Alisa B Busch
Biographic Data
| ID | 5534249 |
|---|---|
| NAME | Alisa B Busch |
| GIVEN NAMES | Alisa B |
| FAMILY NAME | Busch |
| SIGNATURE | BUSCH A B |
| AFFILIATIONS | McLean Hospital |
| ORCID | 0000-0002-1828-9098 |
| VERIFIED | Yes |
| TOTAL WORKS | 23 |
| TOTAL CITATIONS | 3 |
| AUTHOR COUNT | 23 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2006 |
| LATEST PUBLICATION YEAR | 2024 |
| H-INDEX | 1 |
Characteristics of Mental Health Specialists Who Shifted Their Practice Entirely to Telemedicine
This cohort study investigates the number and characteristics of US mental health specialists who had shifted to a fully virtual practice as of 2022
Expanding Treatment Options for Alcohol Use Disorder
This Viewpoint discusses the emergence of telemedicine as a potential treatment option for alcohol use disorder and highlights the advantages, disadvantages, and barriers of this care model
Racial and Ethnic Differences in Telemedicine Use
The results of this cross-sectional study of US Medicare enrollees suggest that although nationally, Black individuals, Hispanic individuals, and individuals of other racial groups received more telemedicine visits during the pandemic and disproportionately lived in geographic regions with higher telemedicine use, after controlling for geographic region, Black individuals, Hispanic individuals, and individuals of other racial groups received fewe…
In-Person Visits Before Initiation of Telemedicine for Mental Illness
This cross-sectional study examines how often patients had an in-person visit before initiating telemedicine for mental illness between 2019 and 2022
Use of Telemedicine and Quality of Care Among Medicare Enrollees With Serious Mental Illness
In this cohort study of Medicare beneficiaries with serious mental illness, patients receiving care from practices that had a higher level of telemedicine use during the COVID-19 pandemic had more mental health visits per year compared with prepandemic levels, with no differential changes in other observed quality metrics over the same period
High-deductible Health Plans and Nonfatal Opioid Overdose
OBJECTIVES: Opioid-related overdose is a public health emergency in the United States. Meanwhile, high-deductible health plans (HDHPs) have become more prevalent in the United States over the last 2 decades, raising concern about their potential for discouraging high-need populations, like those with opioid use disorder (OUD), from engaging in care that may mitigate the probability of overdose. This study assesses the impact of an employer offeri…
Measurement Approaches to Estimating Methadone Continuity in Opioid Use Disorder Care
BACKGROUND: Long-term treatment with medications for opioid use disorder (OUD), including methadone, is lifesaving. There has been little examination of how to measure methadone continuity in claims data. OBJECTIVES: To develop an approach for measuring methadone continuity in claims data, and compare estimates of methadone versus buprenorphine continuity. RESEARCH DESIGN: Observational cohort study using de-identified commercial claims from Optu…
Trends in Outpatient Telemedicine Utilization Among Rural Medicare Beneficiaries, 2010 to 2019
In this cross-sectional study of telemedicine utilization before the COVID-19 pandemic, there was sustained growth in telemedicine visits among rural beneficiaries covered by the Medicare program, especially care delivered by nurse practitioners and other nonphysician clinicians. The prepandemic model of telemedicine provided in local health care settings may be a viable modality to maintain in rural communities
Patterns of Mental Health Care Before Initiation of Telemental Health Services
BACKGROUND: Use of telemental health has increased among rural Medicare beneficiaries, particularly among individuals with serious mental illness (SMI). Little is known about what leads to the initiation of telemental health. OBJECTIVE: To categorize the different patterns of mental health care use before initiation of telemental health services among individuals with SMI. METHODS: A cohort of rural beneficiaries with SMI (defined as schizophreni…
Telemental Health and US Rural–Urban Differences in Specialty Mental Health Use, 2010–2017
Objectives. To examine whether growing use of telemental health (TMH) has reduced the rural–urban gap in specialty mental health care use in the United States. Methods. Using 2010–2017 Medicare data, we analyzed trends in the rural–urban difference in rates of specialty visits (in-person and TMH). Results. Among rural beneficiaries diagnosed with schizophrenia or bipolar disorder, TMH use grew by 425% over the 8 years and, in higher-use rural are…
The Effect of Centers for Medicare and Medicaid’s Inpatient Psychiatric Facility Quality Reporting Program on the Use of Restraint and Seclusion
BACKGROUND: Patients in inpatient psychiatry settings are uniquely vulnerable to harm. As sources of harm, research and policy efforts have specifically focused on minimizing and eliminating restraint and seclusion. The Centers for Medicare and Medicaid's Inpatient Psychiatric Facility Quality Reporting (IPFQR) program attempts to systematically measure and reduce restraint and seclusion. We evaluated facilities' response to the IPFQR program and…
Association of Federal Mental Health Parity Legislation With Health Care Use and Spending Among High Utilizers of Services
BACKGROUND: Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the comprehensive federal Mental Health Parity and Addiction Equity Act. OBJECTIVES: To determine the association between federal parity and changes in mental health care utilization and spending, particularly among high utilizers. RESEARCH DESIGN: Difference-in-differences analyses compared changes before and after exposure …
Coverage of Medications That Treat Opioid Use Disorder and Opioids for Pain Management in Marketplace Plans, 2017
BACKGROUND: Efficacious medications to treat opioid use disorders (OUDs) have been slow to diffuse into practice, and insurance coverage limits may be one important barrier. OBJECTIVES: To compare coverage for medications used to treat OUDs and opioids commonly prescribed for pain management in plans offered on the 2017 Health Insurance Marketplace exchanges. RESEARCH DESIGN: We identified a sample of 100 plans offered in urban and in rural count…
Validation of the PHQ-9 in a psychiatric sample
Do Patients at Sites With High RCT Enrollment Propensity Have Better Outcomes
BACKGROUND: Concerns about randomized controlled trial (RCT) generalizability typically center on characteristics of RCT patient participants. Possibly there are RCT site characteristics that distinguish RCT outcomes from those that can be expected in non-RCT settings. OBJECTIVES: To examine whether site propensity toward RCT enrollment is associated with recovery outcomes for patients and whether the association differs between patients who part…
Adverse Clinical Events Among Medicare Beneficiaries Using Antipsychotic Drugs
OBJECTIVE: Medicare Part D provides formulary protections for antipsychotics but does not exempt these drugs from cost-sharing. We investigated the impact of Part D coverage on antipsychotic drug spending, adherence, and clinical outcomes among beneficiaries with varying indications for use. METHODS: We conducted a historical cohort study of Medicare Advantage beneficiaries who received antipsychotic drugs, with diagnoses of schizophrenia or bipo…
Does Exposure to Conflict of Interest Policies in Psychiatry Residency Affect Antidepressant Prescribing
BACKGROUND: Academic medical institutions have instituted conflict of interest (COI) policies in response to concerns about pharmaceutical industry influence. OBJECTIVE: To determine whether exposure to COI policies during psychiatry residency training affects psychiatrists' antidepressant prescribing patterns after graduation. RESEARCH DESIGN: We used 2009 physician-level national administrative prescribing data from IMS Health for 1652 psychiat…
Accurately Predicting Bipolar Disorder Mood Outcomes
BACKGROUND: Monitoring mental health treatment outcomes for populations requires an understanding as to which patient information is needed in electronic format and is feasible to obtain in routine care. OBJECTIVE: To examine whether bipolar disorder outcomes can be accurately predicted and how much clinical detail is needed to do so. RESEARCH DESIGN, DATA SOURCES, AND PARTICIPANTS: Longitudinal study of bipolar disorder patients treated during 2…
Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women
OBJECTIVE: The goal of this study was to characterize racial-ethnic differences in mental health care utilization associated with postpartum depression in a multiethnic cohort of Medicaid recipients. METHODS: In a retrospective cohort study, administrative claims data from New Jersey's Medicaid program were obtained for 29,601 women (13,001 whites, 13,416 blacks, and 3,184 Latinas) who delivered babies between July 2004 and October 2007. Racial-e…
The Rise and Fall of Gabapentin for Bipolar Disorder
CONTEXT: Rising drug costs have increased focus on how new pharmaceuticals diffuse into the marketplace. The case of gabapentin use in bipolar disorder provides an opportunity to study the roles of marketing, clinical evidence, and prior authorization (PA) policy on off-label medication use. DESIGN: Observational study using Medicaid administrative and Verispan marketing data. We examined the association between marketing, clinical trials, and pr…
Longitudinal Racial/Ethnic Disparities in Antimanic Medication Use in Bipolar-I Disorder
OBJECTIVE: To examine racial/ethnic longitudinal disparities in antimanic medication use among adults with bipolar-I disorder. METHODS: Observational study using administrative data from Florida's Medicaid program, July 1997 to June 2005, for enrollees diagnosed with bipolar-I disorder (N = 13,497 persons; 126,413 person-quarters). We examined the likelihood of receiving one of the following during a given quarter: (1) any antimanic agent (antips…
Changes Over Time and Disparities in Schizophrenia Treatment Quality
BACKGROUND: Schizophrenia medication and psychosocial treatment options have expanded since the Schizophrenia PORT was conducted. However, there also have been considerable changes in the delivery of mental health care in the public sector, as well as increasing state concerns about Medicaid cost containment. OBJECTIVES: To examine trends and patient characteristics associated with differences in schizophrenia medication and visit treatment quali…
The Impact of Parity on Major Depression Treatment Quality in the Federal Employees’ Health Benefits Program After Parity Implementation
BACKGROUND: Since the 1990s, parity laws have been implemented to reduce inequities in mental health coverage compared with that for general medical conditions. It is unclear if parity under managed care is associated with improvements in mental health treatment quality. Major depressive disorder (MDD) is a prevalent but often undetected and undertreated and thus could potentially benefit from parity implementation. OBJECTIVE: The objective of th…
Telemental Health and US Rural–Urban Differences in Specialty Mental Health Use, 2010–2017
Objectives. To examine whether growing use of telemental health (TMH) has reduced the rural–urban gap in specialty mental health care use in the United States. Methods. Using 2010–2017 Medicare data, we analyzed trends in the rural–urban difference in rates of specialty visits (in-person and TMH). Results. Among rural beneficiaries diagnosed with schizophrenia or bipolar disorder, TMH use grew by 425% over the 8 years and, in higher-use rural are…
The Impact of Parity on Major Depression Treatment Quality in the Federal Employees’ Health Benefits Program After Parity Implementation
BACKGROUND: Since the 1990s, parity laws have been implemented to reduce inequities in mental health coverage compared with that for general medical conditions. It is unclear if parity under managed care is associated with improvements in mental health treatment quality. Major depressive disorder (MDD) is a prevalent but often undetected and undertreated and thus could potentially benefit from parity implementation. OBJECTIVE: The objective of th…
Longitudinal Racial/Ethnic Disparities in Antimanic Medication Use in Bipolar-I Disorder
OBJECTIVE: To examine racial/ethnic longitudinal disparities in antimanic medication use among adults with bipolar-I disorder. METHODS: Observational study using administrative data from Florida's Medicaid program, July 1997 to June 2005, for enrollees diagnosed with bipolar-I disorder (N = 13,497 persons; 126,413 person-quarters). We examined the likelihood of receiving one of the following during a given quarter: (1) any antimanic agent (antips…
Changes Over Time and Disparities in Schizophrenia Treatment Quality
BACKGROUND: Schizophrenia medication and psychosocial treatment options have expanded since the Schizophrenia PORT was conducted. However, there also have been considerable changes in the delivery of mental health care in the public sector, as well as increasing state concerns about Medicaid cost containment. OBJECTIVES: To examine trends and patient characteristics associated with differences in schizophrenia medication and visit treatment quali…
The Rise and Fall of Gabapentin for Bipolar Disorder
CONTEXT: Rising drug costs have increased focus on how new pharmaceuticals diffuse into the marketplace. The case of gabapentin use in bipolar disorder provides an opportunity to study the roles of marketing, clinical evidence, and prior authorization (PA) policy on off-label medication use. DESIGN: Observational study using Medicaid administrative and Verispan marketing data. We examined the association between marketing, clinical trials, and pr…
Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women
OBJECTIVE: The goal of this study was to characterize racial-ethnic differences in mental health care utilization associated with postpartum depression in a multiethnic cohort of Medicaid recipients. METHODS: In a retrospective cohort study, administrative claims data from New Jersey's Medicaid program were obtained for 29,601 women (13,001 whites, 13,416 blacks, and 3,184 Latinas) who delivered babies between July 2004 and October 2007. Racial-e…
Accurately Predicting Bipolar Disorder Mood Outcomes
BACKGROUND: Monitoring mental health treatment outcomes for populations requires an understanding as to which patient information is needed in electronic format and is feasible to obtain in routine care. OBJECTIVE: To examine whether bipolar disorder outcomes can be accurately predicted and how much clinical detail is needed to do so. RESEARCH DESIGN, DATA SOURCES, AND PARTICIPANTS: Longitudinal study of bipolar disorder patients treated during 2…
Adverse Clinical Events Among Medicare Beneficiaries Using Antipsychotic Drugs
OBJECTIVE: Medicare Part D provides formulary protections for antipsychotics but does not exempt these drugs from cost-sharing. We investigated the impact of Part D coverage on antipsychotic drug spending, adherence, and clinical outcomes among beneficiaries with varying indications for use. METHODS: We conducted a historical cohort study of Medicare Advantage beneficiaries who received antipsychotic drugs, with diagnoses of schizophrenia or bipo…
Does Exposure to Conflict of Interest Policies in Psychiatry Residency Affect Antidepressant Prescribing
BACKGROUND: Academic medical institutions have instituted conflict of interest (COI) policies in response to concerns about pharmaceutical industry influence. OBJECTIVE: To determine whether exposure to COI policies during psychiatry residency training affects psychiatrists' antidepressant prescribing patterns after graduation. RESEARCH DESIGN: We used 2009 physician-level national administrative prescribing data from IMS Health for 1652 psychiat…
Do Patients at Sites With High RCT Enrollment Propensity Have Better Outcomes
BACKGROUND: Concerns about randomized controlled trial (RCT) generalizability typically center on characteristics of RCT patient participants. Possibly there are RCT site characteristics that distinguish RCT outcomes from those that can be expected in non-RCT settings. OBJECTIVES: To examine whether site propensity toward RCT enrollment is associated with recovery outcomes for patients and whether the association differs between patients who part…
Validation of the PHQ-9 in a psychiatric sample
Coverage of Medications That Treat Opioid Use Disorder and Opioids for Pain Management in Marketplace Plans, 2017
BACKGROUND: Efficacious medications to treat opioid use disorders (OUDs) have been slow to diffuse into practice, and insurance coverage limits may be one important barrier. OBJECTIVES: To compare coverage for medications used to treat OUDs and opioids commonly prescribed for pain management in plans offered on the 2017 Health Insurance Marketplace exchanges. RESEARCH DESIGN: We identified a sample of 100 plans offered in urban and in rural count…
Association of Federal Mental Health Parity Legislation With Health Care Use and Spending Among High Utilizers of Services
BACKGROUND: Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the comprehensive federal Mental Health Parity and Addiction Equity Act. OBJECTIVES: To determine the association between federal parity and changes in mental health care utilization and spending, particularly among high utilizers. RESEARCH DESIGN: Difference-in-differences analyses compared changes before and after exposure …
Telemental Health and US Rural–Urban Differences in Specialty Mental Health Use, 2010–2017
Objectives. To examine whether growing use of telemental health (TMH) has reduced the rural–urban gap in specialty mental health care use in the United States. Methods. Using 2010–2017 Medicare data, we analyzed trends in the rural–urban difference in rates of specialty visits (in-person and TMH). Results. Among rural beneficiaries diagnosed with schizophrenia or bipolar disorder, TMH use grew by 425% over the 8 years and, in higher-use rural are…
The Effect of Centers for Medicare and Medicaid’s Inpatient Psychiatric Facility Quality Reporting Program on the Use of Restraint and Seclusion
BACKGROUND: Patients in inpatient psychiatry settings are uniquely vulnerable to harm. As sources of harm, research and policy efforts have specifically focused on minimizing and eliminating restraint and seclusion. The Centers for Medicare and Medicaid's Inpatient Psychiatric Facility Quality Reporting (IPFQR) program attempts to systematically measure and reduce restraint and seclusion. We evaluated facilities' response to the IPFQR program and…
Trends in Outpatient Telemedicine Utilization Among Rural Medicare Beneficiaries, 2010 to 2019
In this cross-sectional study of telemedicine utilization before the COVID-19 pandemic, there was sustained growth in telemedicine visits among rural beneficiaries covered by the Medicare program, especially care delivered by nurse practitioners and other nonphysician clinicians. The prepandemic model of telemedicine provided in local health care settings may be a viable modality to maintain in rural communities
Patterns of Mental Health Care Before Initiation of Telemental Health Services
BACKGROUND: Use of telemental health has increased among rural Medicare beneficiaries, particularly among individuals with serious mental illness (SMI). Little is known about what leads to the initiation of telemental health. OBJECTIVE: To categorize the different patterns of mental health care use before initiation of telemental health services among individuals with SMI. METHODS: A cohort of rural beneficiaries with SMI (defined as schizophreni…
Use of Telemedicine and Quality of Care Among Medicare Enrollees With Serious Mental Illness
In this cohort study of Medicare beneficiaries with serious mental illness, patients receiving care from practices that had a higher level of telemedicine use during the COVID-19 pandemic had more mental health visits per year compared with prepandemic levels, with no differential changes in other observed quality metrics over the same period
High-deductible Health Plans and Nonfatal Opioid Overdose
OBJECTIVES: Opioid-related overdose is a public health emergency in the United States. Meanwhile, high-deductible health plans (HDHPs) have become more prevalent in the United States over the last 2 decades, raising concern about their potential for discouraging high-need populations, like those with opioid use disorder (OUD), from engaging in care that may mitigate the probability of overdose. This study assesses the impact of an employer offeri…
Measurement Approaches to Estimating Methadone Continuity in Opioid Use Disorder Care
BACKGROUND: Long-term treatment with medications for opioid use disorder (OUD), including methadone, is lifesaving. There has been little examination of how to measure methadone continuity in claims data. OBJECTIVES: To develop an approach for measuring methadone continuity in claims data, and compare estimates of methadone versus buprenorphine continuity. RESEARCH DESIGN: Observational cohort study using de-identified commercial claims from Optu…
Characteristics of Mental Health Specialists Who Shifted Their Practice Entirely to Telemedicine
This cohort study investigates the number and characteristics of US mental health specialists who had shifted to a fully virtual practice as of 2022
Expanding Treatment Options for Alcohol Use Disorder
This Viewpoint discusses the emergence of telemedicine as a potential treatment option for alcohol use disorder and highlights the advantages, disadvantages, and barriers of this care model
Racial and Ethnic Differences in Telemedicine Use
The results of this cross-sectional study of US Medicare enrollees suggest that although nationally, Black individuals, Hispanic individuals, and individuals of other racial groups received more telemedicine visits during the pandemic and disproportionately lived in geographic regions with higher telemedicine use, after controlling for geographic region, Black individuals, Hispanic individuals, and individuals of other racial groups received fewe…
In-Person Visits Before Initiation of Telemedicine for Mental Illness
This cross-sectional study examines how often patients had an in-person visit before initiating telemedicine for mental illness between 2019 and 2022
Medicine (23 works) · Psychiatry (19 works) · Health care (18 works) · Mental health (10 works) · Family medicine (8 works) · Internal Medicine (8 works) · Internal Medicine (8 works) · Psychology (8 works) · Telemedicine (8 works) · Telemedicine and Telehealth Implementation (8 works)