Practically Speaking
December 2023

The Foundation is excited to officially announce the latest recipients of the Greater Value Portfolio grant program. This initiative supports two-year research projects with a maximum award of $440,000 each, aiming to advance promising approaches for a more valuable healthcare system. The program’s objective is to assess tools and strategies that organizations can readily employ to enhance the value of healthcare services for patients and communities. Additionally, applicants are required to collaborate with a healthcare service delivery organization or be affiliated with a research unit integrated into a healthcare organization.

Christopher Gillette, PhD
Wake Forest University

Partnering Organizations: Wake Forest University School of Medicine, the University of North Carolina at Chapel Hill, University of South Carolina

“AIMEPCCo: American Indian Men’s Experiences with Prostate Cancer Communication“

Prostate cancer (PC) poses a significant threat to American Indian/Alaska Native (AIAN) men, contributing to high mortality rates. Low screening rates and delayed diagnoses are key factors in these adverse outcomes, and disparities in screening access further exacerbate the problem. Culturally tailored communication and shared decision-making (SDM) strategies are urgently required to address screening rate and outcome disparities in this historically marginalized population. This mixed-methods study pursues three specific aims:

• Aim 1: Explore facilitators and barriers to PC-related communication, delve into role preferences in SDM, and identify preference-relevant factors that impact PC screening decisions among Lumbee men.
• Aim 2: Elicit PC-related communication SDM roles, screening preferences, and the factors influencing PC screening uptake among Lumbee men through a Discrete Choice Experiment (DCE) survey.
• Aim 3: Quantify SDM roles and screening preferences among Lumbee men, outline trade-offs, and identify practical, acceptable, preference-aligned strategies for PC communication and screening tailored specifically to the Lumbee community.

Sarah Roth, PhD
Center for Outcomes Research and Education (CORE)

Partnering Organization: The Providence Health System

“Engaging Hospital Systems to Increase Colorectal Cancer Screening Persistency & Follow-Up“

This study evaluates the impact of a large-scale colorectal cancer (CRC) screening program utilizing mailed fecal immunochemical tests (FIT) to lower barriers to screening. Three central research questions (RQs) guide the investigation:

• RQ1: Examining patient compliance with FIT program guidelines for engagement, persistency, and follow-up.
• RQ2: Assessing the extent to which the FIT program enhances access to appropriate CRC screening.
• RQ3: Investigating the patient experience within the FIT program, including participation and follow-up care challenges.

The study spans diverse sociodemographic groups to determine if the FIT program mitigates disparities in CRC screening quality and outcomes. This research is conducted in collaboration with Providence, a seven-state health system committed to serving underserved populations. Providence Network Clinical Outreach Service, a specialized team focusing on patient engagement and addressing lapsed care, plays a vital role in this partnership. The research will inform Providence Network Clinical Outreach Service’s plan for improving, scaling, and expanding the FIT program, with a focus on addressing potential disparities in the program’s reach. The insights may lead to tailored outreach strategies, provision of care coordination, and the refinement of educational materials for specific populations.

Elizabeth Sutton, PhD
Woman’s Hospital

Partnering Organization: Woman’s Hospital

“Testing effectiveness of Her Health Program to add healthcare value in fourth trimester“

Healthcare disparities in postpartum support affect birthing persons from racial and ethnic minorities and low-income backgrounds. This research aims to assess the effectiveness of the Her Health program in reducing disparities, alleviating financial burdens, and improving care consistency during the first postpartum year. The program incorporates patient navigation and medical trust-building education. The primary outcome is the receipt of postpartum care. Successful outcomes may pave the way for patient navigation programs to enhance the value of maternal healthcare and narrow health disparity gaps in the postpartum period.

The study is divided into three main aims:

• Aim 1: Evaluate the effectiveness of Her Health in increasing postpartum healthcare access.
• Aim 2: Examine the impact of Her Health on medical trust, self-efficacy, and health literacy.
• Aim 3: Compare total healthcare spending during the first postpartum year between Her Health and Standard Care participants

Rishi Wadhera, MD, MPP, MPhil
Beth Israel Deaconess Medical Center, Inc.

Partnering Organization: MassHealth

“Accountable Care Organizations in Medicaid: Reducing Low-Value Care for Working-Age Adults“

This study addresses the enduring issue of low-value healthcare in the United States, focusing on low-income working-age adults enrolled in Medicaid. It seeks to investigate the influence of Accountable Care Organizations (ACOs), which are responsible for both cost and quality of care for a designated patient population, in enhancing the value of healthcare. However, the impact of ACOs on low-value healthcare for working-age Medicaid beneficiaries remains relatively unexplored. The study aims to provide vital insights into Medicaid ACOs in Massachusetts, guiding model design and restructuring, particularly under the MassHealth Section 1115 innovation waiver. The research aims are to:

• Aim 1: Characterize the use of low-value care across 13 measures for working-age adults (aged 21-64 years) enrolled in Medicaid.
• Aim 2: Determine whether low-value care changed among working-age adults enrolled in Medicaid after the implementation of Medicaid ACOs in Massachusetts
• Aim 3: Determine if there were changes in low-value care across key subgroups, including women, racial and ethnic minority adults, and adults with multiple chronic conditions, after the implementation of Medicaid ACOs in Massachusetts versus control states.