Do Acquisitions of Hospice Agencies by Private Equity Firms and Publicly Traded Corporations Impact End-of-Life Quality and Cost of Care?

私募股权公司和上市公司收购临终关怀机构是否会影响临终护理质量和护理成本？

• 批准号: 10351004
• 负责人: Robert Tyler Braun
• 金额: $ 11.3万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10351004
• 关键词: Administrator; Affect; Aging; Applications Grants; Area; Atlases; Behavior; Caring; Characteristics; Client satisfaction; Clinical; Cross-Sectional Studies; Data; Databases; Education; Elderly; Event; Fee-for-Service Plans; Foundations; Funding; Geriatrics; Goals; Growth; Health Policy; Health Resources; Health Sciences; Health Services; Healthcare; Holly; Hospice Care; Incentives; Industry; Interview; Investments; Leadership; Long-Term Care; Medicare; Medicare claim; Mentored Research Scientist Development Award; Mentors; Methodology; Methods; Modeling; National Institute on Aging; Nursing Staff; Organizational Culture; Outcome; Ownership; Patients; Perception; Physician Executives; Physicians; Policies; Privatization; Process; Provider; Public Health; Qualitative Methods; Qualitative Research; Quality of Care; Quality of life; Quasi-experiment; Research; Research Design; Research Personnel; Research Training; Role; Structure; Training; United States Centers for Medicare and Medicaid Services; Universities; Work; care costs; care delivery; career; clinical care; cost; econometrics; end of life; end of life care; health care delivery; health care service organization; hospice environment; improved; instructor; intervention delivery; medical schools; mid-career faculty; novel; operation; patient population; payment; population health; pressure; professor; response; service providers; skills; success; trend

PROJECT SUMMARY/ABSTRACT This is a K01 Mentored Research Scientist Development Award submitted to the National Institute on Aging by Robert Tyler Braun, an Instructor in the Department of Population Health Sciences at Weill Cornell Medical College (WCMC). Dr. Braun's career goal is to become an independent researcher on improving end-of-life care for the elderly by assessing various policy interventions and delivery models of hospice care. This K01 application will provide Dr. Braun with the necessary training 1) to gain expertise in aging and hospice research; 2) to understand clinical care for hospice patients; and 3) to gain methodological skills to conduct qualitative studies related to hospice delivery and care. Dr. Braun has assembled a mentor team of accomplished researchers from WCMS and Vanderbilt University School of Medicine (VUSM): Dr. Lawrence Casalino (primary mentor) who is the Livingston Farrand Professor of Public Health at WCMC and an expert on health care organization and behavior, and qualitative methods; Dr. Holly Prigerson (co-mentor) who is the Irving Sherwood Wrights Professor of Geriatrics at WCMC and an expert on end-of-life care; Dr. David Stevenson (co-mentor) who is a professor and the holder of the Endowed Directorship in Health Policy Education at VUMC and an expert in the delivery of hospice care; and Dr. Mark Unruh (co-mentor) who is an Associate Professor in the Department of Population Health Sciences at WCMC with expertise in long-term care and Medicare claims data. Over the past couple of decades, the hospice industry has moved from largely a not-for-profit sector to predominately for-profit. Facilitated by relatively easy market entry and generous Medicare payments, PE firms and PTCs have been acquiring hospices (many of them non-profit), with the goal to deliver short-term, above market returns to their investors. Despite this emergence, little is known of its effect on hospice care. Building on his previous research and training on assessing this phenomenon in physician practices, Dr. Braun will identify the organizational, staffing, patient, and quality characteristics associated with PE and PTC acquisitions using publicly available hospice data from Center for Medicare and Medicaid Services (CMS) (Aim 1), use rigorous econometric methods to assess the effect PE and PTC acquisition on hospice care using patient-level Medicare claims (Aim 2), and use qualitative methods to assess organizational, cultural, and delivery aspects of hospices post-acquisition integration (Aim 3). This research will be a foundation for an R01 grant application and will incorporate the new skills acquired through his training, which inform opportunities for improvement in hospice delivery of care.

项目概要/摘要 这是向国家提交的 K01 指导研究科学家发展奖 人口健康科学系讲师罗伯特·泰勒·布劳恩 (Robert Tyler Braun) 的老龄化研究所 威尔康奈尔医学院（WCMC）。布劳恩博士的职业目标是成为一名独立的 研究人员通过评估各种政策干预措施来改善老年人的临终关怀 临终关怀的提供模式。此 K01 应用程序将为 Braun 博士提供必要的培训 1）获得老龄化和临终关怀研究方面的专业知识； 2）了解临终关怀患者的临床护理； 3) 获得进行与临终关怀服务和护理相关的定性研究的方法技能。 Braun 博士组建了一支由来自 WCMS 和 范德比尔特大学医学院 (VUSM)：Lawrence Casalino 博士（主要导师） WCMC 公共卫生教授利文斯顿·法兰德 (Livingston Farrand) 和卫生保健组织和专家 行为和定性方法； Holly Prigerson 博士（联合导师），Irving Sherwood Wrights WCMC 老年病学教授、临终关怀专家；大卫·史蒂文森博士（共同导师） 是 VUMC 的教授和卫生政策教育捐赠董事职位的持有者， 提供临终关怀的专家；和 Mark Unruh 博士（共同导师），他是 WCMC 人口健康科学系，拥有长期护理和医疗保险方面的专业知识 索赔数据。 在过去的几十年里，临终关怀行业已经从很大程度上是非营利性的 行业以营利性为主。相对容易的市场准入和慷慨的医疗保险促进 支付、私募股权公司和 PTC 一直在收购临终关怀医院（其中许多是非营利性的），其目标是 为投资者提供高于市场的短期回报。尽管出现了这种情况，但人们对其知之甚少 对临终关怀的影响。基于他之前评估这一现象的研究和培训 医生实践中，布劳恩博士将确定组织、人员配置、患者和质量 使用中心公开的临终关怀数据与 PE 和 PTC 收购相关的特征 对于医疗保险和医疗补助服务 (CMS)（目标 1），使用严格的计量经济学方法来评估 使用患者层面的医疗保险索赔（目标 2）影响临终关怀中 PE 和 PTC 的获取，并使用 评估收购后临终关怀组织、文化和交付方面的定性方法 一体化（目标 3）。这项研究将成为 R01 拨款申请的基础，并将纳入 通过培训获得的新技能为改善临终关怀提供了机会 提供护理。