# Association of Health Care Delivery and Payment Innovations with Avoidable Cardiovascular Hospitalizations

> **NIH NIH F30** · CASE WESTERN RESERVE UNIVERSITY · 2020 · $8,993

## Abstract

The annual cost of cardiovascular disease (CVD) in the United States is estimated to exceed $1.2 trillion by
2035, with the costs of CVD hospitalizations driving that estimate.[1] Despite this projected growth, many
hospitalizations for CVD are potentially preventable if patients receive appropriate and timely ambulatory care.
The role that healthcare delivery and payment reform may play in attenuating the expected rise in both the rate
of CVD hospitalizations and associated costs is currently unknown. Examples of innovative models of
healthcare delivery and payment include the patient centered medical home (PCMH), shared savings
accountable care organizations (ACO), meaningful use of electronic medical records (EMR), and the presence
of regional health improvement collaboratives (RHIC). These four approaches saw widespread adoption during
the last decade. For example, between 2008 and 2014 the number of medical home sites rose nationally from
214 to 6,800. In Ohio, the number of medical home sites rose from zero in 2008 to 520 in 2014.[2] Despite this
rapid growth, uncertainty exists about the effect of these four approaches on patient outcomes and cost of care
for cardiovascular conditions. For chronic illnesses such as CVD, these approaches demonstrated early
successes across a range of disease management indicators such as provider experience,[3] patient
experience,[3-5] processes of care,[5, 6] preventive care utilization,[7] and high cost care utilization.[3] Importantly,
prior studies of the effects of these paradigms on potentially preventable CVD hospitalization have focused on
each approach individually and have not addressed associated costs. Moreover, no prior study has mapped
the evolution of the healthcare market penetration of these four approaches. Thus the question of whether and
how the growing healthcare market penetration of these four approaches affects the hospitalization rate and
costs for CVD remains unanswered.
The overall objective of this proposal is to address this question with two specific aims: first, to quantify the
healthcare market penetration of patient centered medical homes, shared savings accountable care
organizations, regional health improvement collaboratives, and electronic medical records throughout the state
of Ohio; second, to model the relationship between changes in the rate of CVD hospitalization and changing
healthcare market penetration of each of the four approaches. Successful model development will empower
policy makers to make data-driven decisions regarding further implementation and support of integrated
models of healthcare delivery and payment transformation that will help improve care quality and reduce costs.

## Key facts

- **NIH application ID:** 9873062
- **Project number:** 5F30HL132433-04
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Joseph Elias Tanenbaum
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $8,993
- **Award type:** 5
- **Project period:** 2017-02-10 → 2020-05-17

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9873062

## Citation

> US National Institutes of Health, RePORTER application 9873062, Association of Health Care Delivery and Payment Innovations with Avoidable Cardiovascular Hospitalizations (5F30HL132433-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9873062. Licensed CC0.

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