Ashley M. Kranz

Choosing a Different Path for a Healthier Future After COVID-19

Today, every American community is sitting at a crossroads, as local governments continue to address the health crisis of COVID-19 while grappling with the financial realities of maintaining operations. While some communities may take a more traditional route of only investing further in health care services, there is an opportunity to take a more holistic approach and address the multitude of factors that have contributed to the devastation of COVID-19.

Journal Article

Association Between Insurance Type and Fluoride Varnish Application During Well-Child Visits in Massachusetts

We compare rates of fluoride varnish (FV) applications during well-child visits for children covered by Medicaid and private medical insurance in Massachusetts.

Journal Article

The Impact of Nurse Practitioner-Led Primary Care on Quality and Cost for Medicaid-Enrolled Patients in States With Pay Parity

This retrospective cohort study evaluated the quality and cost implications of receiving primary care from nurse practitioners (NPs) compared to physicians in 14 states that reimburse NPs at the Medicaid fee-for-service physician rate (pay parity).

Research Brief

Putting Equity First in COVID-19 Vaccination

The Equity-First Vaccination Initiative aimed to reduce racial disparities in COVID-19 vaccination rates in the United States. Five demonstration sites implemented hyperlocal, community-led strategies to increase vaccine confidence and access.

Report

The U.S. Equity-First Vaccination Initiative: Impacts and Lessons Learned

The authors detail impacts and lessons learned from the U.S. Equity First Vaccination Initiative, which aimed to increase COVID-19 vaccination access and confidence in communities of individuals who identify as Black, Indigenous, and People of Color.

Report

The U.S. Equity-First Vaccination Initiative: Early Insights

The Equity-First Vaccination Initiative aims to reduce racial/ethnic disparities in U.S. coronavirus vaccination rates. Five demonstration sites are using hyper-local, community-led strategies to increase vaccine confidence and access.

Research Brief

Early Insights from the Equity-First Vaccination Initiative

The Equity-First Vaccination Initiative aims to reduce racial/ethnic disparities in COVID-19 vaccination rates in the United States. Five demonstration sites are using hyper-local, community-led strategies to increase vaccine confidence and access.

Journal Article

A Comparison of Approaches to Identify Live Births Using the Medicaid Analytic eXtract

This study described and validated five approaches to identifying births using Medicaid data.

Report

Claims-Based Reporting of Post-Operative Visits for Procedures with 10- or 90-Day Global Periods: Updated Results Using Calendar Year 2018 Data

The authors of this report summarize patterns of post-operative visits for surgical procedures furnished in 2018 and paid for by Medicare. This report follows an earlier report that summarized these patterns from July 1, 2017, through June 30, 2018.

Report

Claims-Based Reporting of Post-Operative Visits for Procedures with 10- or 90-Day Global Periods: Updated Results Using Calendar Year 2019 Data

The authors of this report summarize patterns of post-operative visits for surgical procedures furnished in calendar year 2019 and paid for by Medicare. This report follows two earlier reports that summarized these patterns for earlier periods.

Report

Assessing Health and Human Services Needs to Support an Integrated Health in All Policies Plan for Prince George's County, Maryland

This report describes a health and human services needs assessment of Prince George's County, Maryland. Findings from this report can inform Prince George's County's pursuit of a Health in All Policies approach to policymaking.

Journal Article

Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) has disrupted the delivery of health care services, including dental care. The objective of this study was to quantify and describe US adults who delayed dental care due to the COVID-19 pandemic.

Journal Article

Impact of State-Level Training Requirements for Medical Providers on Receipt of Preventive Oral Health Services for Young Children Enrolled in Medicaid

Our objective was to test whether training requirements were associated with higher rates of preventive oral health services for Medicaid-enrolled children <6 years.

Report

Claims-Based Reporting of Post-Operative Visits for Procedures with 10- or 90-Day Global Periods: Final Report

The authors of this report summarize patterns of post-operative visits where Medicare bundles payment for post-operative care into payment for surgical procedures. The results suggest fewer visits occur than Medicare assumes in its payment rates.

Journal Article

Health System Affiliation of Physician Organizations and Quality of Care for Medicare Beneficiaries Who Have High Needs

This article tests the hypothesis that health systems provide better care to patients with high needs by comparing differences in quality between system-affiliated and nonaffiliated physician organizations.

Journal Article

Racial and Ethnic Disparities in Care for Health System-Affiliated Physician Organizations and Non-Affiliated Physician Organizations

This article assesses racial and ethnic disparities in care for Medicare fee-for-service beneficiaries and whether disparities differ between health system-affiliated physician organizations (POs) and nonaffiliated POs.

Journal Article

Do Oral Health Services in Medical Offices Replace Pediatric Dental Visits?

This study failed to find evidence that medical preventive oral health services (POHS) replaced dental visits for young children enrolled in Medicaid and, in fact, offers evidence that increased medical POHS was associated with increased utilization of dental care. Given lower than desired rates of dental visits for this population, delivery of medical POHS should be expanded.

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.

Infographic

State Policies Related to Substance Use in Pregnancy

This infographic illustrates the evolution from 2000 to 2015 of state policy environments related to substance use in pregnancy. Punitive or potentially punitive policies were more commonly enacted than were policies supporting treatment.

Journal Article

Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics

This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists.

Journal Article

Care Management Reduced Infant Mortality for Medicaid Managed Care Enrollees in Ohio

The Ohio Department of Medicaid introduced requirements to be delivered by Medicaid managed care organizations (MCOs). This study evaluated the impact of care management on reducing infant mortality in the largest Medicaid MCO in Ohio.

Journal Article

Impact of a Medicaid Policy on Preventive Oral Health Services for Children with Intellectual Disabilities, Developmental Disabilities, or Both

The authors examined the impact of state policies allowing delivery of POHS in medical offices on receipt of POHS among Medicaid enrollees with IDD.

Journal Article

Patterns of Postoperative Visits Among Medicare Fee-for-service Beneficiaries

To describe patterns of postoperative visits reported for Medicare fee-for-service (FFS) patients.

Journal Article

Federally Qualified Health Center Strategies for Integrating Care with Hospitals and Their Association with Measures of Communication

Health centers differ in the use of strategies to integrate care with hospitals. Overall, integration activity is associated with better communication.

Journal Article

Specialty Care Access for Medicaid Enrollees in Expansion States

In a survey of community health center medical directors in 9 Medicaid expansion states and DC, nearly 60% reported difficulty obtaining new specialist visits and multiple access barriers on behalf of their patients.

Journal Article

Association of Punitive and Reporting State Policies Related to Substance Use in Pregnancy With Rates of Neonatal Abstinence Syndrome

State policies that impose punitive action against pregnant women who use illicit substances are associated with higher rates of infants being born with opioid withdrawal.

Report

Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans: Findings from Interviews and Case Studies

How are the needs of dually enrolled beneficiaries in Medicare and Medicaid met? This report presents ways that Medicare Advantage (MA) plans and Medicare-Medicaid plans can meet the needs of dually enrolled beneficiaries.

Journal Article

Access, Quality, And Financial Performance Of Rural Hospitals Following Health System Affiliation

Health system affiliation was associated with improved financial performance for rural hospitals but that it also could reduce local access to certain services and was not associated with improved health care quality for the two measures examined.

Journal Article

Changes in Pediatric Dental Coverage and Visits Following the Implementation of the Affordable Care Act

Comparing pre- and post-ACA periods, private dental insurance increased by 4.6% (P=0.013) and annual dental visits were unchanged (2.7%, P=0.071) comparing children likely or unlikely to be affected by the ACA.

Journal Article

Delivery of Preventive Oral Health Services by Rurality: A Cross-Sectional Analysis

Using a multistate sample of Medicaid claims, we examined a child's odds of receiving preventive oral health services in a medical office by county rurality.

Journal Article

Low Rates of Pediatric Dental Coverage for Families Purchasing Marketplace Insurance Plans

Pediatric dental care is an essential health benefit that the Affordable Care Act requires most private health plans to cover. It is unknown how these different pediatric dental coverage offerings may affect uptake of coverage.

Journal Article

Perspectives on Opportunities and Challenges for Medicare Advantage Plans to Address Social Determinants of Health Via the CHRONIC Care Act

The effect of the 2018 CHRONIC Care Act and how it may evolve before implementation begins in 2020 remains uncertain as we wait to see how MA plans will interpret eligibility criteria and services offered without any additional allotted funding.

Journal Article

Association Between Type of Health Insurance and Children's Oral Health, NHANES 2011–2014

Oral health outcomes were similar for children with public and private health insurance. However, children in low- income families and with less educated parents had greater odds of untreated caries, suggesting that initiatives focused on publicly insured populations may miss other vulnerable children of low socioeconomic status.

Journal Article

Impact of Medicaid Policy on the Oral Health of Publicly Insured Children

State policies that support non-dental primary care providers' application of fluoride varnish treatment were associated with improvements in oral health for young children with public insurance.

Journal Article

Using Health IT to Coordinate Care and Improve Quality in Safety-Net Clinics

This study examined factors associated with use of health information technology (HIT) capabilities for improved care coordination and quality of care in U.S. health centers.

Report

A Psychometric Study of the Modified Bridges for Newborns Screening Tool

This report describes RAND Corporation work evaluating the psychometric characteristics of the Modified Bridges for Newborns, a screening tool to identify high-risk mothers in Los Angeles Count who are eligible for supportive services.

Report

Testing New Codes to Capture Post-Operative Care

This report summarizes RAND's pilot testing of a set of proposed nonpayment codes that physicians would use for post-operative visits. The goal of testing was to assess whether practitioners understood and could correctly apply the codes.

Report

Improving Population Health Through an Innovative Collaborative: The Be There San Diego Data for Quality Group

The Be There San Diego Data for Quality (DFQ) Group created a safe venue for competing health care organizations in San Diego County to share performance data on quality-of-care measures, insights, lessons learned, and challenges they face.

Report

Developing Codes to Capture Post-Operative Care

This report makes recommendations to the Centers for Medicare & Medicaid Services on a set of nonpayment codes that can be used to collect information on the number and level of post-operative visits.

Journal Article

Using Electronic Health Record Data for Healthy Weight Surveillance in Children, San Diego, California, 2014

The expanded use of electronic health records (EHRs) provides new opportunities to monitor population health at the local level.