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PA-20-072, Measuring the Clinical and Economic Outcomes Associated with Delivery Systems: "Are Health Systems Better at Responding to Pandemics?"

Award Number: U19HS024072
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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OTHER PROJECT INFORMATION – Project Summary/Abstract PA-20-072: Are Health Systems Better at Responding to Pandemics? The goal of this project is to provide evidence on whether integrated health systems lead to better or worse care outcomes than independent providers during the COVID-19 epidemic. Health care has undergone enormous consolidation in recent years, as providers have rapidly assembled into bigger systems. Practitioners and policy makers have engaged in spirited debate about whether such consolidation is good or bad, but there has been only a little empirical evidence on the topic. We will study the impact of integrated care in a crucially important setting – the response to the COVID-19 epidemic. Integrated systems of care have some advantages during an epidemic: they may have the financial resources to better withstand negative revenue shocks, more physical space to separate COVID-19 and non- COVID-19 patients, and better information technology infrastructure to permit widescale telemedicine. However, integrated systems may be so focused on acute patients that they fail to keep up with the community-based population in need. Large integrated systems may also be less in touch with the needs of each individual patient. Our proposed analysis has three components. First, we will examine how medical treatments differ for patients in and outside of integrated health systems during the COVID-19 crisis. Measures of treatment will include testing for COVID-19 as well as medical care receipt apart of COVID-19: visits with health care providers (both in-person and telemedicine), and maintenance of chronic therapy for those in the community. Second, we will examine how health outcomes and the experience of care differ for patients in and outside of systems. Some outcome measures are appropriate for many groups of patients, including death, hospitalization with severe disease, and patient assessments of the quality of care received. Other outcomes are specific to certain subgroups, including tumor progression for patients with cancer, changes in site of delivery for pregnant patients, and ability to live independently for adults and children with physical and mental impairments. Third, we will examine how the organization of care is changing as a result of COVID-19. To understand this, we will track practice closures along with mergers of smaller providers into larger systems as the COVID-19 epidemic proceeds. Our patient analysis will use several sources of data, including Medicare claims, claims records for commercially insured individuals, and people giving birth in a large state. To track closures, we will use Medicare payment data along with private sector data on health care consolidation.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = -$3,870 )
2023	2021	NATIONAL BUREAU OF ECONOMIC RESEARCH INC	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	001	5	6/6/2023	SUPPLEMENT FOR EXPANSION	-$1,935
2023	2021	NATIONAL BUREAU OF ECONOMIC RESEARCH INC	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	5/4/2023	SUPPLEMENT FOR EXPANSION	-$1,935
														Subtotal = -$3,870

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	NATIONAL BUREAU OF ECONOMIC RESEARCH, INC.	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	001	5	12/9/2021	SUPPLEMENT FOR EXPANSION	$0
2022	2019	NATIONAL BUREAU OF ECONOMIC RESEARCH, INC.	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	12/9/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $2,348,744 )
2021	2021	NATIONAL BUREAU OF ECONOMIC RESEARCH, INC.	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	001	5	12/15/2020	SUPPLEMENT FOR EXPANSION	$2,348,744
2021	2019	NATIONAL BUREAU OF ECONOMIC RESEARCH, INC.	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	12/15/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $2,348,744

Issue Date FY: 2020 ( Subtotal = $0 )
2020	2019	NATIONAL BUREAU OF ECONOMIC RESEARCH, INC.	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	7/7/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2019 ( Subtotal = $3,492,100 )
2019	2019	NATIONAL BUREAU OF ECONOMIC RESEARCH, INC.	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	8/29/2019	NON-COMPETING CONTINUATION	$3,492,100
														Subtotal = $3,492,100

Issue Date FY: 2018 ( Subtotal = $3,492,100 )
2018	2018	NATIONAL BUREAU OF ECONOMIC RESEARCH, INC.	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	8/24/2018	NON-COMPETING CONTINUATION	$3,492,100
														Subtotal = $3,492,100

Issue Date FY: 2017 ( Subtotal = $3,492,100 )
2017	2017	NATIONAL BUREAU OF ECONOMIC RESEARCH, INC.	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	9/1/2017	NON-COMPETING CONTINUATION	$3,492,100
														Subtotal = $3,492,100

Issue Date FY: 2016 ( Subtotal = $3,492,100 )
2016	2016	NATIONAL BUREAU OF ECONOMIC RESEARCH	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	8/31/2016	NON-COMPETING CONTINUATION	$3,492,100
														Subtotal = $3,492,100

Issue Date FY: 2015 ( Subtotal = $3,492,100 )
2015	2015	NATIONAL BUREAU OF ECONOMIC RESEARCH	1050 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	9/1/2015	NEW	$3,492,100
														Subtotal = $3,492,100

Grand Total All Awards = $19,805,375

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PA-20-072, Measuring the Clinical and Economic Outcomes Associated with Delivery Systems: "Are Health Systems Better at Responding to Pandemics?"

Award Number: U19HS024072

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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