Quarterly Topic

Health Care Practice / Quality

Content Type:

  • Quarterly Article

    Advancing Equity: Lean Leader Practices and a Path Forward

    August 2025 Dorothy Y. Hung LILLIAN C. LEVY Thomas G. Rundall ELINA REPONEN WILLIAM HUEN Stephen M. Shortell

    Lean management is a sociotechnical approach to quality improvement that aims for consistency in work processes and outcomes. This can be leveraged to reduce inequities by ensuring delivery of high-quality care to meet the needs of patients with diverse backgrounds. Despite recent efforts in the field, there is limited study on how managers implement health equity and workforce diversity goals as strategies to improve patient care. Given the important role of leadership in fostering workplace culture, we examined leader activities and specifically their use of lean management practices to support equity initiatives in health care. More

  • Quarterly Article

    Measuring Primary Care Productivity in the Era of Interprofessional Team Care: Stakeholder, Scoping Review, and Implementation Perspectives

    August 2025 LISA V. RUBENSTEIN SYDNE J. NEWBERRY ISHITA GHAI ANEESA MOTALA IDAMAY CURTIS PAUL G. SHEKELLE TODD H. WAGNER L. DIEM TRAN STEPHEN D. FIHN KARIN M. NELSON

    Current primary care productivity measures do not account for investment in interprofessional primary care teams in relation to primary care goals and thus are insufficient for assessing and improving primary care efficiency and productivity. We explored alternative productivity measurement methods. More

  • Quarterly Article

    Determinants of When Community Behavioral Health Clinics Partner With Emergency Response Systems: The Role of Capacity in 911 Referral and Co-response Models

    August 2025 Amanda I. Mauri Zoe Lindenfeld Charley Willison THERESE L. TODD Jonathan Purtle DIANA SILVER

    Individuals with behavioral health disorders are more likely to experience substantial harm from a police encounter, prompting reforms to minimize encounters between police and people experiencing a behavioral health crisis. One strategy involves expanding partnerships between certified community behavioral health clinic (CCBHC) mobile crisis teams and emergency response systems, often through two models: 911 referral, wherein a CCBHC’s behavioral health practitioner–only team responds to 911 calls, and co-response, wherein a CCBHC clinician joins a police or emergency medical services (EMS) team. More

  • Quarterly Article

    A Policy and Regulatory Framework to Promote Care Delivery Redesign and Production Efficiency in Health Care Markets

    June 2025 Dennis P. Scanlon Jillian B. Harvey Cheryl L. Damberg Pratiksha Mahendra Bhagat Yunfeng Shi

    In this article, we discuss why reliance on transaction prices and market share alone is not sufficient for effective health policy development and regulatory enforcement in health care markets that are imperfectly competitive. We discuss the need to better measure the output produced by health care suppliers and to capture the costs of producing that output. More

  • Quarterly Opinion

    Global Public Health for a New President

    December 2024 Lawrence O. Gostin Alexandra Finch Adi Radhakrishnan Eric A. Friedman

    In every major global health milestone in our lifetimes, the United States has been at the forefront—from smallpox eradication in 1980 and the… More

  • Quarterly Article

    Launching Financial Incentives for Physician Groups to Improve Equity of Care by Patient Race and Ethnicity

    October 2024 Hector P. Rodriguez SARAH D. EPSTEIN Amanda L. Brewster TIMOTHY T. BROWN STACY CHEN Salma Bibi

    This article qualitatively assess physician groups’ barriers and facilitators of planning and implementing BCBSMA’s financial incentives to improve equity of ambulatory care quality by patient race and ethnicity. More

  • Quarterly Article

    A Hexagonal Aim as a Driver of Change for Health Care and Health Insurance Systems

    July 2024 Pierre-Henri Bréchat Angela Fagerlin Anthony Ariotti Alexis Pearl Lee Smitha Warrier Nancy Gregovich Pascal Briot Rajendu Srivastava

    The Quadruple Aim includes improving the experience of care, improving the health of populations, reducing per capita costs of care, and improving the work life of the care providers. We propose expanding a recently defined Fifth Aim of health equity to include health democracy, ensuring that that the health and health care wants, needs, and responsibilities of populations are being met, and also propose adding a Sixth Aim of preserving and improving the health of the environment to create the best health possible. More

  • Quarterly Article

    The Role of Place in Person- and Family-Oriented Long-Term Services and Supports

    July 2023 Chanee D. Fabius Safiyyah M. Okoye Mingche M. J. Wu Andrew D. Jopson Linda C. Chyr Julia Burgdorf Jeromie Ballreich Danny Scerpella Jennifer L. Wolff

    A framework and analyses describing the variable relationships between LTSS-relevant environmental factors and person-reported care experiences. More

  • Quarterly Article

    Toward a Values-Informed Approach to Complexity in Health Care: Hermeneutic Review

    May 2023 Trisha Greenhalgh Eivind Engebretsen Roland Bal Sofia Kjellström

    In this review paper, authors explore the crucial contribution of human values to complex interaction and change. In the form of “simple rules,” we offer some preliminary recommendations for a more contemporary and values-informed approach to complexity in health care. We invite a new generation of research to extend the existing evidence base. More

  • Quarterly Article

    How Emerging Telehealth Models Challenge Policymaking

    September 2022 Mitchell Tang Michael E. Chernew Ateev Mehrotra

    For years, telehealth has been touted as a potentially transformative technology that will increase health care access and efficiency. Although the use of telehealth already was growing, the pandemic drove a dramatic expansion. More