William & Mary

Fellows Present Research on Virginia Health Policy Issues

Student research fellows at the Schroeder Center for Health Policy presented results from their work to staff from the General Assembly’s Joint Commission on Health Care and the Williamsburg Health Foundation and faculty from William & Mary and Eastern Virginia Medical School (EVMS).  These presentations represented the capstone of a joint seven-week research experience completed in conjunction with EVMS.

Under the Schroeder Center – Brock Institute (SC-BI) Summer Health Policy Research Fellowship Program, students from William & Mary and medical students from EVMS were competitively selected to conduct independent research studies focused on health policy/health services issues in Virginia.  The three William & Mary fellows – Jimmy Cao and Molly Smith (both senior Economics majors) and John Snouffer (a first year M.P.P. student) – all utilized multiple years of patient-level databases and readmissions and transfers databases from Virginia Health Information.  These large datasets contain detailed patient-level clinical, financial, and demographic information on all inpatient hospitalizations in Virginia.

The William & Mary student fellows, who worked under the supervision of Dr. Jen Mellor, Professor of Economics and Director of the Schroeder Center, focused on these important health policy issues currently facing the Commonwealth: 

  • Jimmy Cao’s study, “Alcohol-related Hospitalizations in Virginia:  The Role of Race, Economic Conditions, and Alcohol Licenses,” found that the percentage of African Americans living in a county is associated with an increase in a county’s alcoholic liver disease (ALD) rate.  The association is even greater if the county also experiences a high poverty rate.  His work also suggests that of those individuals admitted to a hospital for ALD treatment, African Americans tend to have higher costs for their care and are more likely to be admitted as emergency hospitalizations.  Unexpectedly, Cao also found that the density of alcohol licenses in a county is not strongly associated with an increase in the county’s ALD rate. 
  • Molly Smith’s study, “Hospital Readmissions Among Virginia Medicare Beneficiaries After the Affordable Care Act,” examined the effectiveness of the Affordable Care Act’s recent implementation of the Hospital Readmissions Reduction Program (HRRP) on reducing readmissions for Medicare patients in Virginia hospitals.  Previous research suggested that readmissions would decrease as a result of the HRRP, particularly for integrated hospitals, hospitals in counties with high patient care availability, and non-safety net hospitals. Smith’s study produced different results, and found instead that the HRRP is largely ineffective in reducing readmissions of Medicare patients in Virginia at this time. 
  • John Snouffer’s study, “Access to Inpatient Care by Virginia’s Young Adults after the Affordable Care Act,” found that the Affordable Care Act’s dependent coverage mandate is responsible for increases in inpatient utilization in Virginia and a decrease in the number of uninsured, young adult patients diagnosed with mental illness and admitted to Virginia inpatient hospitals.  This is the case for all non-birth non-emergency admissions, all mental illness admissions, and all substance abuse admissions.

Prior to completing and presenting their research studies, the William & Mary and EVMS SC-BI Fellows received on-campus mentoring, advising, and training in research methods and data analytics.  In addition, the students benefitted from independent and small group interaction with various health policy experts during site visits to both William & Mary and EVMS.

Students met with faculty at both institutions.  William & Mary faculty included David Aday, Ph.D. (Department of Sociology), Jennifer Bickham-Mendez, Ph.D. (Department of Sociology), Daifeng He, Ph.D. (Department of Economics), Scott Ickes, Ph.D. (Department of Kinesiology and Health Sciences), and Jennifer Mellor, Ph.D. (Department of Economics; Schroeder Center for Health Policy). 

EVMS faculty included John Ball, Ph.D. (Department of Psychiatry), Paul Chidester, M.D. (Vice President Medical Affairs, Sentara Norfolk General Hospital), Stephen Deutsch, M.D. (Chair, Department of Psychiatry and Behavioral Sciences), Jessica Mees-Campbell, M.D. (Department of Psychiatry), Andrew Plunk, Ph.D. (Department of Pediatrics, Research Division), and Cynthia Romero, M.D., FAAFP (M. Foscue Brock Institute for Community and Global Health). 

Students also had the opportunity to hear from guest lecturers with expertise in various aspects of health policy.  Included among this group were Michele Chesser (Senior Health Policy Analyst on the General Assembly’s Joint Commission on Health Care) and Kathie Zimbro, Ph.D., R.N. (Director of Clinical & Business Intelligence & Quality Research Institute, Sentara Healthcare).

Professor Mellor, Schroeder Center Director, states, “we are pleased that the SC-BI Fellowships provide intensive student research experiences that support the Schroeder Center’s mission to increase health policy research at William & Mary.”