ers to compare the impact of interventions that change some or all inputs.

The tool supports decision-makers in delivering a fast and effective response to the pandemic. Hydroxyfasudil The unique contribution of the planner is that it allows users to compare the impact of interventions that change some or all inputs.

Since coronavirus disease 2019 (COVID-19) has caused dramatic changes in everyday life, a major concern is whether patients have adequate access to mental health care despite shelter-in-place ordinances, school closures, and social distancing practices.

The aim was to examine the availability of telehealth services at outpatient mental health treatment facilities in the United States at the outset of the COVID-19 pandemic, and to identify facility-level characteristics and state-level policies associated with the availability.

Observational cross-sectional study.

All outpatient mental health treatment facilities (N=8860) listed in the Behavioral Health Treatment Services Locator of the Substance Abuse and Mental Health Services Administration on April 16, 2020.

Primary outcome is whether an outpatient mental health treatment facility reported offering telehealth services.

Approximately 43% of outpatient mental health facilities in the United States reported telehealth availability at the outset ofase availability over the course of the COVID-19 pandemic.

Evidence-based health promotion programs can help older adults manage chronic conditions and address behavioral risk factors, and translating these interventions to population-scale impact depends on reaching people outside of clinical settings. Area Agencies on Aging (AAAs) have emerged as important delivery sites for health promotion programs, but the impacts of their expanded role in delivering these interventions remain unknown.

The objective of this study was to test whether evidence-based health promotion programs implemented by AAAs from 2008 to 2016 influenced health care use and spending by older adults and to examine how agencies’ organizational capacity for implementation influenced these population-level impacts.

We used panel regression models to examine how the expansion of health promotion programs offered by AAAs over the course of 2008-2016 was associated with a change in health care use and spending by older adults in counties served by the AAAs. We examined impact separately for high d to extend their ability to effect change in more regions of the country.

AAAs are an example of community-based organizations that can contribute to health care policy goals such as cost containment. Organizational development support may be needed to extend their ability to effect change in more regions of the country.

Medicare home health providers are now required to deliver family caregiver training, but potential consequences for service intensity are unknown.

The objective of this study was to assess how family caregiver training needs affect the number and type of home health visits received.

Observational study using linked National Health and Aging Trends Study (NHATS), Outcomes and Assessment Information Set (OASIS), and Medicare claims data. Propensity score adjusted, multivariable logistic, and negative binomial regressions model the relationship between caregivers’ training needs and number/type of home health visits.

A total of 1217 (weighted n=5,870,905) National Health and Aging Trends Study participants receiving Medicare-funded home health between 2011 and 2016.

Number and type of home health visits, from Medicare claims. Family caregivers’ training needs, from home health clinician reports.

Receipt of nursing visits was more likely when family caregivers had medication management [adjusted odds ratio (aOR) 3.03; 95% confidence interval (CI) 1.06, 8.68] or household chore training needs (aOR 3.38; 95% CI 1.33, 8.59). Receipt of therapy visits was more likely when caregivers had self-care training needs (aOR 1.70; 95% CI 1.01, 2.86). Receipt of aide visits was more likely when caregivers had household chore (aOR 3.54; 95% CI 1.82, 6.92) or self-care training needs (aOR 2.12; 95% CI 1.11, 4.05). Medication management training needs were associated with receiving an additional 1.06 (95% CI 0.11, 2.01) nursing visits, and household chores training needs were associated with an additional 3.24 total (95% CI 0.21, 6.28) and 1.32 aide visits (95% CI 0.36, 2.27).

Family caregivers’ activity-specific training needs may affect home health visit utilization.

Family caregivers’ activity-specific training needs may affect home health visit utilization.

The patient-centered medical home (PCMH) model has been widely adopted, but the evidence on its effectiveness remains mixed. One potential explanation for these mixed findings is variation in how the model is implemented by practices.

To identify the impact of different approaches to PCMH adoption on health care utilization in a long-term, geographically diverse sample of patients.

Difference-in-differences evaluation of PCMH impact on cost and utilization.

A total of 5,314,284 patient-year observations from the HealthCore Integrated Research Database, and 5943 practices which adopted the PCMH model in 14 states between 2011 and 2015.

PCMH adoption, as defined by the National Committee for Quality Assurance.

Six claims-based utilization measures, plus total health care expenditures. We employ hierarchical clustering to organize practices into groups based on their PCMH capabilities, then use generalized difference-in-differences models with practice or patient fixed effects to estimate the effect of PCMH recognition (overall and separately by the groups identified by the clustering algorithm) on utilization.

PCMH adoption was associated with a >8% reduction in total expenditures. We find significant reductions in emergency department utilization and outpatient care, and both lab and imaging services. In our by-group results we find that while the reduction in outpatient care is significant across all 3 groups, the reduction in emergency department utilization is driven entirely by 1 group with enhanced electronic communications.

The PCMH model has significant impact on patterns of health care utilization, especially when heterogeneity in implementation is accounted for in program evaluation.

The PCMH model has significant impact on patterns of health care utilization, especially when heterogeneity in implementation is accounted for in program evaluation.