Dr. Jie Chen, an associate professor of health services administration at the University of Maryland School of Public Health, has received a $1.3 million grant from the National Institute of Aging for a study titled, “Effect of Hospital and Community Care Coordination on Health Care Access, Quality and Equity among Individuals with Risk Factors or Diagnosis of ADRD.”
The study will identify care coordination practices and Accountable Care Organization (ACOs) structures that can improve health care access, quality of care and costs for African Americans and Latinos with Alzheimer’s disease and related dementia (ADRD) or its risk factors. The researchers will also study care coordination among vulnerable populations who receive federal housing assistance from the U.S. Department of Housing and Urban Development.
African Americans and Latinos over the age of 65 are significantly more likely to develop ADRD than their white counterparts. The gap is even wider for those living in poverty. Previous studies, including the research team’s own, cite poor care coordination as an important driver of this discrepancy.
“Care coordination is the facilitation of the appropriate delivery of health care services through communication and collaboration among the patient, community, and medical providers,” says Dr. Chen, who is principal investigator. The researchers identify care coordination strategies such as chronic care management and post-hospital discharge continuity of care programs as practices that control costs, delay the progression of co-morbid diseases and improve quality of life for patients with ADRD and those who are at risk for developing ADRD. They highlight ACOs as having the potential to promote such care coordination but note that there is little evidence showing how these system-level care coordination strategies have improved health care access, quality and equity for populations with ADRD.
To build the evidence base, the researchers plan to assess the impact of care coordination practices and ACO models using Medicare fee-for-service claims data and newly released Medicare Advantage data with Shared Savings Program Accountable Care Organizations data. They plan to highlight practices and models that will reduce racial and ethnic disparities by making care integration cost-effective underserved populations. “Our results will provide policy makers with critical information on how to utilize existing resources to integrate care coordination across the health care system to ensure that minorities get access to the most appropriate and effective care,” they say.
Co-investigators include University of Maryland School of Public Health faculty members Drs. Luisa Franzini, Eva DuGoff, Andrew Fenelon, Jing Zhang, and Carson Smith; University of Pittsburgh’s Dr. Charles F. Reynolds III. and University of Maryland School of Public Health graduate students Ms. Deanna Barath, Ms. Aitalohi Amaize, Ms, Ivy Benjenk and Ms. Priscilla Novak.