Rachel M Werner
Biographic Data
| ID | 5533823 |
|---|---|
| NAME | Rachel M Werner |
| GIVEN NAMES | Rachel M |
| FAMILY NAME | Werner |
| SIGNATURE | WERNER R M |
| AFFILIATIONS | Philadelphia VA Medical Center |
| ORCID | 0000-0003-3435-4221 |
| VERIFIED | Yes |
| TOTAL WORKS | 16 |
| TOTAL CITATIONS | 0 |
| WORKS AS AUTHOR | 16 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2010 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 0 |
Payments to Physician Practices and Incentives to Serve Different Racial and Ethnic Groups
In this study, US physician practices were paid more for outpatient visits with non-Hispanic White patients than for outpatient visits with Hispanic or non-Hispanic Black patients. Payment disparities were larger in pediatrics and partly explained by insurance. Differential financial incentives to serve non-Hispanic White patients may worsen disparities in health care access, utilization, and quality
Toward Integrating Care for Dually Eligible Beneficiaries
This Viewpoint discusses the challenges in creating integrated care for dually eligible Medicare and Medicaid beneficiaries and presents policy recommendations for increasing enrollment in integrated plans
Challenges and Opportunities in Implementing a Multicomponent Dementia Caregiver Program in a Complex Healthcare System
The Tailored Activity Program (TAP), an intervention for people living with dementia (PLWD) and their caregivers, has been shown to reduce behavioral symptoms for PLWD and caregiver burden. While TAP is proven as an evidence-based practice (EBP), it has yet to be implemented at scale. The Department of Veterans Affairs (VA) has prioritized the Age-Friendly Health System (AFHS) initiative, providing an opportunity to test implementation of TAP in …
Association of Medicare Advantage Star Ratings With Racial and Ethnic Disparities in Hospitalizations for Ambulatory Care Sensitive Conditions
BACKGROUND: Enrollment in high-quality Medicare Advantage (MA) plans, measured by a 5-star quality rating system, was lower among racial and ethnic minority enrollees than White enrollees partly due to fewer high-quality plans available in their counties of residence. This may contribute to racial and ethnic disparities in ambulatory care sensitive condition (ACSC) hospitalizations. OBJECTIVE: We examined whether there were racial and ethnic disp…
Trends in Outpatient Care and Use of Telemedicine After Hospital Discharge in a Large Commercially Insured Population
This cross-sectional study examines changes in use of telemedicine vs in-person care among a commercially insured population durring the COVID-19 pandemic
Association of Patient Outcomes With Bundled Payments Among Hospitalized Patients Attributed to Accountable Care Organizations
In this cohort study, compared with inclusion in bundled payments alone, simultaneous inclusion in both ACOs and bundled payment programs was associated with lower institutional postacute care spending and readmissions for medical episodes and lower readmissions but not spending for surgical episodes. Receiving care under models such as ACOs may improve episode outcomes under bundled payments
Association Between 5-Star Nursing Home Report Card Ratings and Potentially Preventable Hospitalizations
Nursing homes' publicly reported star ratings increased substantially since Centers for Medicare & Medicaid Services's Nursing Home Compare adopted a 5-star rating system. Our objective was to test whether the improvements in nursing home 5-star ratings were correlated with reductions in rates of hospitalization. We hypothesized that increased attention to 5-star star ratings motivated nursing homes to make changes that improved their star rating…
Organizational Processes and Patient Experiences in the Patient-centered Medical Home
BACKGROUND: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. OBJECTIVE: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. RESEARCH DESIGN: We analyzed visit data from p…
Improving Patient-centered Care
Participants understood the patient centered approach, despite experiencing a lack of resources and training and could push through solutions to patient engagement barriers while working within the limits of their settings
Comparing the Contributions of Acute and Postacute Care Facility Characteristics to Outcomes After Hospitalization for Hip Fracture
OBJECTIVE: To quantify the contribution of acute versus postacute care factors to survival and functional outcomes after hip fracture. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using Medicare data; subjects included previously ambulatory nursing home residents hospitalized for hip fracture between 2005 and 2009. METHODS: We used logistic regression to measure the associations of hospital and nursing home factors with functiona…
Creating a Toolkit to Reduce Disparities in Patient Engagement
BACKGROUND: Patient engagement has become a major focus of health care improvement efforts nationally. Although evidence suggests patient engagement can be beneficial to patients, it has not been consistently defined, operationalized, or translated into practice. OBJECTIVES: Our objective was to develop a toolkit to help providers increase patient engagement and reduce disparities in patient engagement. RESEARCH DESIGN: We used qualitative interv…
Effectiveness of Long-term Acute Care Hospitalization in Elderly Patients With Chronic Critical Illness
BACKGROUND: For patients recovering from severe acute illness, admission to a long-term acute care hospital (LTAC) is an increasingly common alternative to continued management in an intensive care unit (ICU). OBJECTIVE: To examine the effectiveness of LTAC transfer in patients with chronic critical illness. RESEARCH DESIGN: Retrospective cohort study in United States hospitals from 2002 to 2006. SUBJECTS: Medicare beneficiaries with chronic crit…
The Patient-centered Medical Home
BACKGROUND: The patient-centered medical home (PCMH) has increasingly been looked to by policy makers, health care providers, and private insurers as a potential solution to the fragmented and inefficient US health care system. Whether the PCMH achieves these goals is not known. OBJECTIVES: To evaluate a PCMH demonstration project implemented in 2011 in 8 New Jersey primary care practices covering over 10,000 plan members. RESEARCH DESIGN: We con…
Quality Improvement Under Nursing Home Compare
BACKGROUND: Changes in resident outcomes may be driven by many factors, including changes in nursing home care processes. Understanding what processes, if any, lead to successful improvements in resident outcomes could create a stronger case for the continued use of these outcome measures in nursing home report cards. OBJECTIVE: To test the extent to which improvements in outcomes of care are explained by changes in nursing home processes, a sett…
Malpractice Premiums and the Supply of Obstetricians
Using longitudinal data on practicing obstetricians from 1998 to 2004 derived from Pennsylvania, Florida, and New York hospital discharge data, this study finds that rising malpractice premiums are associated with an increased rate of exit and a reduced rate of entry for obstetricians. In Pennsylvania and Florida, where premiums rose by an average of 20% per year for four years, the combined effect of more exits and fewer entries was associated w…
Impact of Changes in Clinical Practice Guidelines on Assessment of Quality of Care
BACKGROUND: Measures for pay-for-performance and public reporting programs may be based on clinical practice guidelines. The impact of guideline changes over time-and whether evolving clinical evidence can render measures based on prior guidelines misleading-is not known. OBJECTIVE: To assess the impact of using different percutaneous coronary intervention (PCI) guidelines when evaluating whether PCI was indicated. RESEARCH DESIGN: PCIs from the …
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Malpractice Premiums and the Supply of Obstetricians
Using longitudinal data on practicing obstetricians from 1998 to 2004 derived from Pennsylvania, Florida, and New York hospital discharge data, this study finds that rising malpractice premiums are associated with an increased rate of exit and a reduced rate of entry for obstetricians. In Pennsylvania and Florida, where premiums rose by an average of 20% per year for four years, the combined effect of more exits and fewer entries was associated w…
Impact of Changes in Clinical Practice Guidelines on Assessment of Quality of Care
BACKGROUND: Measures for pay-for-performance and public reporting programs may be based on clinical practice guidelines. The impact of guideline changes over time-and whether evolving clinical evidence can render measures based on prior guidelines misleading-is not known. OBJECTIVE: To assess the impact of using different percutaneous coronary intervention (PCI) guidelines when evaluating whether PCI was indicated. RESEARCH DESIGN: PCIs from the …
Effectiveness of Long-term Acute Care Hospitalization in Elderly Patients With Chronic Critical Illness
BACKGROUND: For patients recovering from severe acute illness, admission to a long-term acute care hospital (LTAC) is an increasingly common alternative to continued management in an intensive care unit (ICU). OBJECTIVE: To examine the effectiveness of LTAC transfer in patients with chronic critical illness. RESEARCH DESIGN: Retrospective cohort study in United States hospitals from 2002 to 2006. SUBJECTS: Medicare beneficiaries with chronic crit…
The Patient-centered Medical Home
BACKGROUND: The patient-centered medical home (PCMH) has increasingly been looked to by policy makers, health care providers, and private insurers as a potential solution to the fragmented and inefficient US health care system. Whether the PCMH achieves these goals is not known. OBJECTIVES: To evaluate a PCMH demonstration project implemented in 2011 in 8 New Jersey primary care practices covering over 10,000 plan members. RESEARCH DESIGN: We con…
Quality Improvement Under Nursing Home Compare
BACKGROUND: Changes in resident outcomes may be driven by many factors, including changes in nursing home care processes. Understanding what processes, if any, lead to successful improvements in resident outcomes could create a stronger case for the continued use of these outcome measures in nursing home report cards. OBJECTIVE: To test the extent to which improvements in outcomes of care are explained by changes in nursing home processes, a sett…
Comparing the Contributions of Acute and Postacute Care Facility Characteristics to Outcomes After Hospitalization for Hip Fracture
OBJECTIVE: To quantify the contribution of acute versus postacute care factors to survival and functional outcomes after hip fracture. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using Medicare data; subjects included previously ambulatory nursing home residents hospitalized for hip fracture between 2005 and 2009. METHODS: We used logistic regression to measure the associations of hospital and nursing home factors with functiona…
Creating a Toolkit to Reduce Disparities in Patient Engagement
BACKGROUND: Patient engagement has become a major focus of health care improvement efforts nationally. Although evidence suggests patient engagement can be beneficial to patients, it has not been consistently defined, operationalized, or translated into practice. OBJECTIVES: Our objective was to develop a toolkit to help providers increase patient engagement and reduce disparities in patient engagement. RESEARCH DESIGN: We used qualitative interv…
Association Between 5-Star Nursing Home Report Card Ratings and Potentially Preventable Hospitalizations
Nursing homes' publicly reported star ratings increased substantially since Centers for Medicare & Medicaid Services's Nursing Home Compare adopted a 5-star rating system. Our objective was to test whether the improvements in nursing home 5-star ratings were correlated with reductions in rates of hospitalization. We hypothesized that increased attention to 5-star star ratings motivated nursing homes to make changes that improved their star rating…
Organizational Processes and Patient Experiences in the Patient-centered Medical Home
BACKGROUND: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. OBJECTIVE: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. RESEARCH DESIGN: We analyzed visit data from p…
Improving Patient-centered Care
Participants understood the patient centered approach, despite experiencing a lack of resources and training and could push through solutions to patient engagement barriers while working within the limits of their settings
Trends in Outpatient Care and Use of Telemedicine After Hospital Discharge in a Large Commercially Insured Population
This cross-sectional study examines changes in use of telemedicine vs in-person care among a commercially insured population durring the COVID-19 pandemic
Association of Patient Outcomes With Bundled Payments Among Hospitalized Patients Attributed to Accountable Care Organizations
In this cohort study, compared with inclusion in bundled payments alone, simultaneous inclusion in both ACOs and bundled payment programs was associated with lower institutional postacute care spending and readmissions for medical episodes and lower readmissions but not spending for surgical episodes. Receiving care under models such as ACOs may improve episode outcomes under bundled payments
Association of Medicare Advantage Star Ratings With Racial and Ethnic Disparities in Hospitalizations for Ambulatory Care Sensitive Conditions
BACKGROUND: Enrollment in high-quality Medicare Advantage (MA) plans, measured by a 5-star quality rating system, was lower among racial and ethnic minority enrollees than White enrollees partly due to fewer high-quality plans available in their counties of residence. This may contribute to racial and ethnic disparities in ambulatory care sensitive condition (ACSC) hospitalizations. OBJECTIVE: We examined whether there were racial and ethnic disp…
Payments to Physician Practices and Incentives to Serve Different Racial and Ethnic Groups
In this study, US physician practices were paid more for outpatient visits with non-Hispanic White patients than for outpatient visits with Hispanic or non-Hispanic Black patients. Payment disparities were larger in pediatrics and partly explained by insurance. Differential financial incentives to serve non-Hispanic White patients may worsen disparities in health care access, utilization, and quality
Toward Integrating Care for Dually Eligible Beneficiaries
This Viewpoint discusses the challenges in creating integrated care for dually eligible Medicare and Medicaid beneficiaries and presents policy recommendations for increasing enrollment in integrated plans
Challenges and Opportunities in Implementing a Multicomponent Dementia Caregiver Program in a Complex Healthcare System
The Tailored Activity Program (TAP), an intervention for people living with dementia (PLWD) and their caregivers, has been shown to reduce behavioral symptoms for PLWD and caregiver burden. While TAP is proven as an evidence-based practice (EBP), it has yet to be implemented at scale. The Department of Veterans Affairs (VA) has prioritized the Age-Friendly Health System (AFHS) initiative, providing an opportunity to test implementation of TAP in …
Medicine (14 works) · Health care (11 works) · Family medicine (9 works) · Nursing (8 works) · Healthcare Policy and Management (6 works) · Primary Care and Health Outcomes (6 works) · Emergency Medicine (5 works) · Internal Medicine (5 works) · MEDLINE (5 works) · Political science (5 works)