The needs of refugees and the struggles on the part of service providers to address this diverse population have received limited attention within the academic literature. This paper profiles Hauora o Puketapapa/Roskill Union and Community Health Centre (HoP), which is a non-profit, community owned and operated health clinic designed to deliver accessible, affordable and appropriate primary hea...

PROVIDENCE – G. ALAN KUROSE, MD, MBA, president and CEO of Coastal Medical, recently described the growth and transformation of the designated Accountable Care Organization (ACO) over recent years to the Executive Masters in Healthcare Leadership program at the Brown School of Public Health. Dr. Kurose, who began his career in a small internal medicine practice, gave a snapshot of Coastal: It i...

The authors describe an approach to primary prevention in which indirect services are redefined to include community services aimed at promoting mental health and preventing emotional and mental disorders. At the Peninsula Hospital Community Mental Health Center such services are family-focused and include consultation, education, collaboration with other agencies, and early intervention with c...

Community-Based Participatory Research (CBPR) has the twin goals of generating data and shaping policy decisions, yet examples that combine these goals are scarce in the literature. We describe how a community-based survey was created and used to help develop a county health plan. The Genesee Health Plan (GHP), a community-initiated non-profit organization, provides primary care, prescription d...

BACKGROUND Large multispecialty physician group practices, with a central role for primary care practitioners, have been shown to achieve high-quality, low-cost care for patients with chronic disease. We assessed the extent to which informal multispecialty physician networks in Ontario could be identified by using health administrative data to exploit natural linkages among patients, physicians...

PURPOSE Medicare's merit-based incentive payment system and narrowing of physician networks by health insurers will stoke clinicians' and policy makers' interest in care delivery attributes associated with value as defined by payers. METHODS To help define these attributes, we analyzed 2009 to 2011 commercial health insurance claims data for more than 40 million preferred provider organizatio...

OBJECTIVES To assess the ability of gait speed alone and a three-item lower extremity performance battery to predict 12-month rates of hospitalization, decline in health, and decline in function in primary care settings serving older adults. DESIGN Prospective cohort study. SETTING Primary care programs of a Medicare health maintenance organization (HMO) and Veterans Affairs (VA) system. ...

This article addresses the management of depression in primary care from the perspective of a health maintenance organization. The rise of managed care systems is briefly discussed with reference to their impact on choice of treatment strategies. Cost-effectiveness considerations pertinent to a health maintenance organization are reviewed. A simplified protocol for the treatment of depression w...

OBJECTIVE To determine the impact of Florida's Medicaid Demonstration 4 years post-implementation on per member per month (PMPM) Medicaid expenditures and whether receiving care through HMOs versus provider service networks (PSNs) in the Demonstration was associated with PMPM expenditures. DATA Florida Medicaid claims from two fiscal years prior to implementation of the Demonstration (FY0405,...

OBJECTIVES Because of high purchase costs of newer vaccines, financial risk to private vaccination providers has increased. We assessed among pediatricians and family physicians satisfaction with insurance payment for vaccine purchase and administration by payer type, the proportion who have considered discontinuing provision of all childhood vaccines for financial reasons, and strategies used ...