Happy spring! Traditionally, spring is a time to think of growth and new beginnings, but I find myself more in a Thanksgiving-type mood. I am thankful to have been able to catch up with so many of you last week at the DeFriese Lecture. One nice aspect of that is the opportunity to visit with former Shepsters who put so much into the Center, including mentoring many of us who are currently here. There are some giants in the health services research field, and I feel blessed they remain engaged and committed to their legacies. I am also grateful to have had the time to visit with our speaker, Dr. Julia Adler-Milstein. She had a very busy time in Chapel Hill and met with many of you. She reflected on the atypical sense of community we have at UNC and how lucky we are to be able to work with such great colleagues across the campus. On a more personal note, I am also thankful to have the opportunity to work in this field. I spent the first part of last week visiting an ill family member. Because of my familiarity with many of the research projects here, I better appreciated how they tried to navigate the system and how the various actors affected the care trajectory – not always for good. It’s a reminder that what we do here matters. In my case, it was watching a family member and their caregiver struggle with transition from acute to post-acute to rehab to home health – and just how vulnerable we are to our fractured healthcare system. We have a lot of work to do, and we are doing some great stuff here. Read more about some of this exciting work below. - Mark Holmes |
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Today is the day! GiveUNC is Carolina’s university-wide day of giving—a day when alumni, friends, faculty/staff and other Carolina supporters come together to support the causes they care about most, like the Sheps Cente r.
As an important member of the Sheps Center community, you have an opportunity over the next 24 hours to make a difference. Your gift today will support early career health services researchers by providing them with mentorship, training opportunities, interdisciplinary faculty connections, a dedicated workspace in our building with a built-in peer network, and so much more, including fostering successful research and policy work that will affect the health of our communities, our state, and our nation.
Here are 3 ways you can make an impact today:
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Make a gift of any size to the Sheps Center before 11:59pm tonight.
- Promote #GiveUNC on your social media networks.
- Encourage your peers to make a gift to the Sheps Center to ensure our goals are met!
Follow us throughout the day as supporters from all over come together to benefit the Sheps Center and the entire Carolina community.
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As one of the longest-serving members of The Sheps Center, Ed Slanker has seen the Center grow and evolve over the past 20 years. His duties have likewise expanded, and he now takes on a range of responsibilities, including desktop security, project invoicing for the web development and analytical programming teams, and serving as the Center's Superintendent. In addition, Ed is a talented videographer, and he has filmed, directed, and edited many of the Center's video projects.
Interestingly, Ed also has a fascinating past as a professional rock musician, having toured the world and made appearances on several late night talk shows and MTV. Despite his rockstar credentials, Ed is down-to-earth and committed to his work at Sheps. The Sheps community values his expertise, attention to detail, and willingness to go above and beyond to support the Center's goals.
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Improving care and outcomes in assisted living communities: Two pragmatic clinical trials |
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The Program on Aging, Disability, and Long-term Care, led by Co-Directors Drs. Sheryl Zimmerman and Philip Sloane, has recently been awarded more than $9.3 million from the National Institute on Aging to conduct two pragmatic R01 clinical trials. Both trials are aimed at improving care and outcomes in assisted living communities – efforts that align seamlessly with the newly instated CEAL@UNC’s goal of advancing the well-being of the people who live and work in assisted living.
Evaluating a National Person-Centered Training Program to Strengthen the Dementia Care Workforce
This project, a collaboration with the Alzheimer’s Association, will study two models of dementia care training provided to staff across six states. One program is essentiALZ, a low-cost, evidence-based, online training program; the other is Project ECHO, a widely used virtual tele-mentoring model. Outcomes will examine change in organizational practices and staff and resident wellbeing.
A Pragmatic Crossover Trial to Test the Effectiveness of a Novel Lighting System to Reduce Nighttime Falls in Persons with Alzheimer’s Disease and Related Dementias
This project is testing the effectiveness of horizontal and vertical lights intended to promote postural stability and reduce nighttime falls. It follows from a recent R21 pilot study that found a 34% reduction in falls due to the lights and will enroll 390 residents across 42 communities. If effective, this passive lighting system has the potential to become a new standard of care.
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How might a rapid, multi-payer shift from fee-for-service to value-based payment influence health care outcomes? |
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Healthcare payers across the nation have implemented value-based payment models for over a decade, but the impact on health care spending has generally been modest. Many believe this is due to the fact that health care providers cannot fundamentally transform health care delivery while only a portion of their payment has moved to value-based payment models, while most remains under traditional fee-for-service payment, a problem sometimes characterized as having “one foot on the dock and one foot in a boat.” This suggests that were health care payment to shift to value-based models in concert across payers, health care providers would then have the opportunity to more fundamentally change the way they deliver care through new innovations not sustainable under historic health care reimbursement.
North Carolina is embarking upon a bold innovation in this space as three of the major payers in North Carolina (NC Medicaid, Blue Cross and Blue Shield of North Carolina, and Medicare) are shifting to value-based payment models very rapidly; the state is projected to go from roughly 15% of payment under risk-based models to more than 70% in just five years. With support from Arnold Ventures, Dr. Valerie Lewis, Sheps Research Fellow and Associate Professor of Health Policy and Management, and her team are taking advantage of the unique laboratory of our state to understand how health care providers with a greater share of patients under new models are able to improve care for patients. Through qualitative interviews as well as linking quantitative data from multiple sources, they will develop the first empirical evidence on how a broad shift to value-based payment influences patient outcomes, such as acute care use, avoidable hospitalizations and emergency department visits, and preventive care. Furthermore, they will unpack how this varies across providers, such as what approaches to payment reform facilitate or inhibit success. They anticipate the results will have widespread influence on the national conversation about payment reform in health care.
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Gordon H. DeFriese Lecture focuses on improving clinical care with the use of EHR audit log data |
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The 2023 Gordon H. DeFriese Distinguished Lecture on Health Services Research and Health Policy was held on Wednesday March 22nd at the North Carolina Botanical Garden in Chapel Hill. Keynote speaker Dr. Julia Adler-Milstein, professor of medicine at the University of California San Francisco, presented Turning Digital "Fumes" into a Breath of Fresh Air. A reception was held afterward where guests met and chatted with Dr. Adler-Milstein. There was a wonderful turnout of faculty, staff, students, and community members who attended this hybrid event in person and on Zoom.
The DeFriese Lecture was established by colleagues and friends of Dr. Gordon DeFriese to honor his leadership as Director of the Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, and his many research, teaching, and public service contributions to the people of North Carolina and the nation.
If you would like to support this lectureship and it's future events, please click here.
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NEW FACES AT THE SHEPS CENTER |
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Connor Sullivan, PhD
Program on Health Workforce Research and Policy
Connor Sullivan is a Research Associate / Data Analyst for the UNC Sheps Center Program on Health Workforce Research and Policy. Connor holds a PhD in Clinical Psychology from Virginia Tech and received his undergraduate degree from UNC Chapel Hill, which he is excited to return to and give back to the Carolina community!
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Laura Briell
Program on Aging, Disability, and Long Term Care
Laura joined the Sheps Center in October of 2022 as a Social/Clinical Research Assistant. She is involved with Dr. Laura Hanson’s study team working on the “Palliative Care for Persons with Late-stage Alzheimer’s Disease and Related Dementias and their Caregivers: A Randomized Clinical Trial” research study. Laura has a strong background in working with the geriatric and aging population, and she looks forward to continuing her work in research! In her free time, she enjoys knitting and hiking.
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Caitlin Hildebrand, MD, MPH
AHRQ NRSA trainee
Dr. Hildebrand is completing a PhD in nutrition at Gillings School of Global Public Health. Her dissertation, “Exploring strategies to better equip primary care physicians (PCPs) to provide nutrition care,” takes a design thinking approach to understand PCPs’ opinions on desired approaches to enhance nutrition training of physicians and nutrition care in their current practice. Since joining Dr. Alice Ammerman’s research team at the Center for Health Promotion and Disease Prevention at UNC, she has collaborated on projects addressing food access and food insecurity and efforts to address medical student nutrition training at UNC School of Medicine.
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Juan Hincapie-Castillo, PhD
Research Fellow
Juan is an Assistant Professor at the UNC Department of Epidemiology. He works at the intersection of legal and pharmacoepidemiology leveraging large real-world data sources to evaluate and promote evidence-based policymaking, primarily applied to improving prescribing policies and the provision of equitable pain management and safe psychotropic medication use.
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EXTERNAL PARTNER SHOUTOUT |
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For the past year, the Sheps Center has been supporting the NC Navigator Consortium’s work to conduct outreach and free assistance with health insurance enrollment through the Federally Facilitated Marketplace. The NC Navigator Consortium, led by Legal Aid of North Carolina, is comprised of 10 health care, social service, and legal aid organizations that collectively serve all 100 counties in North Carolina.
Project: The Sheps Center has been working with NC Navigator Consortium to identify areas with lower rates of enrollment, considering their eligibility. In the first phase of the three-year project, we developed a near-real-time dashboard which highlights counties where the enrollment seems to lag projected eligibility. We provide this information to the NC Navigator Consortium to inform strategic decision-making around outreach, enrollment assistance, and community partnership strengthening in areas with high rates and counts of unenrolled, eligible individuals. This project is funded by the Kate B. Reynolds Charitable Trust.
Impact: Thanks in large part to the NC Navigator Consortium, in January, North Carolina closed out the 2023 Open Enrollment Period with a state record-breaking 800,850 consumer plan selections. This represents an impressive 19.5% increase over last-year’s record-breaking plan selection and the 5th highest of any state with a Federally Facilitated Marketplace this year, regardless of population size.[i]
Sheps researchers have learned so much from their talented and passionate partners in the NC Navigator Consortium who wear a range of hats from policy and data wonks to community engagement leaders all while having seemingly boundless energy for enrolling North Carolinians in quality, affordable health insurance. Thank you, NC Navigator Consortium!
For more information about this project, contact Susie Gurzenda at sbg@unc.edu.
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School becomes new home for CEAL@UNC; Work to advance...
Forr 20 years, the national Center for Excellence in Assisted Living (CEAL) has focused on advancing the well-being of people who live and work in assisted living through research, practice, and policy. These efforts will expand and intensify as...
Read more
ssw.unc.edu
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JAMA Author Interviews: USPSTF Recommendation: Syphilis ...
Interview with Katrina E. Donahue, MD, MPH, USPSTF member and coauthor of Screening for Syphilis Infection in Nonpregnant Adolescents and Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement. Hosted by JAMA Editor in...
Read more
podcasts.apple.com
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Rooted: Mark Holmes - UNC Research
Mark Holmes has worked for UNC-Chapel Hill for 25 years in a variety of roles, most recently as director of the Cecil G. Sheps Center for Health Services Research. He is also a professor of health policy and management in the Gillings School of...
Read more
research.unc.edu
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North Carolina poised to expand Medicaid
North Carolina is on the verge of becoming the latest state to expand Medicaid eligibility under the Affordable Care Act through a deal legislative leaders announced Thursday. The Tar Heel State's hospital industry backs the expansion, which...
Read more
www.modernhealthcare.com
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NC legislators receive public health briefing at...
March 14, 2023 The UNC Gillings School of Global Public Health shares a long tradition with the legislators who serve North Carolina: Once every two years, all of North Carolina's legislators are invited to visit the School and receive a briefing ...
Read more
sph.unc.edu
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North Carolina Launches Caregiving Workforce Strategic...
North Carolina leaders are projecting shortages in direct care workers, nurses and other caregiving positions in the coming decade. At the same time, demand for these services is rising. To address this gap, the North Carolina Department of...
Read more
www.ncdhhs.gov
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When Rural Hospitals Close, Nearby Hospitals Suffer
By Cara Murez HealthDay Reporter FRIDAY, Dec. 23, 2022 (HealthDay News) -- When rural hospitals shut down people need to go elsewhere, and a new study finds that nearby hospitals bear the strain of that patient overflow.
Read more
www.usnews.com
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The purpose of this study was to understand how families from diverse sociodemographic backgrounds perceived the impact of the pandemic on the development of their children. The team used a multimethod approach guided by Bronfenbrenner's Ecological Systems Theory, which identifies 5 developmental systems (micro, meso, exo, macro, and chrono). They conducted semi-structured interviews with 48 families, with a total of 99 children ages newborn to 19 years, who also completed the COVID-19 Exposure and Family Impact Survey. Most qualitative themes pertained to developmental effects of the microsystem and macrosystem. In addition to negative impacts, many parents perceived positive pandemic-attributed effects on their child's development, mainly from increased time for parent-child interaction. Families reported a variety of economic hardships on the COVID-19 Exposure and Family Impact Survey, such as having to move out of their homes and experiencing decreased income. These findings hold important lessons for leaders who wish to design innovative solutions that address inequities in maternal, family, and child health.
A full list of Sheps Center publications from December 2022-March 2023 can be found here.
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Subscribe to and read other Sheps Center newsletters:
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Have feedback on this newsletter or suggested content for future newsletters? Contact Lindsay McCall.
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