331490
Using network analysis to measure changes in local collaboration resulting from implementation of the Texas Healthcare Transformation and Quality Improvement Program
Tuesday, November 3, 2015
: 9:10 a.m. - 9:30 a.m.
Monica Wendel, Dr.P.H., M.A.,
Health Promotion and Behavioral Sciences, University of Louisville School of Public Health and Information Sciences, Louisville, KY
Liza Creel, PhD, MPH,
School of Public Health and Information Sciences, Department of Health Management and Systems Sciences, University of Lousiville, Louisville, KY
Rebecca Wells, PhD,
School of Public Health, University of Texas Health Science Center, Houston, TX
Sean Gregory, PhD,
School of Public Health, Texas A&M University, College Station, TX
Angela Cummings, DrPH,
Center for Analytics and Decision Support, Texas Health and Human Services Commission, Austin, TX
In 2011, Texas received approval from the Centers for Medicare and Medicaid Services (CMS) for a 5-year 1115(a) Medicaid Waiver Demonstration Project aimed at increasing access to care, improving the quality of care, and decreasing cost. One element of the waiver is a Delivery System Reform Incentive Program (DSRIP) to incentivize transformative changes to local health service delivery systems. DSRIP was implemented through the creation of 20 Regional Healthcare Partnerships encompassing all Texas counties. Given DSRIP’s focus on system transformation, CMS and the State are interested in whether local implementation of these activities through Regional Healthcare Partnerships strengthens collaboration among organizations in each region. To assess changes in collaboration, an interorganizational network survey was designed and administered via telephone to Regional Healthcare Partnership members, focusing on relationships between organizations prior to and following DSRIP implementation (2011 vs. 2013) specific to service delivery, and resource and data sharing. The overall response rate for the survey was 84%. All RHPs experienced an increase in density; the mean increased from 36% of all ties present in 2011 to 47% in 2013. Network centralization also increased substantially, from a mean of 34 percent in 2011 to 55 percent in 2013. Findings suggest that a statewide policy change implemented at a regional level can increase collaboration among organizations in the region. As policies continue to emphasize system transformation, others states can adapt the implementation approach used in Texas as means for strengthening collaboration.
Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Public health or related public policy
Learning Objectives:
Describe the strategy for local implementation of the statewide Medicaid policy initiative; Discuss the intended outcomes related to increased interorganizational collaboration as part of health system transformation; and Explain the relevance of the study findings to future initiatives
Keyword(s): Medicaid, Community-Based Partnership & Collaboration
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I have served as key research staff, and now Co-PI, on this project to assess changes in regional networks after implementation of a policy that encouraged increased collaboration. I was involved in the instrument design, data collection, data analysis, and dissemination of the results. My research interests include understanding the impact of policies on delivery and public health systems.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
