<mods:mods xmlns:mods="http://www.loc.gov/mods/v3" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-4.xsd"><mods:titleInfo><mods:title>Evaluation of Rhode Island's Health Home Initiative</mods:title></mods:titleInfo><mods:name type="personal"><mods:namePart>Flores, Michael W</mods:namePart><mods:role><mods:roleTerm type="text">creator</mods:roleTerm></mods:role></mods:name><mods:name type="personal"><mods:namePart>Galárraga, Omar</mods:namePart><mods:role><mods:roleTerm type="text">Advisor</mods:roleTerm></mods:role></mods:name><mods:name type="personal"><mods:namePart>Wilson, Ira</mods:namePart><mods:role><mods:roleTerm type="text">Reader</mods:roleTerm></mods:role></mods:name><mods:name type="personal"><mods:namePart>Trivedi, Amal</mods:namePart><mods:role><mods:roleTerm type="text">Reader</mods:roleTerm></mods:role></mods:name><mods:name type="personal"><mods:namePart>Cook, Benjamin</mods:namePart><mods:role><mods:roleTerm type="text">Reader</mods:roleTerm></mods:role></mods:name><mods:name type="corporate"><mods:namePart>Brown University. Department of Health Services, Policy and Practice</mods:namePart><mods:role><mods:roleTerm type="text">sponsor</mods:roleTerm></mods:role></mods:name><mods:originInfo><mods:copyrightDate>2018</mods:copyrightDate></mods:originInfo><mods:physicalDescription><mods:extent>13, 124 p.</mods:extent><mods:digitalOrigin>born digital</mods:digitalOrigin></mods:physicalDescription><mods:note type="thesis">Thesis (Ph. D.)--Brown University, 2018</mods:note><mods:genre authority="aat">theses</mods:genre><mods:abstract>Approximately 10 million US adults have a Serious Mental Illness (SMI). These&#13;
individuals have higher rates of morbidity and shorter life-expectancies than the general&#13;
population. Persons with SMI are at increased risk of visiting the emergency room and&#13;
being hospitalized due to multiple comorbidities; and, inconsistent or nonexistent use of&#13;
outpatient services. To address health disparities, section 2703 of the Affordable Care&#13;
Act allocated funds for Health Homes (HH), patient-centered care that afford the&#13;
chronically ill with comprehensive behavioral and primary care services. This dissertation&#13;
describes an evaluation of Rhode Island’s (RI) HH program, which provided coordinated&#13;
and integrated care to Medicaid beneficiaries with SMI who used community mental&#13;
health centers (CMHC) as their medical home. The aims of this dissertation were 1)&#13;
evaluate the extent to which HH impacted outpatient service use; 2) establish the degree&#13;
to which hospital and emergency department use were affected by HH; and 3) identify&#13;
the care setting that impacted health services use among HH participants. Using RI&#13;
Medicaid claims (2009-2012) and a quasi-experimental difference-in-differences&#13;
approach with propensity score weighting, health service use was evaluated before and&#13;
after the introduction of HH. In Chapter 1, findings suggest HH was associated with an&#13;
increase in outpatient service use, overall and for visits associated with obesity and&#13;
chronic obstructive pulmonary disease. Chapter 2 results showed HH was associated&#13;
with a decrease in the proportion having a hospitalization for acute ambulatory care&#13;
sensitive conditions and for non-mental illness conditions. Additionally, HH was&#13;
associated with a decrease in emergency department use for non-mental illness&#13;
conditions. Findings also indicated HH was associated with an increase in the proportion&#13;
having a hospitalization for a mental illness as well as an increase in the number of&#13;
emergency department visits for all-cause and non-mental illness conditions. In Chapter&#13;
3, results suggest HH participants within an integrated care setting experienced a&#13;
decrease in the proportion having a hospitalization for all-cause and non-mental illness&#13;
conditions. Investment in CMHC based integration can improve access to and use of&#13;
outpatient services as well as decrease hospital and emergency department use among&#13;
Medicaid beneficiaries with SMI.</mods:abstract><mods:subject authority="fast" authorityURI="http://id.worldcat.org/fast" valueURI="http://id.worldcat.org/fast/01013657"><mods:topic>Medicaid</mods:topic></mods:subject><mods:subject><mods:topic>Serious mental illness</mods:topic></mods:subject><mods:subject authority="fast" authorityURI="http://id.worldcat.org/fast" valueURI="http://id.worldcat.org/fast/00975636"><mods:topic>Integrated delivery of health care--Evaluation</mods:topic></mods:subject><mods:subject><mods:topic>Health Home</mods:topic></mods:subject><mods:subject><mods:topic>ACA</mods:topic></mods:subject><mods:language><mods:languageTerm authority="iso639-2b">English</mods:languageTerm></mods:language><mods:recordInfo><mods:recordContentSource authority="marcorg">RPB</mods:recordContentSource><mods:recordCreationDate encoding="iso8601">20180615</mods:recordCreationDate></mods:recordInfo><mods:identifier type="doi">10.26300/v2pg-xj56</mods:identifier><mods:accessCondition type="rights statement" xlink:href="http://rightsstatements.org/vocab/InC/1.0/">In Copyright</mods:accessCondition><mods:accessCondition type="restriction on access">Collection is open for research.</mods:accessCondition><mods:typeOfResource authority="primo">dissertations</mods:typeOfResource></mods:mods>