Health Care Practice / Quality

Funded partially by the Older Americans Act, state Long-Term Care Ombudsman Programs (LTCOPs) provide a critical role in serving as advocates for older adults in long-term care (LTC) facilities. Ombudsmen regularly visit residents, resolve disputes, and assist with discharge planning. In 2022, the National Academies of Sciences, Engineering, and Medicine called for increased LTCOP funding to improve nursing home (NH) quality. More

Starting in 2015, states could apply for section 1115 substance use disorder (SUD) waivers to strengthen their continuum of care for treatment of opioid use disorder (OUD). More

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

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

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

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

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

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

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

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