Our Research
As a public benefit company, Waymark is committed to learning from our research, sharing our findings, and moving community-based care forward.
Impact of Community Health Center Losses on County-Level Mortality: A Natural Experiment in the United States, 2011–2019
We conducted a natural experiment study using difference-in-differences analysis of propensity score–matched US counties from 2011 through 2019. Loss of CHC sites was associated with an increase in age-adjusted all-cause mortality of 3.54 deaths per 100 000 population (95% CI: 1.19, 5.90; p = 0.003) in the year following the loss. The largest increase was observed for cancer mortality (2.61 per 100 000; 95% CI: 0.59, 4.62; p = 0.011). Primary care physician density and patient volume loss both mediated the relationship.
Medicaid Expansion Among Nonelderly Adults and Cardiovascular Disease: Efficiency Vs. Equity
We found that the benefits of expansion generally balanced out the costs while redistributing health from higher to lower income groups. In probabilistic sensitivity analysis, we found—using a health opportunity cost threshold of $150,000—that Medicaid expansion was cost-effective in reducing CVD outcomes 53% of the time and both cost-effective (efficient) and equity enhancing 26% to 29% of the time.
Transportation Barriers and Diabetes Outcomes: A Longitudinal Analysis
In this observational study, we used a target trial emulation framework to estimate the potential of addressing transportation barriers to improve T2DM outcomes. Specifically, we sought to estimate whether not experiencing transportation barriers, compared with experiencing them, would be associated with better glycemic, blood pressure, and cholesterol outcomes among adults with T2DM in a network of community-based health centers.
Procedural Prescription Denials and Risk of Acute Care Utilization and Spending Among Medicaid Patients
In this cross-sectional study of 19 725 Medicaid enrollees across 2 states and 2 independent health plans, those experiencing specific procedural prescription denials had a higher risk of physiologically related emergency department visits and hospitalizations compared with those without a denial in the subsequent 60 days after matching and further adjustment for risk of acute care. These findings suggest that although procedural prescription denials may aim to curb immediate drug costs, some denials may prompt heightened acute care utilization and expenses that outweigh the short-term prescription budget savings.
How AI can bring better care to Medicaid patients
Sadiq Patel, Waymark's VP of Data Science and AI, examines barriers to AI/ML adoption in Medicaid and lays out potential solutions to address these challenges — including actively seeking input from patients and the people who serve them: PCPs, community health workers, pharmacists, therapists, care coordinators, and community organizations.
Simulating A/B testing versus SMART designs for LLM-driven patient engagement to close preventive care gaps
Using microsimulations, we compared both the statistical power and false positive rates of A/B testing and Sequential Multiple Assignment Randomized Trials (SMART) for developing personalized communications across multiple effect sizes and sample sizes. SMART showed better cost-effectiveness and net benefit across all scenarios, but superior power for detecting heterogeneous treatment effects (HTEs) only in later randomization stages, when populations were more homogeneous and subtle differences drove engagement differences.
Geographic Variations and Facility Determinants of Acute Care Utilization and Spending for ACSCs
We analyzed data for 48.4 million patients receiving Medicaid across 34 states and Washington DC, and found that nearly 40% are for conditions that coule be prevented or managed through timely access to primary care. As many Medicaid programs struggle to manage rising costs, these findings demonstrate that early interventions can meaningfully improve outcomes and reduce costs for their Medicaid populations.
Population Health Implications of Medicaid Prerelease and Transition Services for Incarcerated Populations
A large population of incarcerated people may be eligible for prerelease and transition services under the new Medicaid Reentry Section 1115 Demonstration Opportunity. We found that several disease prevalence rates were sufficiently high among incarcerated populations to likely skew overall Medicaid population prevalence of these diseases when prerelease and transition services are expanded, implying the need for planning of additional data exchange and service delivery infrastructure by state Medicaid plans.
Supporting Rising-Risk Medicaid Patients Through Early Intervention
We assessed outcomes from our early interventions for 64,278 patients covered by two Medicaid health plans and assigned to 2,298 primary care providers (PCPs) spanning multiple practices in the states of Washington and Virginia. We found that Waymark achieved a 22.9% reduction in all-cause ED and hospital visits, including a 20.4% reduction in avoidable ED visits and 48.3% reduction in avoidable hospitalizations for rising-risk patients receiving Waymark services (compared to a matched control group of rising-risk patients over a 6-month follow-up period).
The Risk Of Perpetuating Health Disparities Through Cost-Effectiveness Analyses
We examined how competing risks, baseline health care costs, and indirect costs can differentially affect cost-effectiveness analyses for racial and ethnic minority populations. We illustrate that these structural factors can reduce estimated quality-adjusted life-years and cost savings for disadvantaged groups, making interventions focused on disadvantaged populations appear less cost-effective.
