Sangeeta C. Ahluwalia

@AhluwaliaPhD on Twitter

Associate Research Department Director, Behavioral and Policy Sciences Department; Senior Policy Researcher

Santa Monica Office

Education

Ph.D. in health policy, University of California, Berkeley

Media Resources

This researcher is available for interviews.

To arrange an interview, contact the RAND Office of Media Relations at (310) 451-6913, or email media@rand.org.

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Overview

Sangeeta Ahluwalia (she/her/hers) is associate research department director for the Behavioral and Policy Sciences Department and a senior policy researcher at the RAND Corporation. She is also an adjunct associate professor of health policy at the UCLA Fielding School of Public Health. Ahluwalia conducts research in two areas: 1) improving access and quality of end-of-life care and 2) improving public health emergency preparedness and response. Her end-of-life care research centers on quality measure development, evidence synthesis, and delivery system interventions to enhance advance care planning communication. She is currently project director of a CMS-funded effort to develop patient-reported quality measures for outpatient palliative care, and recently completed an NIH-funded grant to evaluate group visits for advance care planning. Her public health emergency research includes efforts to improve syndromic surveillance and understand individual-level barriers and facilitators to preparedness and response. She is an experienced qualitative researcher and is a fellow of the NIMH/VA Implementation Research Institute. Ahluwalia received her Ph.D. in health policy and M.A. in political science from UC Berkeley, and her M.P.H from UCLA.

Research Focus

Concurrent Non-RAND Positions

Adjunct Associate Professor of Health Policy, UCLA Fielding School of Public Health

Recent Projects

MACRA Palliative Care Quality Measure Development
NCP Clinical Guidelines for Palliative Care Systematic Review
Group visits for advance care planning among older adults with heart failure
Development and Maintenance of Post-acute Care Cross Setting Standardized Patient Assessment Data
Understanding the Relationship Between Health Care Delivery Systems and PCOR Processes and Outcomes

Honors & Awards

Leonard Schaeffer Medal for Mission and Impact, RAND Corporation
Finalist, SGIM Milton W. Hamolsky Junior Faculty Award for Outstanding Scientific Abstract, SGIM
Finalist, SGIM Outstanding Scientific Abstract in Geriatrics, SGIM

Commentary

Amidst a Pandemic, a Mental Health Crisis May Be Looming
The effects of the COVID-19 pandemic on health care workers' mental health could be significant and may weaken the health care system's ability to resolve the crisis and survive over the long term. Interventions to promote psychological well-being should be implemented now.
Apr 1, 2020 The RAND Blog
Let People Make Their Own End-of-Life Decisions
Major advances in health technology have helped people to live longer, but not necessarily better, lives. Medicare recently announced plans to reimburse providers for time spent counseling patients and their caregivers about the kind of care patients would want to receive near the end of their lives.
Jul 15, 2015 Newsweek

Publications

Journal Article
Protecting the Mental and Physical Well-Being of Frontline Health Care Workers During COVID-19: Study Protocol of a Cluster Randomized Controlled Trial
The COVID-19 pandemic has placed health care workers at unprecedented risk of stress, burnout, and moral injury. This paper describes the design of an ongoing cluster randomized controlled trial to compare the effectiveness of Stress First Aid (SFA) to Usual Care (UC) in protecting the well-being of frontline health care workers.
May 17, 2022
Journal Article
Standardized Assessment of Depression Symptoms in Post-Acute Care: A Screening Threshold Approach
The present study tested a gateway version of a depression screening protocol (PHQ-2 to 9). Findings suggest the feasibility of a gateway scoring approach to standardized assessment of depression symptoms among PAC patients.
Mar 8, 2022
Journal Article
Understanding What Works: Measuring and Monitoring Quality in Medi-Cal's Home and Community-Based Services
This issue brief describes challenges and opportunities related to measuring, reporting, and monitoring the quality of HCBS sponsored by Medi-Cal.
Jan 26, 2022
Research Brief
New Patient-Centered Quality Measures for Office-Based Palliative Care
This research brief describes the development and testing of two patient-centered quality measures of symptom management and communication and provides considerations for palliative care providers that plan to use them.
Sep 13, 2021
Report
MACRA Palliative Care Quality Measure Development—Testing Summary Report: Measure Name: Receiving Desired Help for Pain
The authors describe the results of their national beta field test for a performance measure designed to assess the extent to which patients who used ambulatory palliative care received the help they wanted for their pain.
Sep 3, 2021
Report
MACRA Palliative Care Quality Measure Development—Testing Summary Report: Measure Name: Feeling Heard and Understood
The authors describe the results of their national beta field test for a performance measure designed to assess the extent to which patients who used ambulatory palliative care felt heard and understood by their palliative care provider and team.
Sep 3, 2021
Journal Article
Perceived Impacts of a Medicaid Rebalancing Initiative to Increase Home- and Community-Based Services
Stakeholders reported that BIP participation had a range of impacts on the HCBS ecosystem, often beyond the structural reforms. Our findings highlight BIP impacts to monitor over the long term and to consider in evaluations of future rebalancing efforts.
Jul 16, 2021
Journal Article
Developing Health Equity Measures
This work identified existing approaches to health equity measurement and evaluated those approaches using input from an expert panel.
May 21, 2021
Journal Article
Promises and Pitfalls of Health Information Technology for Home and Community-Based Services
Structural reforms required by the Medicaid Balancing Incentive Program gave states an opportunity to modernize their HCBS systems through health information technology. Barriers to technology adoption persist, underscoring the need for continued support in future rebalancing efforts.
Sep 15, 2020
Journal Article
Factors Explaining State Differences in Applying for a Recent Long-Term Care Program That Promotes Aging in Place: Perspectives of Medicaid Administrators
This article examines the reasons underlying states' decisions regarding their applications to the Balancing Incentive Program.
Aug 4, 2020
Journal Article
Dyadic Model of Adaptation to Life-Limiting Illness
This review of the scholarly and empirical literature as well as a growing body of research examining adjustment to the prospect of the end of life support the concept of dyads, where one member of a mutual partnership is experiencing losses in the context of life-threatening illness while the other member goes through adjustments.
Jun 26, 2020
Draft
MACRA Palliative Care Quality Measure Development: Summary Report of Alpha Testing
Summarizes findings from a small pilot study which was conducted to evaluate the feasibility of data collection processes and refine the testing plan in advance of a larger national field test.
Jun 15, 2020
Report
Options for Maintaining Clinical Proficiency During Peacetime
The U.S. Army Medical Department cares for war wounded during conflict and operates medical treatment facilities that care for service members, their beneficiaries, and military retirees. How can the Army help providers prepare at home for wartime?
May 19, 2020
Report
The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of Gun Policies in the United States, Second Edition
This report, the second edition of an earlier work, synthesizes the available scientific evidence for the effects of various firearm policies on firearm deaths, violent crime, the gun industry, defensive gun use, and other outcomes.
Apr 22, 2020
Report
Development of Palliative Care Quality Measures for Outpatients in a Clinic-Based Setting: A Report on Information Gathering Activities
This report summarizes information gathering activities completed as of September 2019. It provides background information on the importance of and need for development of quality measures for palliative care based on patient-reported experience.
Feb 25, 2020
Journal Article
What Are the Determinants of Health System Performance? Findings from the Literature and a Technical Expert Panel
This study is part of an ongoing effort to discover how and why some health systems in the United States are high performing and others are not.
Feb 1, 2020
Journal Article
Engagement of Providers and Advocates in a Rebalancing Initiative to Increase HCBS Access for Medicaid Beneficiaries
Rebalancing long-term services and supports toward increased home- and community-based services will engage and affect multiple stakeholder groups, including governmental and nongovernmental stakeholders. This study describes stakeholder engagement in a LTSS rebalancing initiative.
Jan 29, 2020
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
How Are Medical Groups Identified as High Performing? The Effect of Different Approaches to Classification of Performance
To accurately identify "high-performing providers", a standard definition of high-performance and an agreed-upon approach to measurement are necessary.
Jul 24, 2019
Journal Article
Rural-Urban Disparities in Access to Home- and Community-Based Services and Supports: Stakeholder Perspectives From 14 States
This paper presents findings from a qualitative study examining the impact of the Medicaid Balancing Incentive Program. The analysis in this paper examines factors associated with rural disparities in access to home and community-based services.
Jun 26, 2019
Report
Core Competencies for Amputation Rehabilitation
The authors identify core competencies and behaviors in nine provider disciplines that participate in amputation rehabilitation and offer recommendations on how to implement them in the military health setting.
Jun 3, 2019
Journal Article
Development and Maintenance of Standardized Cross Setting Patient Assessment Data for Post-Acute Care: Summary Report of Findings from Alpha 2 Pilot Testing
Results of the Alpha 2 feasibility test, used to help develop standardized assessment-based data elements to meet the requirements of the Improving Medicare Post-Acute Care Transformation(IMPACT) Act of 2014.
Jun 7, 2018
Journal Article
"It Encourages Them to Complain": A Qualitative Study of the Unintended Consequences of Assessing Patient-Reported Pain
This article describes potential unintended consequences of implementing routine pain screening in primary care.
Apr 11, 2018
Journal Article
A Systematic Review in Support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, Fourth Edition
A substantial body of evidence exists to support clinical practice guidelines for quality palliative care but the quality of evidence is limited.
2018
Journal Article
Barriers to Using Nonpharmacologic Approaches and Reducing Opioid Use in Primary Care
Decreasing the reliance of VA providers on opioid prescribing for chronic pain requires local availability of nonpharmacologic pain therapies (NPTs) as well as provider efficacy in prescribing NPTs.
Dec 14, 2017
Journal Article
Challenges to Teaming for Pain in Primary Care
Better understanding task distribution related to chronic pain assessment and management can help improve team-based pain care.
Aug 23, 2017
Journal Article
What Defines a High-Performing Health System: A Systematic Review
Lack of a consistent definition of a high-performing health system severely hampers our ability to compare delivery systems based on performance.
Aug 15, 2017
Journal Article
A Systematic Review of Peer-Supported Interventions for Health Promotion and Disease Prevention
A systematic review that categorized and assessed the effects of peer interventions - by peer role, intervention type, and outcomes - suggests ways to involve peers that have improved health and wellness.
Aug 3, 2017
Journal Article
End-of-Life Care Planning in Accountable Care Organizations: Associations with Organizational Characteristics and Capabilities
About 60 % of Accountable Care Organizations (ACOs) have some kind of end-of-life care planning processes in place, but only about 20% have established advanced planning processes.
Jul 18, 2017
Journal Article
Development and Feasibility of a Structured Goals of Care Communication Guide
Studies demonstrate the benefits of discussing goals of care and advance care planning, yet many patients with serious illness do not engage in such discussions with healthcare providers.
May 30, 2017
Report
Development and Maintenance of Standardized Cross Setting Patient Assessment Data for Post-Acute Care: Summary Report of Findings from Alpha 1 Pilot Testing
This report presents results of the first Alpha 1 feasibility test of proposed items to include in the post-acute care patient assessment instruments for measuring seven areas of health status for Medicare beneficiaries.
Apr 27, 2017
Journal Article
Populations and Interventions for Palliative and End-of-Life Care: A Systematic Review
This evidence review found that palliative care improves outcomes for cancer, dementia, congestive heart failure, and chronic obstructive pulmonary disease.
Sep 12, 2016
Journal Article
A Qualitative Inquiry on Palliative and End-of-Life Care Policy Reform
Despite recent broad interest in reforming end-of-life care policies, the palliative care field faces many challenges to expanding use.
Apr 20, 2016
Journal Article
A Hospital-Based Advance Care Planning Intervention for Patients with Heart Failure: A Feasibility Study
The purpose of this study was to evaluate the feasibility of implementing a multiple-component hospital-based intervention on completion of ACP forms among HF patients.
Feb 18, 2016
Report
Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans
The Department of Veterans Affairs health care system, with broad resources and capabilities, provides timely and high-quality care to most, but not all, patients. Meeting veterans' needs over the next five years will require additional capacity.
Dec 31, 2015
Report
Meditation for Major Depressive Disorder: A Systematic Review
RAND researchers conducted a systematic review that synthesized evidence from trials of mindfulness-based cognitive therapy to assess its efficacy and safety in treating major depressive disorder.
Oct 7, 2015
Journal Article
Association of Early Patient-Physician Care Planning Discussions and End-of-Life Care Intensity in Advanced Cancer
Early patient-physician care planning discussions may influence the intensity of end-of-life (EOL) care received by veterans with advanced cancer.
Jul 28, 2015
Journal Article
Measuring Experience with End-of-Life Care: A Systematic Literature Review
We conducted a systematic review of PubMed, PsycINFO, and PsycTESTS for all English-language articles published after 1990 using instruments to measure adult patient, family, or informal caregiver experiences with end-of-life care.
Mar 15, 2015
Journal Article
The Future as a Series of Transitions: Qualitative Study of Heart Failure Patients and Their Informal Caregivers
Patients and caregivers view heart failure as a series of transitions, including the shock of first being diagnosed; learning to adjust to life with heart failure; reframing and taking back control of one's life; and understanding and accepting that death is inevitable.
2015
Journal Article
A Systematic Review of Family Meeting Tools in Palliative and Intensive Care Settings
We systematically reviewed PubMed for articles describing family meeting tools and abstracted information on tool type, usage, and content.
2015