Health Services & Economics

"We design, evaluate, and propagate high-quality and high-value health care.”

Kai Yeung, PharmD, PhD
Kaiser Permanente Washington Health Research Institute Assistant Investigator
Washington Permanente Medical Group, Internal Medicine

Research overview

Kaiser Permanente Washington Health Research Institute (KPWHRI) 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 aims including 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 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 addressing obesity includes studies on the effectiveness of bariatric surgery for weight loss and conditions related to obesity such as heart disease and diabetes complications.
  • The rapidly rising cost of pharmacotherapy is one of the most challenging problems in all of medicine. We’re researching how best to encourage patients to adhere to their treatment, improve long-term health outcomes, and lower total costs of care. Dr. Beverly Green is exploring the use of financial incentives in promoting colorectal cancer screening and Dr. Nora Henrikson is finding effective and integrated ways for clinical teams to discuss cost of care with cancer patients.
  • Curbing overdiagnosis and overtreatment is important because getting too much of some types of health care can be as harmful as not getting enough. At the Center for Accelerating Care Transformation (ACT Center), we’re working to avoid harmful overuse of care through a project called Taking Action on Overuse. We tackle increasingly prevalent issues, such as long-term opioid use for chronic pain.
  • The ACT Center (formerly known as the MacColl Center for Health Care Innovation) has also helped to spread the Chronic Care Model around the world, guiding quality improvement efforts for diabetes, asthma, heart disease, and other chronic conditions. It is also addressing health care workforce issues to help transform the U.S. health care system.

The impact of our health services research is extensive. Being part of the Kaiser Permanente system, along with our membership in the Health Care Systems Research Network, the Breast Cancer Surveillance Consortium, and other national and international collaborations increases the size and diversity of our study populations. These connections also help KPWHRI shape care and policy beyond the Kaiser Permanente Washington system.

Recent publications on Health Services & Economics

Schousboe JT, Sprague BL, Abraham L, O'Meara ES, Onega T, Advani S, Henderson LM, Wernli KJ, Zhang D, Miglioretti DL, Braithwaite D, Kerlikowske K. Cost-effectiveness of screening mammography beyond age 75 years: a cost-effectiveness analysis. Ann Intern Med. 2022 Jan;175(1):11-19. doi: 10.7326/M20-8076. Epub 2021 Nov 23. PubMed

Bell SK, Bourgeois F, DesRoches CM, Dong J, Harcourt K, Liu SK, Lowe E, McGaffigan P, Ngo LH, Novack SA, Ralston JD, Salmi L, Schrandt S, Sheridan S, Sokol-Hessner L, Thomas G, Thomas EJ. Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care. BMJ Qual Saf. 2021 Oct 16:bmjqs-2021-013672. doi: 10.1136/bmjqs-2021-013672. Online ahead of print. PubMed

Richesson RL, Marsolo KS, Douthit BJ, Staman K, Ho PM, Dailey D, Boyd AD, McTigue KM, Ezenwa MO, Schlaeger JM, Patil CL, Faurot KR, Tuzzio L, Larson EB, O'Brien EC, Zigler CK, Lakin JR, Pressman AR, Braciszewski JM, Grudzen C, Fiol GD. Enhancing the use of EHR systems for pragmatic embedded research: lessons from the NIH Health Care Systems Research Collaboratory. J Am Med Inform Assoc. 2021 Oct 1:ocab202. doi: 10.1093/jamia/ocab202. Online ahead of print. PubMed

Austin EJ, LeRouge C, Lee JR, Segal C, Sangameswaran S, Heim J, Lober WB, Hartzler AL, Lavallee DC. A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization. Learn Health Syst. 2021 Mar 1;5(4):e10263. doi: 10.1002/lrh2.10263. eCollection 2021 Oct. PubMed

Fagnan LJ, Ramsey K, Dickinson C, Kline T, Parchman ML. Place matters: closing the gap on rural primary care quality improvement capacity - the Healthy Hearts Northwest study. J Am Board Fam Med. 2021 Jul-Aug;34(4):753-761. doi: 10.3122/jabfm.2021.04.210011. PubMed

Researchers in Health Services & Economics

Michael L. Parchman, MD, MPH

Senior Investigator, Center for Accelerating Care Transformation
206-287-2704
Michael.X.Parchman@kp.org

Curriculum vitae (CV)

David E. Arterburn, MD, MPH

Senior Investigator, KPWHRI; Physician, Washington Permanente Medical Group, Internal Medicine
206-287-4610
David.E.Arterburn@kp.org

Curriculum vitae (CV)

Rita Mangione-Smith, MD, MPH

Vice President for Research and Health Care Innovation, Kaiser Permanente Washington; Executive Director and Senior Investigator, Kaiser Permanente Washington Health Research Institute
206-287-2988
Rita.M.Mangione-Smith@kp.org

Curriculum vitae (CV)

Eric B. Larson, MD, MPH, MACP

Senior Investigator and former Executive Director, Kaiser Permanente Washington Health Research Institute; Former Vice President for Research and Health Care Innovation, Kaiser Permanente Washington
206-287-2988
Eric.B.Larson@kp.org

Curriculum vitae (CV)

Robert Penfold, PhD

Senior Investigator
206-287-2232
Robert.B.Penfold@kp.org

Curriculum vitae (CV)

James D. Ralston, MD, MPH

Senior Investigator
206-287-2076
James.D.Ralston@kp.org

Curriculum vitae (CV)

Katie Coleman, MSPH

Director, Collaborative Science; Director, Center for Accelerating Care Transformation
206-287-2872
Katie.F.Coleman@kp.org

Curriculum vitae (CV)

Katharine A. Bradley, MD, MPH

Senior Investigator
206-287-2151
Katharine.A.Bradley@kp.org

Curriculum vitae (CV)

Paula Lozano, MD, MPH

Senior Investigator, Kaiser Permanente Washington Health Research Institute
206-287-2113
Paula.Lozano@kp.org

Curriculum vitae (CV)

Jessica Chubak, PhD, MBHL

Senior Investigator
206-287-2556
Jessica.Chubak@kp.org

Curriculum vitae (CV)

Karen Wernli, PhD

Associate Investigator
206-287-2934
Karen.J.Wernli@kp.org

Curriculum vitae (CV)

Erin J. Bowles, MPH

Research Associate
206-287-2708
Erin.A.Bowles@kp.org

Curriculum vitae (CV)

Nora Henrikson, PhD, MPH

Associate Investigator
206-287-4675
Nora.B.Henrikson@kp.org

Curriculum vitae (CV)

Aruna Kamineni, PhD, MPH

Assistant Investigator
206-287-2922
Aruna.S.Kamineni@kp.org

Curriculum vitae (CV)

Gwen Lapham, PhD, MPH, MSW

Assistant Investigator
206-287-2021
Gwen.T.Lapham@kp.org

Curriculum vitae (CV)

Melissa L. Anderson, MS

Senior Collaborative Biostatistician
206-287-2647
Melissa.L.Anderson@kp.org

Curriculum vitae (CV)

Eric Johnson, MS

Senior Collaborative Biostatistician
206-287-2105
Eric.Johnson@kp.org

Curriculum vitae (CV)

Lorella Palazzo, PhD

Research Associate
206-287-2173
Lorella.G.Palazzo@kp.org

Curriculum vitae (CV)

Paula R. Blasi, MPH

Research Associate
206-287-2094
Paula.R.Blasi@kp.org

Curriculum vitae (CV)

Leah Tuzzio, MPH

Senior Research Associate
206-287-2109
Leah.Tuzzio@kp.org

Curriculum vitae (CV)

Cara C. Lewis, PhD, HSPP

Senior Investigator
206-442-4076
Cara.C.Lewis@kp.org

Curriculum vitae (CV)

Yates Coley, PhD

Assistant Biostatistics Investigator
206-287-2071
Rebecca.Y.Coley@kp.org

Curriculum vitae (CV)

Joseph E. Glass, PhD, MSW

Associate Investigator
206-287-4266
Joseph.E.Glass@kp.org

Curriculum vitae (CV)

Kai Yeung, PharmD, PhD

Assistant Investigator
206-287-2063
Kai.Yeung@kp.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
Lynn.Debar@kp.org

Curriculum vitae (CV)

Paige D. Wartko, PhD, MPH

Research Associate
206-442-5230
Paige.D.Wartko@kp.org

Curriculum vitae (CV)

Julia J. Smith,

Senior Collaborative Biostatistician
206-287-2715
Julia.J.Smith@kp.org

Curriculum vitae (CV)

Leah K. Hamilton, PhD

Research Associate II
206-287-2515
Leah.K.Hamilton@kp.org

Curriculum vitae (CV)

Chloe Krakauer, PhD

Collaborative Biostatistician II
chloe.a.krakauer@kp.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

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