Laurel Health Advisors

Laurel Health Advisors is currently serving as a prime contractor for a four-region area in rural Washington State to evaluate the use of telehealth on adolescents and young adults with mental health disorders. This mixed-methods, multi-site evaluation examines the use of telehealth within schools, libraries, correctional facilities, hospitals, community health centers, and rural health clinics. The evaluation examines the economic impact and clinical outcomes over an 18-month period of the use of telehealth on mental health disorders, co-occurring substance use disorders, and co-occurring chronic health conditions. Laurel Health is conducting a range of quantitative and qualitative evaluations of existing and new data collection to inform the potential expansion of telehealth services. Through this work, we conduct a targeted literature review, key informant interviews, a regionwide survey, focus groups with providers to inform future policy and comprehensive economic analysis.

Laurel Health used a random forest modeling approach to develop a predictive analytic model to predict diabetes neuropathy rates among rural populations in Mississippi. By employing this model, Laurel Health could significantly aid in the early identification of individuals at risk by constructing multiple decision trees during the training phase and outputting the class that is the mode of the classes of individual trees. For diabetes neuropathy rates, input variables included patient demographics, health history, lifestyle factors, and clinical measurements such as blood glucose levels and HbA1c. The ensemble nature of the model allowed for handling a large number of input variables and their interactions, making it robust against overfitting and ideal for complex relationships in medical data. Moreover, its inherent feature importance evaluation identified which factors most strongly predict neuropathy risk, which helped guide the client in developing targeted interventions.

Laurel Health worked with the American Association of Retired People (AARP) to develop and use a difference in difference (DiD) methodology to evaluate policy the effect of Medicaid expansion on uncompensated care states that have not expanded Medicaid under the Affordable Care Act (ACA). By comparing the changes in uncompensated care costs in states that expanded Medicaid versus those that did not, before and after the policy implementation, we could isolate the effect of Medicaid expansion from other trends. This quasi-experimental approach mitigated the confounding variables that could affect the outcomes by using the non-expansion states as a control group. By assuming that both groups would have followed parallel paths without the policy change, the model assessed the divergence attributable to Medicaid expansion. This evaluated the policy impacts over time and provided valuable insights into how expanding Medicaid influences the financial burden of healthcare providers due to uncompensated care.

In 2022, Laurel Health Advisors undertook an extensive study with the American Medical Association assessing the cost-effectiveness of telehealth in specialty care. This involved comparing a hybrid telehealth model, which integrates both in-person and telehealth services, against a traditional in-person approach across various medical specialties. The study targeted areas like congestive heart failure, mental health, and urgent care. Utilizing advanced techniques like Markov models and decision tree analysis, the study aimed to evaluate the financial and healthcare outcome implications of these models, providing valuable insights into the efficiency and practicality of telehealth in specialized medical care.

Since 2022, Laurel Health Advisors has been working with Publicis Sapient to develop content to support the hhs.telehealth.gov website, created by the Health Resources and Services Administration (HRSA). This site serves as a comprehensive resource for healthcare providers and patients. It offers information on federal efforts to support and promote virtual healthcare, also known as telehealth. This website includes resources for preparing for virtual health visits and addresses various aspects of telehealth, including policy, billing, licensure, and best practice guides. Laurel Health provides content services for best practice guides, community stories, research recaps, and other areas of information.