Maureen T. Stewart

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BACKGROUND It is uncertain whether lower levels of staffing by nurses at hospitals are associated with an increased risk that patients will have complications or die. METHODS We used administrative data from 1997 for 799 hospitals in 11 states (covering 5,075,969 discharges of medical patients and 1,104,659 discharges of surgical patients) to examine the(More)
OBJECTIVE Improving depression treatment is critical given low rates of appropriate care. Health plan performance measures that address quality of antidepressant medication management, specifically, have been stagnating at relatively low levels. Identifying health plan characteristics associated with better performance could contribute to quality(More)
OBJECTIVE In 2008, the federal Mental Health Parity and Addiction Equity Act (MHPAEA) passed, prohibiting U.S. health plans from subjecting mental health and substance use disorder (behavioral health) coverage to more restrictive limitations than those applied to general medical care. This require d some health plans to make changes in coverage and(More)
OBJECTIVE Health plans play a key role in facilitating improvements in population health and may engage in activities that have an impact on access, cost, and quality of behavioral health care. Although behavioral health care is becoming more integrated with general medical care, its delivery system has unique aspects. The study examined how health plans(More)
Risky, non-dependent alcohol use is prevalent in the United States, affecting 25% of adults (Centers for Disease Control and Prevention, 2014b). Massachusetts has higher rates of alcohol use and binge drinking than most states (Substance Abuse and Mental Health Services Administration, 2015). Serious physical, social, and economic consequences result.(More)
Background The Affordable Care Act and many states' health-care reforms present opportunities and challenges for the substance use disorder (SUD) treatment system. These reforms foster the implementation of new payment and delivery system models that emphasize care coordination and make providers more responsible for patients' clinical management and costs.(More)
, and is increasingly targeted for improvement. As health care payers try to influence the implementation and delivery of alcohol screening and brief intervention (SBI), some are using provider payment approaches. These include specific reimbursement for conducting screening, other financial incentives and linking payment with performance measures. We(More)
Financing, payment, and organization and management of alcohol and other drug (AOD) treatment services are closely intertwined and together determine whether people have access to treatment, how the treatment system is designed, and the quality and cost of treatment services. Since the 1960s, changes in these arrangements have driven changes in the delivery(More)
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