Health Services & Economics

"The greatest challenge in health care is to deliver better quality care without raising its cost. That’s where we’re focusing our research.”

David Arterburn, MD, MPH
Kaiser Permanente Washington Health Research Institute Senior Investigator
Washington Permanente Medical Group, Internal Medicine

Research overview

Kaiser Permanente Washington research covers many fields, but much of what we do is health services research. That means we’re studying what really works—and what doesn't—in health care, with a focus on achieving the Triple Aim: better population health, improved patient experience, and lower health care costs.

“Reducing the growth in health care spending requires improving the quality and timeliness of care and decreasing low-value care, which doesn’t improve health and may actually be harmful,” says Robert Penfold, PhD, an associate investigator at Kaiser Permanente Washington Health Research Institute (KPWHRI).

It all starts with Kaiser Permanente Washington’s learning health system, where research and practice work side by side to inform and improve each other. Researchers benefit from Kaiser Permanente Washington’s comprehensive capture of rich information about patients’ health, use of health care, and costs. Clinical leaders benefit from rigorous evaluations of novel innovations in care delivery and provider reimbursement.

“Together, we are learning what it takes to quickly translate what works into our health system—and track the long-term effects on outcomes that matter to patients, clinicians, and policymakers,” says David Arterburn, MD, MPH, a senior investigator. Here are just a few examples:

  • Our research on shared decision making helps people understand all of their treatment options and make the decisions that are right for them. So they get the care they want and no more; the care they need and no less.
  • Curbing overdiagnosis and overtreatment is important, because getting too much of some types of health care can be as harmful as not getting enough. Kaiser Permanente Washington is on the leading edge of initiatives to avoid harmful overuse of care. And we’re carefully evaluating these innovations, such as Choosing Wisely and value-based insurance design.
  • We’re studying other care models, including accountable care organizations, a payment and delivery model designed to encourage groups of providers to form coalitions.
  • The rapidly rising cost of pharmacotherapy is one of the most challenging problems in all of medicine. We’re researching how best to price medications in ways that encourage patient adherence to treatment, improve long-term health outcomes, and lower total costs of care.

The impact of our health services research reaches far beyond the Kaiser Permanente Washington system and helps to shape care and policy throughout our region and beyond. For added diversity and statistical power, KPWHRI joins with partners in the Health Care Systems Research Network and other national and international collaborations.

KPWHRI’s MacColl Center for Health Care Innovation has helped to spread the Chronic Care Model around the world, guiding quality improvement efforts for diabetes, asthma, heart disease, and other chronic conditions. The MacColl Center is also addressing health care workforce issues, stopping low-value care, and helping to transform the U.S. health care system.

Recent publications on Health Services & Economics

Mafi JN, Parchman M. Low-value care: an intractable global problem with no quick fix. BMJ Qual Saf. 2018 Jan 13. pii: bmjqs-2017-007477. doi: 10.1136/bmjqs-2017-007477. [Epub ahead of print]. PubMed

Babington JR, Edwards A, Wright A, Dykstra T, Friedman AS, Sethi RK. Patient-reported outcome measures: utility for predicting spinal surgery in an integrated spine practice. PM R. 2017 Dec 26. pii: S1934-1482(16)31066-8. doi: 10.1016/j.pmrj.2017.12.004. [Epub ahead of print]. PubMed

Toh S, Rasmussen-Torvik LJ, Harmata EE, Pardee R, Saizan R, Malanga E, Sturtevant JL, Horgan CE, Anau J, Janning CD, Wellman RD, Coley RY, Cook AJ, Courcoulas AP, Coleman KJ, Williams NA, McTigue KM, Arterburn D, McClay J for the PCORnet Bariatric Study Collaborative. The national Patient-Centered Clinical Research Network (PCORnet) bariatric study cohort: rationale, methods, and baseline characteristics. JMIR Res Protoc. 2017 Dec 5;6(12):e222. doi: 10.2196/resprot.8323. PubMed

Lapham GT, Lee AK, Caldeiro RM, McCarty D, Browne KC, Walker DD, Kivlahan DR, Bradley KA. Frequency of cannabis use among primary care patients in Washington state. J Am Board Fam Med. 2017 Nov-Dec;30(6):795-805. doi: 10.3122/jabfm.2017.06.170062. PubMed

Darnell D, Dorsey CN, Melvin A, Chi J, Lyon AR, Lewis CC. A content analysis of dissemination and implementation science resource initiatives: what types of resources do they offer to advance the field? Implement Sci. 2017;12(1):137. doi: 10.1186/s13012-017-0673-x. PubMed

Researchers in Health Services & Economics

Michael L. Parchman, MD, MPH

Director, MacColl Center for Health Care Innovation; Senior Investigator, GHRI
206-287-2704
parchman.m@ghc.org

Curriculum vitae (CV)

David E. Arterburn, MD, MPH

Sr Investigator, Kaiser Permanente Washington Health Research Institute; Physician, Washington Permanente Medicial Group, Internal Medicine
206-287-4610
arterburn.d@ghc.org

Curriculum vitae (CV)

David C. Grossman, MD, MPH

Sr Investigator, Kaiser Permanente Washington Health Research Institute; Sr Associate Medical Director, Market Strategy & Public Policy and Physician, Pediatrics, Washington Permanente Medical Group
206-287-2948
grossman.d@ghc.org

Curriculum vitae (CV)

Eric B. Larson, MD, MPH, MACP

Vice President for Research and Health Care Innovation, Kaiser Foundation Health Plan of Washington; Executive Director & Senior Investigator, Kaiser Permanente Washington Health Research Institute
206-287-2988
larson.e@ghc.org

Curriculum vitae (CV)

Michael R. Von Korff, ScD

Senior Investigator
206-287-2874
vonkorff.m@ghc.org

Curriculum vitae (CV)

Edward H. Wagner, MD, MPH

Director (Emeritus), MacColl Center for Health Care Innovation
206-287-2877
wagner.e@ghc.org

Curriculum vitae (CV)

Robert Penfold, PhD

Associate Investigator
206-287-2232
penfold.r@ghc.org

James D. Ralston, MD, MPH

Senior Investigator
206-287-2076
ralston.j@ghc.org

Curriculum vitae (CV)

Katie Coleman, MSPH

Research Associate
206-287-2872
coleman.cf@ghc.org

Curriculum vitae (CV)

Denise M. Boudreau, PhD

Sr Investigator, Kaiser Permanente Washington Health Research Institute
206-287-2067
boudreau.d@ghc.org

Curriculum vitae (CV)

Katharine A. Bradley, MD, MPH

Senior Investigator
206-287-2151
bradley.k@ghc.org

Curriculum vitae (CV)

Diana S. Buist, PhD, MPH

Director of Research and Strategic Partnership; Senior Investigator
206-287-2931
buist.d@ghc.org

Curriculum vitae (CV)

Daniel C. Cherkin, PhD

Senior Investigator (Emeritus)
206-287-2875
cherkin.d@ghc.org

Curriculum vitae (CV)

Paula Lozano, MD, MPH

Sr Investigator, Kaiser Permanente Washington Health Research Institute; Associate Medical Director for Research and Translation & Physician, Pediatrics, Washington Permanente Medical Group
206-884-8241
lozano.p@ghc.org

Curriculum vitae (CV)

Jessica Chubak, PhD, MBHL

Associate Investigator
206-287-2556
chubak.j@ghc.org

Curriculum vitae (CV)

Karen Wernli, PhD

Associate Investigator
206-287-2934
wernli.k@ghc.org

Curriculum vitae (CV)

Evette J. Ludman, PhD

Senior Research Associate
206-287-2917
ludman.e@ghc.org

Curriculum vitae (CV)

Erin J. Bowles, MPH

Research Associate
206-287-2708
bowles.e@ghc.org

Curriculum vitae (CV)

Nora Henrikson, PhD, MPH

Research Associate
206-287-4675
henrikson.n@ghc.org

Curriculum vitae (CV)

Aruna Kamineni, MPH

Research Associate
206-287-2922
akaminen@fhcrc.org

Curriculum vitae (CV)

Judith Schaefer, MPH

Research Associate
206-287-2077
schaefer.jk@ghc.org

Curriculum vitae (CV)

Gwen Lapham, PhD, MPH, MSW

Research Associate
206-287-2021
lapham.g@ghc.org

Curriculum vitae (CV)

Melissa L. Anderson, MS

Senior Biostatistician
206-287-2647
anderson.melissa@ghc.org

Curriculum vitae (CV)

Eric Johnson, MS

Biostatistician
206-287-2105
johnson.ex@ghc.org

Curriculum vitae (CV)

Lorella Palazzo, PhD

Research Associate
206-287-2173
palazzo.l@ghc.org

Curriculum vitae (CV)

Caitlin Morrison, MPH

Research Associate
206-287-2163
morrison.caitlin@ghc.org

Curriculum vitae (CV)

Nicole Van Borkulo, M Ed

Research Associate
206-287-2866
vanborkulo.n@ghc.org

Curriculum vitae (CV)

Paula R. Blasi, MPH

Research Associate
206-287-2094
blasi.p@ghc.org

Curriculum vitae (CV)

Leah Tuzzio, MPH

Research Associate
206-287-2109
tuzzio.l@ghc.org

Curriculum vitae (CV)

Cara C. Lewis, PhD, HSPP

Associate Investigator
206-442-4076
lewis.cc@ghc.org

Curriculum vitae (CV)

Rebecca Y. Coley, PhD

Assistant Investigator
206-287-2071
coley.r@ghc.org

Curriculum vitae (CV)

Joseph E. Glass, PhD

Assistant Scientific Investigator
206-287-4266
glass.j@ghc.org

Curriculum vitae (CV)

Kai Yeung, PharmD, PhD

Assistant Investigator
(206) 287-2063
yeung.k@ghc.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
debar.l@ghc.org

Curriculum vitae (CV)

Affiliate researchers

Douglas A. Conrad, PhD, MBA, MHA
Health Services and Dental Public Health Sciences
Center for Health Management Research
Finance and Business Economics
University of Washington (UW)

David Grembowski, PhD
Health Services and Dental Public Health Sciences
Adjunct Professor, Sociology, UW

Larry Kessler, ScD
UW Department of Health Services

Leo Morales, MD, PhD
Chief Diversity Officer, Center for Equity, Diversity, and Inclusion
UW Medical School

Emily Williams, PhD, MPH
UW Department of Health Services; VA Health Services Research & Development Center of Excellence