Research

Analytic Insights

The Analytic Insights workgroup investigates key questions impacting healthcare utilization and outcomes in Medicaid populations. One focus area is Centene health plan members’ usage of and engagement with programs and services. Results of these studies will empower health system leaders to quickly assess which services patients use as well as their cost and effectiveness, and to streamline and improve programs and services to better meet patient needs and maximize organizational resources.

The workgroup issued a Call for Proposals in September 2016 and selected five researchers to conduct projects in 2017. To learn more about the Call for Proposal process, visit our Call for Proposals page. A brief synopsis of each analytic study is provided below.

 
Michal Grinstein-Weiss,PhD, MSW, MA
Founding Director​​, Envolve Center for Health Behavior Change

Michal Grinstein-Weiss is the founding director and principal investigator for the Envolve Center for Health Behavior Change. She provides overall strat​egic organizational and scientific leadership for the Center along with the faculty directors and key staff at Envolve. She also serves as the faculty director in the Cen​ter’s Washington University Behavioral Economics workgroup. She is professor at the Brown School and associate director of the Center for Social Development. As a leading expert and researcher in social and economic mobility, Grinstein-Weiss is an influential voice in the design of behavior-based healthcare interventions and innovative social policies to promote household financial security, both in the United States and internationally. She has led successful large-scale research projects for federal, philanthropic, and industry partners and serves as a nonresident senior fellow at the Brookings Institution. Read her full faculty biography here.


Derek Brown, PhD
Lead Faculty​​, Envolve Center for Health Behavior Change

Derek Brown, PhD, is Lead Faculty for the Analytic Studies workgroup of the Envolve Center for Health Behavior Change. Brown is an experienced health economist whose research facilitates improved public health decision making associated with health outcomes, quality of life, cost, cost effectiveness and cost-benefit analysis. His research has appeared in numerous peer-reviewed journals including the American Journal of Public Health, American Journal of Preventive Medicine, Health Economics, Health Services Research, and Value in Health, among others. As Lead Faculty for the Analytic Studies workgroup, Brown provides expert guidance on research methods and design for the Center’s behavior-based health interventions. He received his PhD in Economics from Duke University. Read his full faculty biography here.

 

The Studies

Associations between mental health, health behaviors, and type 2 diabetes

Darrell Hudson, PhD, MPH, a researcher from the Brown School, will determine mental health needs among Centene health plan beneficiaries and examine associations between mental health conditions, health behaviors, such as diet and smoking, and diabetes self-management. Study results will better integrate health coaching and behavioral health counseling as well as help other healthcare providers improve the detection and treatment of mental health conditions among individuals living with diabetes.

Secondary prevention to reduce trauma recidivism and musculoskeletal injury

Patients who have a traumatic injury are at increased risk for a second injury, potentially more serious than the first. This study, conducted by Christopher Dy, MD, MPH, from the department of Orthopedic Surgery at the School of Medicine at Washington University at St. Louis, will identify the frequency of and risk factors for trauma recidivism and debilitating musculoskeletal injury among Centene health plan members, with the goal to prevent future injuries and serious life-long disability. The study will also evaluate the influence of mental health and substance abuse disorders on the likelihood of a second trauma. Study results will enable a greater understanding of the opportunities for secondary and tertiary prevention using behavior change strategies and potentially increase access to mental health resources.

Characterizing Medicaid smokers and utilization of tobacco-dependence treatment

This study, led by Amy McQueen, PhD, Associate Professor of Internal Medicine at the School of Medicine, will leverage the strengths of multiple data sources to characterize smokers and describe the cessation medication prescriptions used by Centene health plan members. Using this robust data set, McQueen will explore characteristics associated with smoking status and tobacco-dependence treatment. If successful, this novel approach will improve the way health plans identify smokers eligible for smoking cessation interventions and potentially increase the number of members able to utilize these services.

Impact of “Medicaid Fee Bump” on patient care access

This project, conducted by Derek Brown, PhD, from the Brown School, will study the impact of a 2013-14 natural experiment, the “Medicaid fee bump,” which increased primary care reimbursement rates with the goal of improving access for Medicaid beneficiaries. The study will directly assess how the policy affected physician behavior and healthcare utilization by individuals to determine if the goal of improved access was achieved. These results can then potentially be applied to other settings where reimbursement rates may impact patient care access.

Profiles and predictors of success in substance use disorder services

David Patterson, PhD, Associate Professor at the Brown School, will analyze assessment, claims, provider and pharmacy data to develop health behavior profiles and predictors of success for members suffering from substance use disorders including opioid and alcohol abuse. These profiles and predictors will identify key elements of success and how Centene behavioral counseling and other community-based services can potentially be improved through adjustments in medication dosage, the provision of wraparound services or other treatment strategies.

Medical home models for children in foster care: Understanding changes in health care use and outcomes

Children who enter foster care, especially those with multiple incidents of maltreatment and trauma, historically have poor health outcomes, including chronic illnesses such as asthma and other respiratory problems, and disruptive behavior disorders. The 2008 Fostering Connections to Success and Increasing Adoptions Act requires states to develop coordinated health services for foster children including continuity of care, and where possible, use of a Medical Home model. Very little is known about the healthcare use of children in foster care with access to Medical Home models compared to areas where such models have not been implemented. This study, led by Melissa Jonson-Reid, PhD, at the Brown School at Washington University in St. Louis, will describe healthcare use patterns for children and youth in foster care in areas with and without medical home models.

Impact of home visits

This study, led by the Envolve Center Analytics Insights team, will determine if members with respiratory conditions who receive home visits from a health coach have better clinical outcomes than members who receive telephonic counseling only. The study will also evaluate whether the home visit program is a cost-effective model.