Example of ongoing research

Medicare Advantage (MA) Research

Over one-half of the elderly in the United States are enrolled in a Medicare Advantage (MA) health plan offered by a private health insurer that is paid for primarily by the federal government. Given the scale of the program ($462 billion of spending in 2024), MA has a profound effect on the elderly as well as the health professionals and organizations that treat them.

About a dozen Cornell Health Policy Center faculty are currently conducting research examining the impact of various aspects of the MA program, and policies that might improve its effectiveness and efficiency. Examples include projects exploring:

• How to provide incentives to MA plans to deliver high-quality and cost-effective medical care (Drs. Colleen Carey, Amelia Bond, Dhruv Khullar)
• The impact of health insurer acquisitions of physician practices on patient risk scores, which affect how much funding MA health plans receive from the government. (Drs. Tyler Braun, Sean Nicholson, Michael Richards, Dhruv Khullar, Larry Casalino)
• Prescription drug access, pricing, and utilization in MA plans (Drs. Pragya Kakani, Amelia Bond, Colleen Carey)
• The impact of telehealth on patient outcomes in MA plans (Dr. Jiani Yu)
• The impact of specialized MA health plans that focus on dual-eligible Medicare and Medicaid enrollees (Drs. Yongkang Zhang and Beth McGinty)
• The effect of health insurer advertising on MA enrollment (Dr. Michael Richards)

Recently published work

Accountable Care Organization (ACO) Impact on Healthcare Spending

A study from Weill Cornell Medicine and CHPC faculty members Amy Bond, Yasin Civalek, William Schpero, Larry Casalino, and Dhruv Khullar, published in JAMA, found that Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved Medicare between $4.1 billion and $8.1 billion from 2012 to 2019. Created by the Affordable Care Act, the MSSP rewards clinicians and health care organizations for meeting quality targets and managing patient care more efficiently, allowing them to share in the savings they generate. Analyzing medical spending data from more than 8 million Medicare patients, researchers found that ACOs achieved substantial cost savings over the program’s first decade, with savings increasing the longer organizations participated, particularly among physician-led and smaller ACOs.

Example of ongoing research

Public Attitudes Toward Opioid Policies

Understanding U.S. public attitudes toward opioid policies is critical for shaping effective, evidence-based responses to the opioid crisis and the stigma associated with drug use. Research in this area examines how communication strategies impact public support for state and federal policies and the extent of public stigma toward opioid addiction, perceptions of responsibility for addressing addiction, and more—all factors that influence policy adoption and implementation.

A team of faculty and post-doctoral fellows from CHPC that span both Weill Cornell Medical College and the Cornell Ithaca campus, including Beth McGinty, Colleen Barry, Jeff Niederdeppe, and Sarah Gutkind, are analyzing U.S. public attitudes toward opioid addiction and treatment policies. The team is currently working on the following:

• Examining support for state policies requiring addiction treatment programs to offer FDA-approved medications for treating opioid addiction
• Exploring levels of public stigma toward opioid addiction, perceptions of who is responsible for addressing the problem, and beliefs about the seriousness of the problem
• Testing whether messages that describe the impact of evidence-based opioid treatment policies, both overall and in addressing racial disparities in overdose rates, can increase public support for these evidence-based policies

Recently published work

Health Policy Communication in the Media

Dhruv Khullar, associate professor at Weill Cornell Medicine and associate director at CHPC, is a contributing writer at The New Yorker covering medicine, health care, and politics. His recent articles have covered diverse topics such as A.I. in healthcare and vaccine policy. A practicing physician, Dr. Khullar uses journalism to combine scientific knowledge with narrative reporting for the public. Read Dr. Khullar’s work here

Example of ongoing research

Disparities in Access to the Medicaid Transportation Benefit

Medicaid, unlike other insurers, is federally mandated to provide transportation services through its non-emergency medical transportation (NEMT) benefit. Recent data indicate gaps in transportation access among Medicaid enrollees, specifically for Black patients. Additionally, several states have argued that the benefit is unnecessary and sought federal approval to limit its eligibility.

A team of researchers from Weill Cornell Medicine and the Cornell Jeb E. Brooks School of Public Policy led by CHPC faculty members William Schpero and Jamila Michener are conducting a study titled “Racial and Ethnic Disparities in Access to the Medicaid Transportation Benefit and Implications for Patient Outcomes.” The study is evaluating racial and ethnic disparities in use of NEMT across states and how transportation barriers affect access to care and health outcomes. A key objective of the work is to estimate the effect of the benefit on disparities in patient outcomes, leveraging state-level variation in availability of NEMT as a natural experiment.

Recently published work

 Initiative on Home Care Work

Drs. Avgar (Cornell University), Sterling (Weill Cornell Medicine), and Dell (Cornell Tech) have been collaborating for the last 8 years. They now lead a new Initiative, “The Initiative on Home Care Work,” which aims to bring scientists, scholars, and clinicians together to improve care that happens in peoples’ home; this includes improving job quality and working conditions for the home care workforce, while also improving care and outcomes for patients. The Initiative is comprised of experts in labor relations and employment, medicine and healthcare, computer science and human centered design, and policy. Community partnership – locally, regionally, and nationally, is at the core of the Initiative’s activities. Additionally, trainees ranging from undergraduate to post-doctoral level are encouraged to join and lead studies. The team conducts both observational and intervention-based studies. Some recent studies include: 

• Investigating the impact of unionization on home care workers’ wages, benefits and health using the Current Population Survey dataset, which found that unionization is an effective means of improving the financial well-being of direct care workers, a workforce that is currently facing challenging working conditions and high levels of turnover.
• Assessing the feasibility of wearable devices among home care workers (HCWs) caring for adults with chronic conditions, which examined HCWs health and wellbeing via activity tracking
• Evaluating the role of novel organizational models in home care, such as co-operative agencies (in which workers own part of the business), which found that care cooperatives may be effective in attracting and retaining home care workers.