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Baylor, Army Collaborate to Create Better Healthcare

April 18, 2017

There is no denying the importance of healthcare and healthcare professionals. Baylor University recognizes the need for a high-quality healthcare administration education.

Baylor's Hankamer School of Business and its Robbins Institute for Health Policy and Leadership offer an MBA in Healthcare Administration, two Executive Healthcare MBA programs (in Austin and Dallas), and the new PhD in Health Services Research program in Economics launches this fall. In addition, the U.S. Army and Baylor University have a Graduate Program in Health and Business Administration at Joint Base San Antonio Fort Sam Houston in San Antonio, Texas. Through these programs, Baylor is able to conduct research as well as educate students to enter the field.

In fact, United States Army Lieutenant Colonel Forest Kim, who is also program director and assistant professor in the Army-Baylor Health and Business Administration program, has been researching the benefits of a new modality of healthcare delivery, the patient-centered medical home (PCMH).

"[PCMH is] a fairly recent modality," Kim said. "There are multiple components to PCMH like team-based care and population health management. Overall, it's a more holistic approach to care of the patient. Treatment is less episodic or acute. If the PCMH is functioning properly, it should result in better patient outcomes to include keeping non-urgent patients out of the [emergency room]."

The Military Health System (MHS) launched PCMH in 2009.

"The neat thing about [the military] is when you have someone at senior levels saying implement something, it gets implemented," Kim said. "It's a great advantage because the military can be looked at as a learning laboratory for the nation. It's a great opportunity to look at different types of care modalities. Everyone has insurance—there's some variation in access, but all our patients are covered, so [studies on the military population] don't have to control for health insurance."

In the evaluative case study, Kim looked at one site, Fort Campbell in Kentucky. At that time, they were rolling out PCMH. Some clinics implemented it and others didn't, so it set up an opportunity to do a natural experiment. He did a comparison between those two groups, looking at a nine-month period of time. Kim controlled for various variables known to affect emergency room (ER) visits, like gender, age, ethnicity and marital status.

The article, "Patient-Centered Medical Home Implementation Effects on Emergency Room Utilization: A Case Study," which was published in Hospital Topics, compared patients' ER visits at the PCMH clinic and the primary care clinic. Kim and his fellow researchers found those enrolled in the PCMH were 67 percent less likely to have used the ER compared to the other ones in the primary care clinic.

But that was just one clinic. Now that the number of PCMH clinics in the federal system has increased, Kim's current research methods class is looking at the 68 PCMHs in the Army that have been recognized by the National Committee for Quality Assurance (NCQA) in an effort to better evaluate the overall impact of PCMH. Although the class hasn't presented its analysis yet, the preliminary results aren't as dramatic, although there is still a reduction in ER visits across the board.

Moving forward, Kim, faculty members at Fort Sam Houston and Baylor's faculty members hope to extend their research collaboration efforts.

"We're a sister program with a 65-year relationship," Kim said. "I think we're just beginning to scratch the surface on opportunities to collaborate. Recently, we've seen the tremendous potential if we increased that partnership. As we're speaking right now, there are plans of faculty development opportunities and research collaborations. The years of experience of main campus faculty is tremendous, and the MHS has mounds and mounds of data that has essentially been untapped. Everyone is really excited about the collaboration. We're hoping it'll springboard to other projects we'll work on together."

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