georgia Tech School of Industrial & Systems Engineering to create an HIV network model tool. This tool, based on local epidemiologic data, helps estimate the hidden HIV transmission network among persons who inject drugs, predict the speed and scope of HIV spread, and quantify the impact of HIV interventions. Dr. Chen has also developed an HIV agent-based model that uses HIV molecular surveillance data to target HIV interventions in an outbreak response.
Public Health Impact: Once completed, the user-friendly interface included in the HIV network model tool can enable decision makers or stakeholders at CDC and in state health departments to test various interventions in the HIV transmission model and compare the cost-effectiveness of these interventions. Insights obtained from integrating molecular surveillance data into an HIV agent-based model can help guide HIV outbreak responses in the future.
Dr. Kun Zhang
PE Fellowship Class of 2013
Research: Dr. Kun Zhang used IMS Health’s National Prescription Audit and government mortality data to examine death rates from opioid prescribing and prescription opioid and heroin overdose in the United States during 2006-2013. In his research, Dr. Zhang examined the combined implementation of mandatory provider review of state-run prescription drug monitoring and pain clinic laws.
Public Health Impact: The analysis, published in an October 2016 Health Affairs article titled “Mandatory Provider Review and Pain Clinic Laws Reduce the Amounts of Opioids Prescribed and Overdose Death Rates”, revealed that the policies reduced opioid amounts prescribed by 8 percent and prescription opioid overdose death rates by 12 percent.
Dr. Muhammad Jami Husain and Dr. Deliana Kostova
PE Fellowship Class of 2013 (Husain) and Class of 2010 (Kostova)
Research: Noncommunicable diseases (NCDs) are often associated with aging, but in low-and middle-income countries, people are suffering and dying early from NCDs. Dr. Husain and Dr. Kostova are both members of the International NCD Economics Research Network, a coalition that aims to address this issue from an economic perspective. Dr. Husain and Dr. Kostova are contributors to a December 2017 supplement in the journal Preventive Medicine titled “Economic perspectives of noncommunicable disease risk factors in developing countriesExternal.” The supplement highlighted economic research on policies that influence NCD risk factors.
Public Health Impact: “The first supplement from network researchers was a success in connecting modelers, end-users, and policy-makers, and driving conversation around translating evidence into impact,” explains Muhammad Jami Husain, PhD, an economist with the Center for Global Health (CGH) at CDC. “The need for a second supplement for continued evidence generation was deemed critically important.”
“The continued engagement of economic experts is key for finding optimal solutions to the rising burden of NCDs globally,” states Deliana Kostova, PhD, a lead economist also with CGH/CDC. “The International NCD Economics Research Network solidifies and expands CDC’s contribution by advancing the international evidence for NCD prevention and control.”
Dr. Cora Peterson
PE Fellowship Class of 2011
Research: As an economist with CDC’s National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Dr. Cora Peterson authored a study titled, “Lifetime Economic Burden of Rape Among U.S. Adults” published in the June 2017 issue of the American Journal of Preventive Medicine. She found that the estimated lifetime cost of rape was $122,461 per victim, or a population economic burden of nearly $3.1 trillion (2014 U.S. dollars) over victims’ lifetimes, based on data indicating >25 million U.S. adults have been raped.
Public Health Impact: Preventing sexual violence could avoid substantial costs for victims, perpetrators, healthcare payers, employers, and government payers.
Dr. Ricardo Basurto-Davila
PE Fellowship Class of 2009
Research: Now a lead economist at the Los Angeles County Health Department, Dr. Ricardo Basurto-Davila co-authored a book published in April 2016 by the National Academies of Sciences, Engineering, and Medicine titled, “Advancing the Power of Economic Evidence to Inform Investments in Children, Youth, and Families.” The report highlights the potential for economic evidence to inform investment decisions for interventions that support the overall health and well-being of children, youth, and families. It describes challenges to the optimal use of economic evidence and offers recommendations to stakeholders to promote a lasting improvement in its quality, utility, and use.
Dr. Xin Xu
PE Fellowship Class of 2009
Research: While working as an economist in CDC’s Office on Smoking and Health, Dr. Xin Xu performed research that describes the success of the Tips from Former Smokers (Tips) media campaign. As a result of the first 12 weeks of the campaign in 2012, “1.6 million smokers tried to quit and more than 100,000 were likely quit smoking permanently.”
Public Health Impact: Results of the analysis showed that the Tips campaign cost only $393 for every life saved – a highly cost effective intervention. This study shows that investing in prevention can reduce disease and save lives and reduce health costs for families and businesses alike. This research was published in an article titled, “Evaluation of the National Tips From Former Smokers Campaign: the 2014 Longitudinal Cohort” that appeared in the March 2016 issue of Preventing Chronic Disease.
Dr. Florence Tangka
PE Fellowship Class of 2001
Research: Dr. Florence Tangka served as editor and significant contributor (along with CDC colleagues) to a special issue in an upcoming December 2017 issue of Cancer Epidemiology, “Cost of Cancer RegistrationExternal.” The issue highlighted the need for cancer registration in the resource-constrained setting and provides evidence on the overall affordability of operating cancer registries. The special issue reviews the costs of registries in Kenya, Uganda, Colombia, India (Mumbai), and Barbados, and estimates the cost of cancer registration.
Public Health Impact and Key Findings:
- Host institution resources are crucial for registry operations and sustainability.
- Cancer registration involves substantial fixed costs and labor.
- The cost of cancer registration spread over the population covered by each registry was low (less than $0.01 to $0.22).
- The cost per cancer case registered varied across registries ($3.77 to $113.39), and was smaller among registries in low-income and lower-middle income countries ($3.77 to $15.62).
- Approaches to increase efficiency, such as data collection procedures and organization/funding structure, could serve to reduce registry costs.
Dr. Tangka also co-edited a June 2017 special issue of Evaluation and Program Planning titled “Importance of Implementation Economics for Program Planning-Evaluation of CDC’s Colorectal Cancer Control Program.” This issue essentially highlights the need to understand the costs of initiating and operationalizing colorectal cancer (CRC) control programs for planning successful implementation of evidence-based recommendations to reduce disparities and increase CRC cancer screening uptake. It emphasizes the need to increase the number of ‘implementation economics’ studies to develop the evidence-base to guide funding decision making, design cost-effective programs and ensure optimal use of limited resources.
Dr. Scott Grosse and Dr. Rui Li
PE Fellowship Class of 1996 (Grosse) and 2005 (Li)
Research: Dr. Scott Grosse and Dr. Rui Li modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. This study, titled “Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016,”was published in the January 2017 issue of Emerging Infectious Diseases.
Public Health Impact: It could reduce Zika virus–related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus–associated microcephaly [ZAM]). Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention.
Dr. Scott Grosse
PE Fellowship Class of 1996
Research: Dr. Scott Grosse and colleagues conducted a re-assessment of the net cost savings per year associated with mandatory folic acid fortification of enriched cereal grain products in the U.S., which was implemented during 1997–1998. The study found that the fortification mandate is estimated to have reduced the annual number of U.S. live-born spina bifida cases by 767.
Public Health Impact: Their study, “Retrospective Assessment of Cost Savings From Prevention: Folic Acid Fortification and Spina Bifida in the U.S.”, published in the May 2016 issue of the American Journal of Preventive Medicine, found that folic acid fortification is estimated to reduce the present value of total direct costs for each year’s birth cohort by $603 million more than the cost of fortification. A conservative estimate of cost savings due to folic acid fortification is $299 million per year.