Denis Agniel

Statistician

Off Site Office

Education

Ph.D. in biostatistics, Harvard University; A.M. in biostatistics, Harvard University; M.S. in statistics, University of Illinois, Urbana-Champaign; B.S. in statistics, Loyola University Chicago; B.A. in philosophy, Loyola University Chicago

One Page Bio

Overview

Denis Agniel is a statistician at the RAND Corporation. He is interested in and maintains active research in a wide array of topics in health, health policy, and criminal justice, including health equity, substance use, health services research, firearm policy, genomics, infectious diseases, mental health, and quality measurement. He has expertise in program evaluation, causal inference, and longitudinal data analysis. He received his Ph.D. in biostatistics from the Harvard T.H. Chan School of Public Health.

Research Focus

Publications

Journal Article
Do Hospital Characteristics Predict Racial-and-Ethnic Disparities in Patient Experience? National Results from the HCAHPS Survey
Large, for-profit hospitals and hospitals serving higher proportions of Black and Hispanic patients tend to be lower performing overall but have smaller disparities in patient experience.
Nov 17, 2023
Report
Reviewing, Refining, and Validating Claims-Based Algorithms of Frailty and Functional Impairment: Final Report
The authors developed new claims-based frailty algorithms that were validated using patient assessment data from post-acute care providers. They then compared the performance of the new algorithms with existing claims-based frailty algorithms.
Nov 6, 2023
Journal Article
Evaluation of Phase II of the Medicare Advantage Value-Based Insurance Design Model Test: First Three Years of Implementation (2020–2022)
RAND researchers are conducting a multiyear evaluation of the VBID Model test using a mixed-methods approach that involves surveys, interviews, and quantitative analyses of the relationship between VBID implementation and a variety of outcomes.
Oct 13, 2023
Journal Article
A Formal Framework For Incorporating Equity Into Health Care Quality Measurement
We propose equity weighting, a new measurement framework to advance equity on multiple fronts that addresses the shortcomings of existing approaches and explicitly calibrates incentives to align with equity goals.
Oct 9, 2023
Journal Article
How Are State Telehealth Policies Associated with Services Offered by Substance Use Disorder Treatment Facilities? Evidence from 2019-2022
An examination of the effect of state policies on the offering of telehealth at substance use disorder treatment facilities.
Sep 11, 2023
Journal Article
Development and Validation of Algorithms to Predict Activity, Mobility, and Memory Limitations Using Medicare Claims and Post-Acute Care Assessments
This study aims to create Medicare-based algorithms for predicting functional impairment, crucial for mortality and care use. Using machine learning and PAC data, memory and activity limitations were assessed with moderate success. While promising for PAC, broader older adult application is uncertain.
Aug 16, 2023
Journal Article
Upstream Suicide Prevention in the U.S. Army: Noncommissioned Officers' Perspectives
This study sheds light on key gaps in training for Army NCOs who are relied upon for detecting and addressing suicide risk factors when they first arise in soldiers.
Jul 20, 2023
Journal Article
Development of a Medicare Plan Dashboard to Promote Health Equity
The HESS dashboard is a potentially useful tool for presenting data on health equity to health plans.
Apr 14, 2023
Journal Article
Predicting Race And Ethnicity To Ensure Equitable Algorithms For Health Care Decision Making
We describe two applications in which imputation of race and ethnicity can help mitigate potential algorithmic biases: equitable disease screening algorithms using machine learning and equitable pay-for-performance incentives.
Aug 23, 2022
Journal Article
Trends in US Ambulatory Care Patterns During the COVID-19 Pandemic, 2019–2021
In this study, there was an increase in the return to expected rates of use of ambulatory care services between March 2020 and February 2021. This increase was lower for patients with Medicaid or Medicaid-Medicare dual eligibility.
2022
Report
Assessing Relationships Between Drug Shortages in the United States and Other Countries
Drug shortages, which occur when the supply does not meet the demand, are a public health concern. The authors assess whether U.S. shortages result in measurable changes in U.S. volume and price of drugs and the same outcomes in other countries.
Oct 27, 2021
Report
SAFE Charlotte: Alternative Response Models and Disparities in Policing
Under contract with Charlotte, North Carolina, the authors evaluated three of the six policing and public-safety recommendations in the city's SAFE Charlotte: Safety and Accountability for Everyone report. They describe their findings in this report.
Sep 28, 2021
Research Brief
The Prevalence of Criminal Records Among Small Business Owners
This research brief addresses a new estimate of how many U.S. small businesses have owners with criminal history records.
Jun 30, 2021
Report
Small Businesses, Criminal Histories, and the Paycheck Protection Program
In this report, researchers estimate how many small businesses have owners with criminal history records and how many businesses were potentially affected by Paycheck Protection Program restrictions on applicants with felony records.
Jun 21, 2021
Journal Article
Assessment of Variation in Electronic Health Record Capabilities and Reported Clinical Quality Performance in Ambulatory Care Clinics, 2014–2017
Between 2014 and 2017, clinics with EHRs having greater capabilities had better quality measures than other clinics, but clinics that gained EHR capabilities during this time had smaller increases in quality that were not statistically significant.
May 4, 2021
Journal Article
Trends in Low-Value Health Service Use and Spending in the US Medicare Fee-for-Service Program, 2014–2018
Among individuals with fee-for-service Medicare receiving any of 32 measured services, low-value care use and spending decreased marginally from 2014 to 2018.
Feb 18, 2021
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Minnesota Reinsurance Program
This report documents findings from the evaluation of Minnesota's waiver, through which the state implemented the Minnesota Premium Security Plan.
2021
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Oregon Reinsurance Program
This report documents findings from the evaluation of Oregon's waiver, through which the state implemented the Oregon Reinsurance Program (ORP).
2021
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Alaska Reinsurance Program
This report documents findings from the evaluation of Alaska's waiver, through which the state implemented the Alaska Reinsurance Program (ARP).
2021
Journal Article
Care Integration Within and Outside Health System Boundaries
We developed manager and staff surveys to collect data on organizational, social, and clinical process integration, at four organizational levels: practice site, physician organization, health system, and outside health systems.
Dec 10, 2020
Journal Article
Distinguishing High-Performing Health Systems Using a Composite of Publicly Reported Measures of Ambulatory Care
A composite measure that uses publicly reported data can produce valid, reliable, and stable rankings of quality of ambulatory care.
Sep 23, 2020
Journal Article
Evaluation of Longitudinal Surrogate Markers
In this paper, we propose a model-free definition for the proportion of the treatment effect on the primary outcome that is explained by the treatment effect on the longitudinal surrogate markers.
Aug 4, 2020
Journal Article
Provision of Social Services and Health Care Quality in US Community Health Centers, 2017
Some community health centers provide social services on-site and this was associated with better performance on measures of health care quality.
Jun 25, 2020
Journal Article
Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY): A Randomized Controlled Trial
Urban Native American teens may benefit from culturally centered programs. No differences found between MICUNAY + Community Wellness Gatherings (CWGs) and CWGs only.
Jan 14, 2020
Report
Real-Time Crime Centers in Chicago: Evaluation of the Chicago Police Department's Strategic Decision Support Centers
The Chicago Police Department's Strategic Decision Support Centers (SDSCs) serve as command, control, and communications hubs. In this report, the authors evaluate the processes, organizational structures, and technologies employed in the SDSCs.
Dec 4, 2019
Journal Article
Understanding U.S. Health Systems: Using Mixed Methods to Unpack Organizational Complexity
Researchers need qualitative data to understand how health systems actually work and influence clinical practice.
Nov 26, 2019
Report
Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test (Volume 1: Executive Summary)
This report, part of a series, describes patient assessment data elements developed and tested by RAND on behalf of the Centers for Medicare & Medicaid services to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014.
Nov 15, 2019
Report
Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test (Volume 3: Sample Description)
This report, part of a series, describes patient assessment data elements developed and tested by RAND on behalf of the Centers for Medicare & Medicaid services to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014.
Nov 15, 2019
Report
Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test (Volume 8: Observational Assessments of Cognitive Function, Mental Status, and Pain)
This report, part of a series, describes patient assessment data elements developed and tested by RAND on behalf of the Centers for Medicare & Medicaid services to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014.
Nov 15, 2019
Report
Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test (Volume 6: Impairments and Special Services, Treatments, and Interventions)
This report, part of a series, describes patient assessment data elements developed and tested by RAND on behalf of the Centers for Medicare & Medicaid services to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014.
Nov 15, 2019
Report
Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test (Volume 7: Global Health, Care Preferences, and Medication Reconciliation)
This report, part of a series, describes patient assessment data elements developed and tested by RAND on behalf of the Centers for Medicare & Medicaid services to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014.
Nov 15, 2019
Report
Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test (Volume 2: Background and Methods)
This report, part of a series, describes patient assessment data elements developed and tested by RAND on behalf of the Centers for Medicare & Medicaid services to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014.
Nov 15, 2019
Report
Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test (Volume 4: Cognitive Function)
This report, part of a series, describes patient assessment data elements developed and tested by RAND on behalf of the Centers for Medicare & Medicaid services to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014.
Nov 15, 2019
Report
Development and Evaluation of Candidate Standardized Patient Assessment Data Elements: Findings from the National Beta Test (Volume 5: Mental Status and Pain)
This report, part of a series, describes patient assessment data elements developed and tested by RAND on behalf of the Centers for Medicare & Medicaid services to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014.
Nov 15, 2019
Journal Article
Using Ancillary Sociodemographic Data to Identify Sexual Minority Adults Among Those Responding "Something Else" or "Don't Know" to Sexual Orientation Questions
Using National Health Interview Survey data, this article compares three analytic strategies for using "something else" and "don't know" responses to estimate health disparities for sexual minorities.
Sep 19, 2019
Journal Article
Overt Perceived Discrimination and Racial Microaggressions and Their Association with Health Risk Behaviors Among a Sample of Urban American Indian/Alaska Native Adolescents
Analyzing the potential effects of the broad range of perceived discrimination (PD) experiences, including both overt PD and racial microaggressions, among urban American Indian/Alaska Native adolescents on health outcomes offers a unique opportunity to further our understanding of these health disparities.
Jun 12, 2019
Journal Article
Unveiling an 'Invisible Population': Health, Substance Use, Sexual Behavior, Culture, and Discrimination Among Urban American Indian/Alaska Native Adolescents in California
American Indian/Alaska Native adolescents in this study used alcohol or other drugs at rates similar to those found in national surveys and rates of risky sexual behavior were also comparable to national data.
Feb 28, 2019
Journal Article
Inpatient Care Experiences Differ by Preferred Language Within Racial/Ethnic Groups
We described differences in patient experiences of hospital care by preferred language within racial/ethnic groups using HCAHPS survey data. We measured patient-mix adjusted overall, between-and within-hospital differences inpatient experience by language, using linear regression.
2019
Journal Article
Developing Adaptive Interventions for Adolescent Substance Use Treatment Settings: Protocol of an Observational, Mixed-Methods Project
Adaptive interventions (AIs) - sequences of decision rules for altering treatment based on an individual's needs - would benefit substance abuse treatment for adolescents.
Feb 8, 2017