IU Indianapolis ScholarWorks :: Browsing by Author "Simon, Kosali I."

Browsing by Author "Simon, Kosali I."

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Alliances to disseminate addiction prevention and treatment (ADAPT): A statewide learning health system to reduce substance use among justice-involved youth in rural communities
(Elsevier, 2021) Aalsma, Matthew C.; Aarons, Gregory A.; Adams, Zachary W.; Alton, Madison D.; Boustani, Malaz; Dir, Allyson L.; Embi, Peter J.; Grannis, Shaun; Hulvershorn, Leslie A.; Huntsinger, Douglas; Lewis, Cara C.; Monahan, Patrick; Saldana, Lisa; Schwartz, Katherine; Simon, Kosali I.; Terry, Nicolas; Wiehe, Sarah E.; Zapolski, Tamika C. B.; Pediatrics, School of Medicine
Background: Youth in the justice system (YJS) are more likely than youth who have never been arrested to have mental health and substance use problems. However, a low percentage of YJS receive SUD services during their justice system involvement. The SUD care cascade can identify potential missed opportunities for treatment for YJS. Steps along the continuum of the cascade include identification of treatment need, referral to services, and treatment engagement. To address gaps in care for YJS, we will (1) implement a learning health system (LHS) to develop, or improve upon, alliances between juvenile justice (JJ) agencies and community mental health centers (CMHC) and (2) present local cascade data during continuous quality improvement cycles within the LHS alliances. Methods/design: ADAPT is a hybrid Type II effectiveness implementation trial. We will collaborate with JJ and CMHCs in eight Indiana counties. Application of the EPIS (exploration, preparation, implementation, and sustainment) framework will guide the implementation of the LHS alliances. The study team will review local cascade data quarterly with the alliances to identify gaps along the continuum. The study will collect self-report survey measures longitudinally at each site regarding readiness for change, implementation climate, organizational leadership, and program sustainability. The study will use the Stages of Implementation Completion (SIC) tool to assess the process of implementation across interventions. Additionally, the study team will conduct focus groups and qualitative interviews with JJ and CMHC personnel across the intervention period to assess for impact. Discussion: Findings have the potential to increase SUD need identification, referral to services, and treatment for YJS.
Assessment of Filled Buprenorphine Prescriptions for Opioid Use Disorder During the Coronavirus Disease 2019 Pandemic
(AMA, 2020-12) Nguyen, Thuy D.; Gupta, Sumedha; Ziedan, Engy; Simon, Kosali I.; Alexander, Caleb; Saloner, Brendan; Stein, Bradley D.; Economics, School of Liberal Arts
The coronavirus disease 2019 (COVID-19) pandemic has profoundly disrupted health care delivery in the US.1 The Centers for Disease Control and Prevention noted a 9.1% increase in reported 12-month counts of drug overdose deaths from March 2019 to March 2020, from 67 726 to 73 860.2 On March 13, 2020, a COVID-19 national emergency was declared. To diminish potential barriers to treatment access, 3 days later, federal guidelines on telemedicine use were released, providing authorized practitioners increased flexibility to prescribe buprenorphine to patients with opioid use disorder (OUD) during this public health emergency.3 Other local, state, and federal policy initiatives have also attempted to preserve access to medication treatment for OUD, yet the cumulative outcome of these undertakings is not clear.
Back to Business and (Re)employing Workers? Labor Market Activity During State COVID-19 Reopenings
(National Bureau of Economic Research, 2020-06) Cheng, Wei; Carlin, Patrick; Carroll, Joanna; Gupta, Sumedha; Rojas, Felipe Lozano; Montenovo, Laura; Nguyen, Thuy D.; Schmutte, Ian M.; Scrivner, Olga; Simon, Kosali I.; Wing, Coady; Weinberg, Bruce; Department of Economics, IU School of Liberal Arts
We study the effect of state reopening policies on a large set of labor market indicators through May 2020 to: (1) understand the recent increase in employment using longitudinal as well as cross-sectional data, (2) assess the likely trajectory of reemployment going forward, and (3) investigate the strength of job matches that were disrupted by COVID-19. Estimates from event studies and difference-in-difference regressions suggest that some of the recent increases in employment activity, as measured by cellphone data on work-related mobility, internet searches related to employment, and new and continuing unemployment insurance claims, were likely related to state reopenings, often predating actual reopening dates somewhat. We provide suggestive evidence that increases in employment stem from people returning to their prior jobs: reopenings are only weakly related to job postings, and longitudinal CPS data show that large shares of the unemployed-on-layoff and employed-but-absent in April who transitioned to employment in May remain in the same industry or occupation. Longitudinal CPS estimates further show declines in reemployment probabilities with time away from work. Taken together, these estimates suggest that employment relationships are durable in the short run, but raise concerns that employment gains requiring new employment matches may not be as rapid.
CMS Practice Assessment Tool Validity for Alternative Payment Models
(MJH Life Science, 2023-02) Boustani, Malaz A.; Perkins, Anthony J.; Davis-Ajami, Mary L.; Simon, Kosali I.; Chang, Chiang-Hua; Solid, Craig A.; Monahan, Patrick O.; Medicine, School of Medicine
Objectives: To study the predictive validity of the CMS Practice Assessment Tool (PAT) among 632 primary care practices. Study Design: Retrospective observational study. Methods: The study included primary care physician practices recruited by the Great Lakes Practice Transformation Network (GLPTN), 1 of 29 CMS-awarded networks, and used data from 2015 to 2019. At enrollment, trained quality improvement advisers scored each of the PAT’s 27 milestones by its degree of implementation based on interviews with staff, review of documents, direct observation of practice activity, and professional judgment. The GLPTN also tracked each practice’s status regarding alternative payment model (APM) enrollment. Exploratory factor analysis (EFA) was used to identify summary scores; mixed-effects logistic regression was used to assess the relationship between derived scores with APM participation. Results: EFA revealed that the PAT’s 27 milestones could be summed into 1 overall score and 5 secondary scores. By the end of the 4-year project, 38% of practices were enrolled in an APM. A baseline overall score and 3 secondary scores were associated with increased odds of joining an APM (overall score: odds ratio [OR], 1.06; 95% CI, 0.99-1.12; P = .061; data-driven care quality score: OR, 1.11; 95% CI, 1.00-1.22; P = .040; efficient care delivery score: OR, 1.08; 95% CI, 1.03-1.13; P = .003; collaborative engagement score: OR, 0.88; 95% CI, 0.80-0.96; P = .005). Conclusions: These results demonstrate that the PAT has adequate predictive validity for APM participation.
Examining the Impact of State-Mandated Insurance Benefits and Reimbursement Provisions on Access to Diabetes Self-Management Education and Training (DSME/T)
(2019-09) Brown-Podgorski, Brittany L.; Vest, Joshua R.; deGroot, Mary K.; Holmes, Ann M.; Shi, Yunfeng; Simon, Kosali I.
With an estimated 30.2 million diagnosed and undiagnosed cases among adults (and another 84 million at risk), diabetes mellitus is one of the most prevalent chronic conditions and a leading cause of mortality in the US. Diabetes self-management education and training (DSME/T) is a recognized standard of care and provides patients with the requisite knowledge and skills to properly manage the condition, improve long-term health outcomes, and reduce health care expenditures. Yet, DSME/T is greatly underutilized. Health insurance coverage that does not include benefits for DSME/T effectively imposes barriers to access for patients in need of the service. Many states have adopted laws and regulations requiring public and/or private insurers in their market to provide benefits for DSME/T; however, these requirements vary by state. It is unclear if these policies effectively improve access to DSME/T services. This dissertation seeks to rigorously assess the impact of state-mandated benefits and reimbursement provisions on access to DSME/T among adult patients with diabetes. The first analysis utilizes a unique combination of legal and programmatic data to quantify changes in the supply of DSME/T resources after the adoption of state-mandated benefits (potential access). The second analysis merges legal data with the Medical Expenditure Panel Survey (MEPS) from 2008 to 2016 to examine the impact of state mandates and reimbursement provisions on patient utilization of DSME/T (realized access). Lastly, the final analysis utilizes electronic health record data (2010-2016) from a safety net population to determine if patients’ evaluated need for DSME/T predicts the likelihood of receiving a DSME/T referral during a provider encounter (equitable access). Using novel data sources and a sophisticated policy analysis technique, this study provides a rigorous assessment of the impact of decades of state policies designed to improve access to care.
Impacts of state COVID-19 reopening policy on human mobility and mixing behavior
(Wiley, 2021) Nguyen, Thuy D.; Gupta, Sumedha; Andersen, Martin S.; Bento, Ana I.; Simon, Kosali I.; Wing, Coady; Economics, School of Liberal Arts
This study quantifies the effect of the 2020 state COVID economic activity reopening policies on daily mobility and mixing behavior, adding to the economic literature on individual responses to public health policy that addresses public contagion risks. We harness cellular device signal data and the timing of reopening plans to provide an assessment of the extent to which human mobility and physical proximity in the United States respond to the reversal of state closure policies. We observe substantial increases in mixing activities, 13.56% at 4 days and 48.65% at 4 weeks, following reopening events. Echoing a theme from the literature on the 2020 closures, mobility outside the home increased on average prior to these state actions. Furthermore, the largest increases in mobility occurred in states that were early adopters of closure measures and hard-hit by the pandemic, suggesting that psychological fatigue is an important barrier to implementation of closure policies extending for prolonged periods of time.
Impacts of State Reopening Policy on Human Mobility
(National Bureau of Economic Research, 2020-05) Nguyen, Thuy D.; Gupta, Sumedha; Andersen, Martin; Bento, Ana; Simon, Kosali I.; Wing, Coady; O’Neill School of Public and Environmental Affairs, IU & IUPUI
This study quantifies the effect of state reopening policies on daily mobility, travel, and mixing behavior during the COVID-19 pandemic. We harness cell device signal data to examine the effects of the timing and pace of reopening plans in different states. We quantify the increase in mobility patterns during the reopening phase by a broad range of cell-device-based metrics. Soon (four days) after reopening, we observe a 6% to 8% mobility increase. In addition, we find that temperature and precipitation are strongly associated with increased mobility across counties. The mobility measures that reflect visits to a greater variety of locations responds the most to reopening policies, while total time in vs. outside the house remains unchanged. The largest increases in mobility occur in states that were late adopters of closure measures, suggesting that closure policies may have represented more of a binding constraint in those states. Together, these four observations provide an assessment of the extent to which people in the U.S. are resuming movement and physical proximity as the COVID-19 pandemic continues.
Vaccinations Against COVID-19 May Have Averted up to 140,000 Deaths in the United States
(Project HOPE, 2021) Gupta, Sumedha; Cantor, Jonathan; Simon, Kosali I.; Bento, Ana I.; Wing, Coady; Whaley, Christopher M.; Economics, School of Liberal Arts
COVID-19 vaccination campaigns continue in the United States, with the expectation that vaccines will slow transmission of the virus, save lives, and enable a return to normal life in due course. However, the extent to which faster vaccine administration has affected COVID-19-related deaths is unknown. We assessed the association between US state-level vaccination rates and COVID-19 deaths during the first five months of vaccine availability. We estimated that by May 9, 2021, the US vaccination campaign was associated with a reduction of 139,393 COVID-19 deaths. The association varied in different states. In New York, for example, vaccinations led to an estimated 11.7 fewer COVID-19 deaths per 10,000, whereas Hawaii observed the smallest reduction, with an estimated 1.1 fewer deaths per 10,000. Overall, our analysis suggests that the early COVID-19 vaccination campaign was associated with reductions in COVID-19 deaths. As of May 9, 2021, reductions in COVID-19 deaths associated with vaccines had translated to value of statistical life benefit ranging between $625 billion and $1.4 trillion.

Browsing by Author "Simon, Kosali I."

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