I had the pleasure of attending AcademyHealth’s Annual Research Meeting, June 26-28, 2016, at the Hynes Convention Center in Boston, Massachusetts. In addition to attending several panel discussions and presentations featuring the latest research in the health services research field, I had the opportunity to present some of my own work.
In January 2016, I had submitted an abstract titled, “Effects of Permanent Supportive Housing on Medicaid Utilization and Costs,” based on my analysis regarding the impact of permanent supportive housing (PSH) on health services utilization and costs among homeless Medicaid beneficiaries in Washington, D.C. My abstract was accepted for a podium presentation.
As in many parts of the United States, homelessness is a significant problem in the District of Columbia. Homeless individuals disproportionately suffer from unmanaged health conditions, which can lead to long-term health issues, including an increased risk of chronic disease, mental illness, and substance use disorders. Inappropriate use of emergency services and acute care is commonplace and may be a consequence of irregular access to preventive services and case management. Placement in PSH can provide stability and increase opportunities for leading healthier lives. In addition, the PSH model has the potential to improve access to comprehensive primary health care, behavioral health, and supportive services for homeless individuals in the United States and other part of the Americas.
I conducted a retrospective, descriptive analysis of administrative claims data using the D.C. Medicaid Management Information System (MMIS) database. The study included 293 homeless D.C. Medicaid beneficiaries who were placed in PSH between October 1, 2011 and September 30, 2012. To examine health services utilization and costs before and after PSH placement, I extracted claims from October 1, 2010 to September 30, 2014 and separated them into three groups based on date of service in relation to the date of PSH placement: 1) year before move-in, 2) first year after move-in, and 3) second year after move-in. For each of these groups, the study examined emergency department, pharmacy, inpatient, outpatient, and behavioral health utilization and cost trends. The analysis showed that placement in PSH may reduce ED and inpatient visits while shifting some of those costs toward non-acute care, such as substance abuse treatment and behavioral health.
My presentation was part of a panel on Medicaid Payment Policy and allowed me to discuss health utilization and access issues pertaining to the homeless population in front of a national audience. I had the opportunity to network with academic researchers as well as analysts from other state Medicaid agencies.
In addition to presenting, I attended several panel presentations featuring experts on various health services research topics, such as innovative health care delivery models and improving health equity in the United States. I attended a late-breaking session on improving clinical care, which included presentations on behavioral health integration and the patient-centered medical home (PCMH) model. The first presenter addressed how taking an integrated approach to mental health can improve behavioral health services in primary care and can reduce the overall cost of care. Another presentation presented findings that Medicaid might be an effective program for expanding access to the PCMH model among low-income adults. Another panel that was really fascinating examined the linkage between clinical claims and population data. This session actually started with a demonstration of linking claims and population data. The session showed how data integration could inform and improve population health and health equity.
I also attended several poster sessions, including one specific to Disparities and Health Equity. One poster presented methods on using Medicaid data to assess health disparities in New York. Their findings revealed that racial and ethnic disparities in obtaining cervical cancer screenings existed at all geographical levels. The methodology presented successfully identified Medicaid sub-populations with disparities and uncovered associated community factors, which in turn could be used to provide stakeholders with guidance on efficiently allocating resources to tackle disparities. Other posters examined topics, such as assessing patient satisfaction of Medicare among Spanish speakers, racial/ethnic differences in patient-centered medical home experiences among veterans, the role of community health workers in reducing disparities, how community heath worker programs can address frequent emergency department utilization, and more.
Attending and presenting at AcademyHealth’s Annual Research Meeting was an enriching experience that enhanced my understanding of current health services research subject areas, such as equity and access to care. I learned how vital research and data are to informing policy and practice. I would highly recommend attending this conference for any students who are interested in health services research.