Michael Anne Kyle, Lumumba Seegars, John M. Benson, Robert J. Blendon, Robert S. Huckman, and Sara J. Singer. 12/2019. “
Toward a Corporate Culture of Health: Results of a National Survey.” Milbank Quarterly, 97, 4, Pp. 954-977.
Publisher's VersionAbstractContext: The private sector has a large potential role in advancing health and well-being, but attention to corporate practices around health tends to focus on a narrow range of issues and on large businesses. Systematically describing private sector engagement in health and well-being is a necessary step toward understanding the current state of the field and developing an agenda for businesses going forward.
Methods: We conducted a national survey of 1,017 private sector organizations to assess current levels of engagement in what we term a culture of health (CoH). We measured corporate CoH along four dimensions, which assess the extent to which businesses promote employee, environmental, consumer, and community health and well-being. We also explored potential explanations for the number of health-related actions taken in each dimension.
Findings: On average, businesses took 38% of health-related actions included in our survey. For each dimension, we found variation among businesses in the number of actions taken (on average, there were almost fourfold differences between the bottom and top quartiles of businesses in terms of actions taken). Mentioning health and well-being in the corporate mission, having a strategic plan for CoH, and perceiving a positive return on CoH investments were all associated with businesses’ actions taken. Fewer than half of businesses, however, perceived a positive return on their CoH investments.
Conclusions: Overall, the private sector is taking steps to foster health and well-being. However, there remains substantial variation among businesses and opportunity for growth, even among those currently taking the most action. Strengthening the business case for a corporate CoH may increase private sector investments in health and well-being. Actions taken by individual businesses, business groups, industries, and regulators have the potential to improve corporate engagement and impact.
Michael Anne Kyle, Robert J. Blendon, John M. Benson, Melinda K Abrams, and Eric C. Schneider. 11/2019. “
Many Medicare Beneficiaries with Serious Illness Report Financial Hardships Despite Coverage.” Health Affairs, 38, 11, Pp. 1801-1806.
Publisher's VersionAbstractIn a national survey, seriously ill Medicare beneficiaries described financial hardships resulting from their illness—despite high beneficiary satisfaction with Medicare overall and the fact that many have supplemental insurance. About half reported a serious problem paying medical bills, with prescription drugs proving most onerous.
Michael Anne Kyle, Emma-Louise Aveling, and Sara J. Singer. 10/2019. “
A Mixed Methods Study of Change Processes Enabling Effective Transition to Team-based Care.” Medical Care Research and Review.
Publisher's VersionAbstractTeam-based care is considered central to achieving value in primary care, yet results of large-scale primary care transformation initiatives have been mixed. We explore how underlying change processes influence the effectiveness of transition to team-based care. We studied 12 academically affiliated primary care practices participating in a learning collaborative, using longitudinal staff survey data to measure progress toward team-based care and qualitative interviews with practice staff to understand practice transformation. Transformation efforts focused on team formation and capacity building for quality improvement. Using thematic analysis, we explored types of change processes undertaken and the relationship between change processes and effective team-based care. We identified three prototypical approaches to change: pursuing functional and cultural change processes, functional only, and cultural only. Practice sites prioritizing both change processes formed the most effective teams: simultaneous functional and cultural change spurred a mutually reinforcing virtuous cycle. We describe implications for research, practice, and policy.