Todd H Wagner
Dados Biográficos
| ID | 2177430 |
|---|---|
| NOME | Todd H Wagner |
| PRENOMES | Todd H |
| SOBRENOME | Wagner |
| ASSINATURA | WAGNER T H |
| AFILIAÇÕES | Stanford University |
| ORCID | 0000-0001-7625-3504 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 22 |
| TOTAL DE CITAÇÕES | 79 |
| TOTAL COMO AUTOR | 22 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1996 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 2 |
Purchasing Versus Providing Care at the VHA
BACKGROUND: The Veterans Health Administration (VHA) greatly expanded the proportion of health care services it purchases from community providers over the last decade, which could impact the quality of care and create care fragmentation. Continuity of care between inpatient and outpatient care delivery systems is critical for high-quality mental health care. OBJECTIVE: To compare rates of outpatient follow-up visits between VHA-purchased and VHA…
The Future of the VA—The Privatization Debate
This Viewpoint describes the debate regarding privatization of Department of Veterans Affairs (VA) health care as well as alternatives to privatization
Are Rates of Skin Procedures Higher in Veterans Health Administrations Purchased Care Than Veterans Health Administrations Delivered Care
BACKGROUND: To improve access to care, the Department of Veterans Affairs (VA) implemented the Veterans Choice Program, allowing enrollees to receive care outside VA facilities if they met eligibility requirements tied to wait times, travel, and availability of services. VA-purchased care has grown significantly to more than $32 billion in 2024, representing 24% of VA's medical care budget. OBJECTIVES: To compare the annual utilization of skin pr…
Hospital Presumptive Eligibility Emergency Medicaid Programs
BACKGROUND: Lack of health insurance is a public health crisis, leading to foregone care and financial strain. Hospital Presumptive Eligibility (HPE) is a hospital-based emergency Medicaid program that provides temporary (up to 60 d) coverage, with the goal that hospitals will assist patients in applying for ongoing Medicaid coverage. It is unclear whether HPE is associated with successful longer-term Medicaid enrollment. OBJECTIVE: To characteri…
The impact of informal caregiving on U.S. Veterans Health Administration utilization and expenditures
Comparing Postoperative Readmission Rates Between Veterans Receiving Total Knee Arthroplasty in the Veterans Health Administration Versus Community Care
BACKGROUND: There are growing concerns that Veterans' increased use of Veterans Health Administration (VA)-purchased care in the community may lead to lower quality of care. OBJECTIVE: We compared rates of hospital readmissions following elective total knee arthroplasties (TKAs) that were either performed in VA or purchased by VA through community care (CC) at both the national and facility levels. METHODS: Three-year cohort study using VA and CC…
County-level Predictors of Growth in Community-based Primary Care Use Among Veterans
BACKGROUND: The 2014 Choice Act expanded the Veterans Health Administration's (VA) capacity to purchase services for VA enrollees from community providers, yet little is known regarding the growth of Veterans' primary care use in community settings. OBJECTIVES: The aim was to measure county-level growth in VA community-based primary care (CBPC) penetration following the Choice Act and to assess whether CBPC penetration increased in rural counties…
Emergency Medicaid Acquisition Through the Affordable Care Act
BACKGROUND: Hospital Presumptive Eligibility (HPE) is a national policy stemming from the Affordable Care Act that allows qualified hospitals, working with state officials, to enroll eligible patients for temporary Medicaid coverage. Although all states are required to operate an HPE program, hospital participation is elective and variable. It is unclear which hospitals choose to participate in HPE and how participation affects hospital utilizati…
Events Associated With Changes in Reliance on the Veterans Health Administration Among Medicare-eligible Veterans
OBJECTIVES: We can learn something about how Veterans value the Veterans Health Administration (VHA) versus community providers by observing Veterans' choices between VHA and Medicare providers after they turn 65. For a cohort of Veterans who were newly age-eligible for Medicare, we estimated the change in VHA reliance (VHA outpatient visits divided by total VHA and Medicare visits) associated with specific events: receiving a life-threatening di…
Evaluating the Role of Past Clinical Information on Risk Adjustment
OBJECTIVE: The objective of this study was to evaluate whether incorporating historical clinical information beyond 1 year improves risk adjustment. DATA SOURCES: Administrative data from the Department of Veterans Affairs and Medicare (for veterans concurrently enrolled in Medicare) for fiscal years (FYs) 2011-2015. STUDY DESIGN: We regressed total annual costs on Medicare hierarchical condition category indicators and risk scores for FY 2015 in…
Iraq and Afghanistan Veterans’ Use of Veterans Health Administration and Purchased Care Before and After Veterans Choice Program Implementation
BACKGROUND: The Veterans Choice Program (VCP), enacted by Congress after concerns surfaced about access, enables veterans to receive care outside Veterans Health Administration (VHA) facilities. Veterans who face long wait times, large driving distances, or particular hardships are eligible for VCP. Prior purchased care programs were comparatively limited in scope. OBJECTIVES: We sought to describe utilization of VHA-provided and purchased outpat…
Self-Reported Utilization of Health Care Services
Self-report is often used to estimate health care utilization. However, the accuracy of such data is of paramount concern. The authors conducted a systematic review of 42 studies that evaluated the accuracy of self-report utilization data, where utilization was defined as a visit to a clinical provider or entity. They also present a broad conceptual model that identifies major issues to consider when collecting, analyzing, and reporting such data…
Free Internet Access, the Digital Divide, and Health Information
BACKGROUND: The Internet has emerged as a valuable tool for health information. Half of the U.S. population lacked Internet access in 2001, creating concerns about those without access. Starting in 1999, a survey firm randomly invited individuals to join their research panel in return for free Internet access. This provides a unique setting to study the ways that people who had not previously obtained Internet access use the Internet when it beco…
Internet use and stigmatized illness
Economies of Scale in Institutional Review Boards
BACKGROUND: Research with human subjects is essential for most clinical and social science research. As such, the ethical treatment of subjects, including the role of Institutional Review Boards (IRBs), is of paramount concern. The prevailing system of IRBs in the United States reflects an integrated approach in which research organizations have their own local IRB. Recent regulatory changes and a few high-profile problems have prompted proposals…
Cost-Related Medication Underuse Among Chronically III Adults
Objectives. We sought information about the cost-related underuse of medications—which medications are underused, by whom, and how often. Methods. Chronically ill adults were asked to identify how often they underused prescription medication for 16 health conditions because of the cost. Results. Eighteen percent of respondents cut back on medication use owing to cost in the previous year, and 14% used less medication at least monthly. Although ra…
Health Insurance Status, Cost-Related Medication Underuse, and Outcomes Among Diabetes Patients in Three Systems of Care
BACKGROUND: Chronically ill patients often experience difficulty paying for their medications and, as a result, use less than prescribed. OBJECTIVES: The objectives of this study were to determine the relationship between patients with diabetes' health insurance coverage and cost-related medication underuse, the association between cost-related underuse and health outcomes, and the role of comorbidity in this process. RESEARCH DESIGN: We used a p…
Use of the Internet and E-mail for Health Care Information
CONTEXT: The Internet has attracted considerable attention as a means to improve health and health care delivery, but it is not clear how prevalent Internet use for health care really is or what impact it has on health care utilization. Available estimates of use and impact vary widely. Without accurate estimates of use and effects, it is difficult to focus policy discussions or design appropriate policy activities. OBJECTIVES: To measure the ext…
New Opportunities for Integrated Child Health Systems
Experts support integrated health systems for children to stimulate risk reduction and to promote child health.1 In 1998, California counties were required to develop integrated child service systems as part of tobacco surtax funds contained in Proposition 10, the Children and Families First Act. Counties have looked to the “Pre-to-Three” program started in 1996 in San Mateo County, Calif, as a potential model. Pre-to-Three was designed to promot…
Does Providing Consumer Health Information Affect Self-Reported Medical Utilization? Evidence From the Healthwise Communities Project
OBJECTIVE: To determine whether providing health information to residents of Boise ID had an effect on their self-reported medical utilization. RESEARCH DESIGN: The Healthwise Communities Project (HCP) evaluation followed a quasi-experimental design. SUBJECTS: Random households in metropolitan zip codes were mailed questionnaires before and after the HCP. A total of 5,909 surveys were returned. MEASURES: The dependent variable was self-reported n…
When Parents Are Given Greater Access to Health Information, Does It Affect Pediatric Utilization
OBJECTIVE: Most studies assessing the effects of consumer health information on medical utilization have used randomized controlled clinical trials with the chronically ill. In this paper, we analyze the effect of the Healthwise Communities Project, a natural experiment that provided free self-care resources, on reported pediatric utilization. RESEARCH DESIGN: Random household surveys were collected before and after the intervention in Boise, Ida…
Cross-cultural development of a quality of life measure for men with erection difficulties
Internet use and stigmatized illness
Cost-Related Medication Underuse Among Chronically III Adults
Objectives. We sought information about the cost-related underuse of medications—which medications are underused, by whom, and how often. Methods. Chronically ill adults were asked to identify how often they underused prescription medication for 16 health conditions because of the cost. Results. Eighteen percent of respondents cut back on medication use owing to cost in the previous year, and 14% used less medication at least monthly. Although ra…
Cross-cultural development of a quality of life measure for men with erection difficulties
Does Providing Consumer Health Information Affect Self-Reported Medical Utilization? Evidence From the Healthwise Communities Project
OBJECTIVE: To determine whether providing health information to residents of Boise ID had an effect on their self-reported medical utilization. RESEARCH DESIGN: The Healthwise Communities Project (HCP) evaluation followed a quasi-experimental design. SUBJECTS: Random households in metropolitan zip codes were mailed questionnaires before and after the HCP. A total of 5,909 surveys were returned. MEASURES: The dependent variable was self-reported n…
When Parents Are Given Greater Access to Health Information, Does It Affect Pediatric Utilization
OBJECTIVE: Most studies assessing the effects of consumer health information on medical utilization have used randomized controlled clinical trials with the chronically ill. In this paper, we analyze the effect of the Healthwise Communities Project, a natural experiment that provided free self-care resources, on reported pediatric utilization. RESEARCH DESIGN: Random household surveys were collected before and after the intervention in Boise, Ida…
Use of the Internet and E-mail for Health Care Information
CONTEXT: The Internet has attracted considerable attention as a means to improve health and health care delivery, but it is not clear how prevalent Internet use for health care really is or what impact it has on health care utilization. Available estimates of use and impact vary widely. Without accurate estimates of use and effects, it is difficult to focus policy discussions or design appropriate policy activities. OBJECTIVES: To measure the ext…
New Opportunities for Integrated Child Health Systems
Experts support integrated health systems for children to stimulate risk reduction and to promote child health.1 In 1998, California counties were required to develop integrated child service systems as part of tobacco surtax funds contained in Proposition 10, the Children and Families First Act. Counties have looked to the “Pre-to-Three” program started in 1996 in San Mateo County, Calif, as a potential model. Pre-to-Three was designed to promot…
Economies of Scale in Institutional Review Boards
BACKGROUND: Research with human subjects is essential for most clinical and social science research. As such, the ethical treatment of subjects, including the role of Institutional Review Boards (IRBs), is of paramount concern. The prevailing system of IRBs in the United States reflects an integrated approach in which research organizations have their own local IRB. Recent regulatory changes and a few high-profile problems have prompted proposals…
Cost-Related Medication Underuse Among Chronically III Adults
Objectives. We sought information about the cost-related underuse of medications—which medications are underused, by whom, and how often. Methods. Chronically ill adults were asked to identify how often they underused prescription medication for 16 health conditions because of the cost. Results. Eighteen percent of respondents cut back on medication use owing to cost in the previous year, and 14% used less medication at least monthly. Although ra…
Health Insurance Status, Cost-Related Medication Underuse, and Outcomes Among Diabetes Patients in Three Systems of Care
BACKGROUND: Chronically ill patients often experience difficulty paying for their medications and, as a result, use less than prescribed. OBJECTIVES: The objectives of this study were to determine the relationship between patients with diabetes' health insurance coverage and cost-related medication underuse, the association between cost-related underuse and health outcomes, and the role of comorbidity in this process. RESEARCH DESIGN: We used a p…
Free Internet Access, the Digital Divide, and Health Information
BACKGROUND: The Internet has emerged as a valuable tool for health information. Half of the U.S. population lacked Internet access in 2001, creating concerns about those without access. Starting in 1999, a survey firm randomly invited individuals to join their research panel in return for free Internet access. This provides a unique setting to study the ways that people who had not previously obtained Internet access use the Internet when it beco…
Internet use and stigmatized illness
Self-Reported Utilization of Health Care Services
Self-report is often used to estimate health care utilization. However, the accuracy of such data is of paramount concern. The authors conducted a systematic review of 42 studies that evaluated the accuracy of self-report utilization data, where utilization was defined as a visit to a clinical provider or entity. They also present a broad conceptual model that identifies major issues to consider when collecting, analyzing, and reporting such data…
Iraq and Afghanistan Veterans’ Use of Veterans Health Administration and Purchased Care Before and After Veterans Choice Program Implementation
BACKGROUND: The Veterans Choice Program (VCP), enacted by Congress after concerns surfaced about access, enables veterans to receive care outside Veterans Health Administration (VHA) facilities. Veterans who face long wait times, large driving distances, or particular hardships are eligible for VCP. Prior purchased care programs were comparatively limited in scope. OBJECTIVES: We sought to describe utilization of VHA-provided and purchased outpat…
Emergency Medicaid Acquisition Through the Affordable Care Act
BACKGROUND: Hospital Presumptive Eligibility (HPE) is a national policy stemming from the Affordable Care Act that allows qualified hospitals, working with state officials, to enroll eligible patients for temporary Medicaid coverage. Although all states are required to operate an HPE program, hospital participation is elective and variable. It is unclear which hospitals choose to participate in HPE and how participation affects hospital utilizati…
Events Associated With Changes in Reliance on the Veterans Health Administration Among Medicare-eligible Veterans
OBJECTIVES: We can learn something about how Veterans value the Veterans Health Administration (VHA) versus community providers by observing Veterans' choices between VHA and Medicare providers after they turn 65. For a cohort of Veterans who were newly age-eligible for Medicare, we estimated the change in VHA reliance (VHA outpatient visits divided by total VHA and Medicare visits) associated with specific events: receiving a life-threatening di…
Evaluating the Role of Past Clinical Information on Risk Adjustment
OBJECTIVE: The objective of this study was to evaluate whether incorporating historical clinical information beyond 1 year improves risk adjustment. DATA SOURCES: Administrative data from the Department of Veterans Affairs and Medicare (for veterans concurrently enrolled in Medicare) for fiscal years (FYs) 2011-2015. STUDY DESIGN: We regressed total annual costs on Medicare hierarchical condition category indicators and risk scores for FY 2015 in…
County-level Predictors of Growth in Community-based Primary Care Use Among Veterans
BACKGROUND: The 2014 Choice Act expanded the Veterans Health Administration's (VA) capacity to purchase services for VA enrollees from community providers, yet little is known regarding the growth of Veterans' primary care use in community settings. OBJECTIVES: The aim was to measure county-level growth in VA community-based primary care (CBPC) penetration following the Choice Act and to assess whether CBPC penetration increased in rural counties…
Comparing Postoperative Readmission Rates Between Veterans Receiving Total Knee Arthroplasty in the Veterans Health Administration Versus Community Care
BACKGROUND: There are growing concerns that Veterans' increased use of Veterans Health Administration (VA)-purchased care in the community may lead to lower quality of care. OBJECTIVE: We compared rates of hospital readmissions following elective total knee arthroplasties (TKAs) that were either performed in VA or purchased by VA through community care (CC) at both the national and facility levels. METHODS: Three-year cohort study using VA and CC…
Hospital Presumptive Eligibility Emergency Medicaid Programs
BACKGROUND: Lack of health insurance is a public health crisis, leading to foregone care and financial strain. Hospital Presumptive Eligibility (HPE) is a hospital-based emergency Medicaid program that provides temporary (up to 60 d) coverage, with the goal that hospitals will assist patients in applying for ongoing Medicaid coverage. It is unclear whether HPE is associated with successful longer-term Medicaid enrollment. OBJECTIVE: To characteri…
The impact of informal caregiving on U.S. Veterans Health Administration utilization and expenditures
The Future of the VA—The Privatization Debate
This Viewpoint describes the debate regarding privatization of Department of Veterans Affairs (VA) health care as well as alternatives to privatization
Are Rates of Skin Procedures Higher in Veterans Health Administrations Purchased Care Than Veterans Health Administrations Delivered Care
BACKGROUND: To improve access to care, the Department of Veterans Affairs (VA) implemented the Veterans Choice Program, allowing enrollees to receive care outside VA facilities if they met eligibility requirements tied to wait times, travel, and availability of services. VA-purchased care has grown significantly to more than $32 billion in 2024, representing 24% of VA's medical care budget. OBJECTIVES: To compare the annual utilization of skin pr…
Purchasing Versus Providing Care at the VHA
BACKGROUND: The Veterans Health Administration (VHA) greatly expanded the proportion of health care services it purchases from community providers over the last decade, which could impact the quality of care and create care fragmentation. Continuity of care between inpatient and outpatient care delivery systems is critical for high-quality mental health care. OBJECTIVE: To compare rates of outpatient follow-up visits between VHA-purchased and VHA…
Medicine (19 obras) · Health care (15 obras) · Family medicine (12 obras) · Healthcare Policy and Management (11 obras) · Environmental health (9 obras) · Veterans Affairs (8 obras) · Primary Care and Health Outcomes (7 obras) · Nursing (6 obras) · Psychology (6 obras) · Business (5 obras)