Investigators: Erin Fraher PhD MPP, Andy Knapton MSc Background/Study Purpose: Congressional proposals to expand Graduate Medical Education have set a goal of funding 3,000 new PGY1 slots for five years for a total of 15,000 new residency positions. The Resident Physician Shortage Reduction Act of 2015 (S.1148), its companion bill in the House (H.R. 2124)… Read more »
The Role of Practice Facilitators in Meeting the HIT Needs of Rural Practices (2015-16)
Authors: Warren Newton, MD MPH; Ann Lefebvre, MSW, CPHQ Background/Policy Relevance Primary care transformation is necessary for health system redesign, but how to support this on a large scale remains unclear. The tasks of contemporary primary care are substantial, and include closing the quality gap and addressing disparities, while lowering total cost of care and… Read more »
Determining the Value and Outcomes of the Doctor of Nursing Practice (DNP) (2015-16)
Investigators: Anna Beeber PhD RN and Cheryl Jones PhD RN Background: As of 2014, 243 DNP programs were enrolling students and an additional 59 DNP programs were in the planning stages. From 2012 to 2013, the number of students enrolled in DNP programs increased from 11,575 to 14,688. During that same period, the number of… Read more »
Predicting Role Transitions for the LPN-to-RN Workforce in North Carolina (2015-16)
Investigators: Cheryl Jones PhD RN, Mark Toles PhD RN and George Knafl PhD Background: Using the dataset developed in our Year 2 project, we will extend our descriptive work to model the key predictors of nurses who transition from LPN to RN roles. Study aims: We will study the likelihood of transitioning (e.g. the dependent… Read more »
Toward a Better Understanding of Social Workers on Integrated Care Delivery Teams (part 1) (2015-16)
Investigators: Mark Fraser PhD; Erica Richman, PhD, MSW; Erin Fraher, PhD, MPP Background: Given the growing number of social workers employed in the healthcare system and the diversity of roles they fill, it is critical to understand the responsibilities and capacity of social workers as healthcare shifts to team-based models of care, value-based payments, and… Read more »
The Future of Medicaid-Funded Graduate Medical Education as the Health Care System Shifts (2015-16)
Investigators: Erin P. Fraher PhD MPP and Julie Spero MSPH Background: While Medicare is the dominant funding source for Graduate Medical Education (GME) in the United States, Medicaid investments in GME totaled nearly $4 billion in 2012. Medicaid GME dollars are attractive to states because they can be matched by federal dollars, thereby increasing the… Read more »
Heart Health NOW! Advancing Heart Health in NC Primary Care
EvidenceNOW: Advancing Heart Health in Primary Care is an initiative of the Agency for Healthcare Research and Quality (AHRQ) to accelerate the dissemination and implementation of patient-centered outcomes research findings into primary care. AHRQ has awarded seven implementation grants that use a variety of interventions to help small and medium-sized primary care practices build… Read more »
Rapid Response to Requests from NCHWA
Investigators: CHWRC investigators and staff as appropriate for each request Part of the CHWRC’s role is to provide rapid response to time-sensitive requests from the National Center for Health Workforce Analysis (NCHWA) and other key constituents. Our rapid response activities allow NCHWA and HRSA to access the wide array of data resources housed at the… Read more »
Tough choices: Autism, private health insurance and family out-of-pocket spending
Emerging patterns in our current work suggest that insurance choices of families raising children with autism are influenced by out-of-pocket expenditures without regard to the breadth and depth of services covered. This is troubling from a policy perspective since low deductible and co-payment plans are expensive and reduce resources thereby constraining use of uncovered services…. Read more »
Adequate Health Insurance for Children with Autism
Evidence and Implications for Defining Essential Benefits – Families raising children with autism contribute significant amounts out-of-pocket to the cost of care and that this pay-as-you-go strategy is associated with disparities in use for vulnerable families (Thomas, Williams et al, 2013; Parish, Thomas, Williams et al, 2013). As a result, in comparison to other children… Read more »
Pathways in Nursing Careers: Transitions from the Role of Licensed Practical Nurse to Registered Nurse in North Carolina (2014-15)
Investigators: Cheryl Jones, PhD, RN, FAAN; George Knafl, PhD; Mark Toles, PhD, RN; Anna Beeber, PhD, RN Background: In a reforming health care system, nursing personnel, including licensed practical nurses (LPNs) and registered nurses (RNs), are viewed as flexible health care workers because they are readily deployed in diverse health care settings, reduce workforce shortages,… Read more »
Physician Assistant and Nurse Practitioner Roles in Patient-Centered Medical Homes (2014-15)
Investigators: Christine Everett, PhD, MPH, PA-C; Perri Morgan, PhD, PA-C Background: Team-based care involving physician assistants (PAs) and nurse practitioners (NPs) is one recommended strategy for improving access, quality, and cost of care in the patient-centered medical home (PCMH). The fact that PA/NPs can, and do, perform a variety of roles on primary care teams,… Read more »
The Role of Physical and Occupational Therapists in the Acute to Post-Acute Care Transition (2014-15)
Investigators: Janet Freburger, PT, PhD (now at the University of Pittsburgh); Anna Johnson, PhD; Dongmei Li, MS. Background: Medicare spending for post-acute care has increased considerably in the past decade with evidence of significant geographic variation in the use of these services. Acute care hospitals and each post-acute setting also have their own separate… Read more »
Diffusion of Physicians and Access to Primary Care: The Role of Person, Program, and Place (2014-15)
Author: Thomas C. Ricketts, PhD, MPH Background: Federal and state policies try to influence physician location choices using a combination of programmatic or extrinsic factors (e.g. bonus payments, subsidized loans) and personal or intrinsic factors (e.g. promoting volunteerism, orienting trainees to underserved populations and selecting motivated students) to encourage physicians to practice in communities where the… Read more »
Understanding How the Diffusion of Physicians Creates Areas of Underservice (2014-15)
Investigators: Thomas Ricketts, PhD; Erin Fraher, PhD, MPP; Andy Knapton, MSc Background: States and the federal government devote substantial resources to influence physicians to practice in underserved areas. Like the general population, the physician workforce is mobile. About 20% of the active employed physician workforce will relocate to another county within a five-year period. Federal… Read more »