Organization

The Stephen M. Shortell Center for Organizational Research in the Health Sector Publications

Trends in Screening for Social Risk in US Physician Practices

Amanda Brewster
Hector P Rodriguez
Genevra Murray
Valerie Lewis
Karen Schifferdecker
Elliott Fisher
2025
Abstract

Importance A wealth of research on screening for social risks in health care has emerged, but evidence is lacking on how social risk screening among physician practices has changed over time.

Objectives To evaluate trends in screening for social risks among US physician practices and examine practice characteristics associated with adoption of social risk screening.

Design, Setting, and Participants The main analysis used a repeated cross-sectional design to analyze...

Trends in Screening for Social Risk in US Physician Practices

January 3, 2025

CHAMP faculty and co-directors along with other members of the CHAMP team investigated if social risk screening in the US has changed over time with their new article recently published in JAMA Network Open. This cross sectional study found that in 2022, 27% of physician practices reported systematically screening patients for 5 common social risks, a significant increase from 15% in 2017. The investigators used a repeated cross-sectional approach using results from the National Survey of Healthcare Organizations and Systems (NSHOS II). Their findings would...

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

December 3, 2024

Blue Cross Blue Shield of Massachusetts (BCBSMA), a large commercial health insurer, is using financial incentives to advance equity of care by patient race and ethnicity. Understanding experiences of this payer and its contracted physician groups can inform efforts elsewhere. In this recently published paper, CHAMP members 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.

CHAMP members conducted key informant...

UC Berkeley Public Health Researchers Awarded Robert Wood Johnson Foundation Grant to Evaluate Equitable Vaccination Access With USAging

October 31, 2024
UC Berkeley Public Health Researchers Awarded Robert Wood Johnson Foundation Grant to Evaluate Equitable Vaccination Access With USAging

October 2024

Systems for Action, a national program of the Robert Wood Johnson Foundation, awarded the UC Berkeley Center for Health Management and Policy Research and USAging a three-year grant to conduct important research on addressing inequities in vaccination access.

UC Berkeley School of Public Health professors Dr. Amanda Brewster and Dr. Jenny Guadamuz are leading this project alongside USAging, the national association...

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

Hector P Rodriguez
Sarah Epstein
Amanda Brewster
Timothy Brown
Stacy Chen
Salma Bibi
2024

Context

Blue Cross Blue Shield of Massachusetts (BCBSMA), a large commercial health insurer, is using financial incentives to advance equity of care by patient race and ethnicity. Understanding experiences of this payer and its contracted physician groups can inform efforts elsewhere. We 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.

Methods

Key informant...

Intensity of Social Needs Case Management Services and Changes in Hospital and Emergency Department Use Among Adult Medicaid Beneficiaries

Crystal Guo
Timothy Brown
Hector P Rodriguez
Margae Knox
Mark Fleming
Elizabeth Hernandez
Daniel Brown
Amanda Brewster
2024

Objectives: We identify the association between high- and low- intensity case management services on hospital and emergency department (ED) use among CommunityConnect patients.

Background: Social needs case management services vary in intensity, including the modality, workforce specialization, and maximum caseload. CommunityConnect is a social needs case management program implemented by Contra Costa Health, a county safety-net health system in California’s San Francisco Bay Area.

Methods: Due to the endogeneity of high-...

Decoding Suicide Decedent Profiles and Signs of Suicidal Intent Using Latent Class Analysis

Yunyu Xiao
Kaiwen Bi
Julie Cerel
Timothy Brown
Yifan Peng
Jyotishman Pathak
J John Mann
2024

Importance: Suicide rates in the US increased by 35.6% from 2001 to 2021. Given that most individuals die on their first attempt, earlier detection and intervention are crucial. Understanding modifiable risk factors is key to effective prevention strategies.

Objective: To identify distinct suicide profiles or classes, associated signs of suicidal intent, and patterns of modifiable risks for targeted prevention efforts.

Design, setting, and participants: This cross-sectional study used data from the 2003-2020 National Violent...

Primary Care Practice Characteristics Associated With Medical Assistant Staffing Ratios

Hector P Rodriguez
Alena Berube
Dorothy Hung
Stephen Shortell
Elliott Fisher
2024

This study characterized adult primary care medical assistant (MA) staffing. National Survey of Healthcare Organizations and Systems (n = 1,252) data were analyzed to examine primary care practice characteristics associated with MA per primary care clinician (PCC) staffing ratios. In 2021, few practices (11.4%) had ratios of 2 or more MAs per PCCs. Compared with system-owned practices, independent (odds ratio [OR] = 1.76, P <0.05) and medical group-owned (OR = 2.09, P <0.05) practices were more likely to have ratios of 2 or more MAs per PCCs, as were...

Safety Net Primary Care Capabilities After the COVID-19 Pandemic

Karen E Schifferdecker
Ching-Wen W Yang
Matthew B Mackwood
Hector P Rodriguez
Stephen Shortell
Ellesse-Roselee Akré
A James O'Malley
Caryn Butler
Alena Berube
Alice O Andrews
Elliott S Fisher
2024

Importance: Federally qualified health centers (FQHCs) provide care to 30 million patients in the US and have shown better outcomes and processes than other practice types. Little is known about how the COVID-19 pandemic contributed to FQHC capabilities compared with other practices.

Objective: To compare postpandemic operational characteristics and capabilities of FQHCs with non-FQHC safety net practices and non-FQHC, non-safety net practices.

Design, setting, and participants: This nationally representative survey conducted...

Rental Housing Deposits and Health Care Use

Margae Knox
Elizabeth Hernandez
Jennifer Ahern
Daniel Brown
Hector P Rodriguez
Mark Fleming
Amanda Brewster
2024

Importance: Housing deposits and tenancy supports have become new Medicaid benefits in multiple states; however, evidence on impacts from these specific housing interventions is limited.

Objective: To evaluate the association of rental housing deposits and health care use among Medicaid beneficiaries receiving social needs case management as part of a Whole-Person Care (Medicaid 1115 waiver) pilot program in California.

Design, setting, and participants: This cohort study compared changes in health care use among a group of...