Kyle L. Grazier

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The Affordable Care Act is aimed at extending health insurance to more than thirty million Americans, including many with untreated substance use disorders. Will those who need addiction treatment receive it once they have insurance? To answer that question, we examined the experience of Massachusetts, which implemented its own universal insurance law in(More)
OBJECTIVE Hospitalization is a critical component of treatment for individuals with serious and persistent mental illness. Despite its resource intensity, the costs of inpatient psychiatric hospitalizations in the United States are not well understood. The objective of this research was to provide cost estimates for inpatient psychiatric care. METHODS(More)
The research reported here examined the factors which affected the decision to remain with either Blue Cross of Washington and Alaska or Group Health Cooperative of Puget Sound, or to change to an independent practice association (IPA) in which the primary care physicians control all care. The natural setting allowed examination of the characteristics of(More)
OBJECTIVE To investigate whether different risk-adjustment methodologies and economic profiling or "practice efficiency" metrics produce differences in practice efficiency rankings for a set of primary care physicians (PCPs). DATA SOURCE Twelve months of claims records (inpatient, outpatient, professional, and pharmacy) for an independent practice(More)
OBJECTIVE Despite the prevailing consensus as to its value, the adoption of integrated care models is not widespread. Thus, the objective of this article it to examine the barriers to the adoption of depression and primary care models in the United States. METHODS A literature search focused on peer-reviewed journal literature in Medline and PsycInfo. The(More)
OBJECTIVE To assess the effect of the 2002 Veterans Millennium Health Care Act, which raised pharmacy copayments from $2 to $7 for lower-priority patients, on medication refill decisions and health services utilization among vulnerable veterans with schizophrenia. STUDY DESIGN Quasi-experimental. METHODS This study used secondary data contained in the(More)
The purpose of this study is to determine the extent to which health maintenance organization (HMO) penetration within the public hospitals' market area affects the financial performance and viability of these institutions, relative to private hospitals. Hospital- and market-specific measures are examined in a fully interacted model of over 2,300 hospitals(More)
Our objective was to determine the influence of health consciousness in the utilization of mammography in asymptomatic African American women. The sample consisted of 670 women who participated in a household interview in two cities. Logistic regression was used to determine the independent effects of health consciousness, holding constant other factors(More)
This paper examines the relative accuracy of risk-adjustment methodologies used to profile primary care physician practice efficiency. Claims and membership data from an independent practice association health maintenance organization (HMO) were processed through risk-adjustment software of six different profiling methodologies. The Group R2 statistic was(More)
To control the rise in expenditures and to increase access to mental health and substance abuse (MH/SA) services, a growing number of employers and states are implementing a "carve-out." Under this arrangement, the sponsor separates insurance benefits by disease or condition, service category, or population and contracts separately for the management of(More)