Technology and Quality Management in Healthcare
University of Hamburg
Placement: Brown University School of Public Health
Mentor: Vincent Mor, Ph.D. (Brown University School of Public Health)
Project: Relationship of Nursing Home Payment and Outcomes: Do Investments Drive Quality in the Intended Areas?
Rudolf Blankart, Dr. rer. pol., is a 2015–16 German Harkness/B. Braun Stiftung Fellow in Health Care Policy and Practice. He is currently an assistant professor of technology and quality management in health care at the University of Hamburg. His current research interests include end-of-life care, cost control, health economics, quality, access, and health technology assessment. Blankart also manages the German team for MedtecHTA, a cross-national research project funded within the Seventh Framework Research Program of the European Commission which investigates health technology assessment concerning medical devices. In addition to his Harkness project, Blankart is also currently working on an analysis of costs of end-of-life care with Ezekiel Emmanuel, M.D., Ph.D., of the University of Pennsylvania and Julie P.W. Bynum, M.D., M.P.H., of The Dartmouth Institute for Health Policy and Clinical Practice. Blankart began his career as a management consultant before returning to academia to earn his doctorate in health economics from the University of Hamburg in 2009.
Hospitalizations of older patients with multiple chronic conditions are one of the major cost drivers within the U.S. healthcare system. Nursing homes hold opportunity for mitigating unnecessary hospitalizations for this population, if high quality care is provided. Since the implementation of the Affordable Care Act (ACA), staffing requirements and payment changes have been implemented for nursing homes, but these changes have not broadly translated to an increase in quality. Blankart will explore the effects of nursing home payment changes from 2000 to 2010 (prior to the ACA), focusing on whether Medicaid reimbursement changes affected performance and patient outcomes. Using a hierarchic model over a ten year period, he will analyze whether changes in Medicaid payment rates have impacted outcomes for patients in nursing homes. A further analysis of funds from wage pass through legislations will indicate whether nursing homes are appropriately investing their resources. Blankart will obtain data from Brown University’s long-term care residential history file built using Medicare Enrollment data, Medicare claims data, and a Minimum Data Set, which contains detailed information on the 15,000 Medicare and Medicaid certified nursing homes (provider information, staffing, quality, etc.). This data will be matched with Medicare/Medicaid patient-level data to accurately measure hospitalizations and any other utilization outcomes. His research aim will be to inform policy makers to implement individually tailored reimbursement systems that optimally incentivize nursing homes, regardless of their performance or their specialization.
Career Activity since Fellowship:
Current Position: Assistant Professor for Regulatory Affairs, University of Bern; Director, National Center of Excellence for Translational Medicine and Entrepreneurship (updated 04/2017)
Harkness Related Publications:
H.M. Hatz, J. Schreyögg, A. Torbica, G. Boriani, C.R. Blankart. “Adoption Decisions for Medical Devices: Results from a European Survey and Implications for HTA,” Health Economics. 2017.
V. Schlage, C.R. Blankart. “Does Direct-care Staffing Impact Nursing Home Outcomes? A Systematic Review,” Die Unternehmung. 2016.
R. Milstein, C.R. Blankart. “The Health Care Strengthening Act: The next level of integrated care in Germany,” Health Policy. 2016.