Visiting Faculty

Dr. Shailender Swaminathan

Department of Economics

Interests

  1. Applied Econometrics
  2. Health Economics
  3. Development Economics

Education

1992

Hindu College, University of Delhi
BA Economics

2000

University of Southern
California
MA Economics

2001

University of Southern
California
Ph.D.

Experience

  • Peer-Reviewer for academic journals (current): Journal of Health Economics, Health Services Research, Health Services Research and Outcomes Methodology, Public Health Reports, American Journal of Managed Care, Maternal and Child Health Journal, Inquiry.
  • Member, Core Committee, Medical Technology Assessment Board, Ministry of Health, Government of India.2017

Research Interest

  • Understanding the costs and benefits of health insurance expansion in the United States. We use over three decades of data both before and after the expansion of Medicare to examine the effects at the time of introduction (1966) and over the following two decades.
  • Recent expansion of Medicaid resulted in gains in health insurance coverage among the poor. We examine whether this policy change had any impact on the health outcomes of patients with End Stage Renal Disease
  • Understand the relationship between the diagnosis of a chronic disease (especially diabetes) and subsequent changes/improvement in health care behaviour- both in terms of exercise and diet.

Awards & Fellowships

Article of the Year Award, Academy Health 2009 for the best paper published in the area of health policy.

Grants received:

Ongoing Research Support

R40 (Trivedi) 4/1/15 – 3/31/18

Health Resources and Service Administration (HRSA)

Medicaid Managed Care and the Quality of Care for Women and Children: Evaluating a Randomized Trial of Enrollment in a Medicaid-Focused or Commercial Health Insurance Plan

The proposed research is innovative and rigorous, as we employ mixed-methods and randomized trial design and assess widely-used, validated quality measures, such as ambulatory care-sensitive admission and emergency department visits, use of effective preventive services, well-child care, and recommend care processes for chronic health conditions.  This research should help inform policy decisions regarding the improved organization and financing of health systems serving MCH populations in the Medicaid program. Role: Co-Investigator

R01 (Trivedi)          2/1/17 – 1/31/21

NIDDK

Impact of Medicaid Expansion on Racial and Socioeconomic Disparities in ESRD

Using clinical data from all incident patients with ESRD in the United States from 2009-2018, our specific aims are: 1. Assess the effects of Medicaid expansion on pre-dialysis care for low-income incident populations; 2. Assess the impact of Medicaid expansion on post-dialysis outcomes; and 3. Evaluate early effects of Medicaid expansion on the incidence of ESRD.

Role: Co-Investigator

Veterans Administration Health Services Research and Development (Mor)

2/1/17 – 1/31/20

The Effect of Reduction and Standardization of Reimbursements in the VA Fee-Basis Program: Impact on Quality of Care and Health Outcomes

The purpose of this study is to assess how the national dialysis contract payment model changed the distribution of quality among facilities participating in the VA Fee Basis program and affected Veterans' outcomes. We will conduct a longitudinal (pre-post) retrospective cohort study of all VA-financed end-stage renal disease (ESRD) providers and patients before (pre-period: 2006-2008) and after (post-period: 2011-2016) implementation of national dialysis contracts. This study will estimate the impact of these policy changes on Veterans and to determine whether a geographically contingent, value based model for purchasing dialysis services from non-VA vendors could improve the overall outcomes experienced by Veterans requiring dialysis.

Role: Co-Investigator

Completed Research Support

R21DK095485 Swaminathan (Principal Investigator) 9/30/11 -8/31/15

NIH, NIDDK

Treatment of Anemia in End Stage Renal Disease: Effect of Warnings and Incentives

In this project, the impact of two policies that have been used to curb the use of the drug Epoetin (EPO) - a drug used to treat anemia among all individuals with the End Stage Renal Disease has been evaluated

R21 AG042302-01 Swaminathan (Principal Investigator) 9/30/11 -8/31/15

NIH, NIA

Effects of Health Insurance Coverage for Preventive Care: Evidence from Medicare

In the current proposal, we seek to understand the casual impact of preventive health care measures introduced as part of the MMA. Two important changes in Medicare effective January 1,2005 were explicitly preventive in nature: i) Lipid profile blood screening tests to ascertain the risk of cardiovascular disease, and ii) Fasting glucose blood tests to screen individuals at “risk” for diabetes. Medicare fully reimbursed providers for the costs of the test.

2T32 HS000011  (Mor) 9/1/08-8/31/13

AHRQ National Research Service Award

The Specific aims of this training program are to recruit highly qualified socio-demographically diverse post- and pre-doctoral trainees. To develop scientists experienced in the use of state-of-the-art health services research methods, with specific foci in evidence-based medicine, comparative effectiveness research, chronic disease and aging, etc. To develop scientists skilled in the communication of scientific knowledge who are able to work in multidisciplinary teams in academia, government and the private sector. To provide didactic as well as "hands on" supervised experience in research by matching trainees with externally funded research teams; and, to develop scientists equipped with the leadership skills to improve health care delivery and influence health policy. Role: Mentor

Mor (PI)    6/1/09 – 12/31/13

Sub w/Quality Partners of RI

Performance Excellence in Kidney Care

Selecting comparison samples between KCP and non-KCP dialysis facilities. Creating Baseline Mortality and Quality files for comparison.  Review, Examine and Create Clinical Performance Measures and Examine Potential Composite Benchmarks.  Recommend Appropriate Clinical Performance Measures.

Role :Investigator

CIN 13-419 (Friedmann)          10/1/14-9/30/15 Providence VAMC

Center of Innovation (COIN) on Long-Term Services and Support for Vulnerable Veterans

This proposed Center of Innovation (COIN) will build on our strong partnership with VA’s Geriatric and Extended Care (GEC); infrastructure developed by the GEC Data Analysis Center (GEC DAC) and HSR&D Research Enhancement Award Program (REAP); collaborations with VA LTSS researchers nationwide established through our recently-funded Long-Term Care CREATE; and long-standing collaborations with long-term care research and training programs at Brown University to facilitate partnered health services research that improves access, quality and value of LTSS for vulnerable Veterans.  The goal is to conduct high-quality, partner health services research in LTSS that will benefit both Veteran and civilian populations. Role: Investigator

1 R01 AG047180-01 (Co-PI, Mor PI) 7/1/14 - 4/30/17

NIA

Emerging Role of Medicare Advantage in Nursing Home Care

To inform policy efforts to improve the quality, outcomes of care for vulnerable nursing home residents.

1RO1AD044374-02   (Co-PIM Trivedi (PI)) 6/1/13 – 5/31/16

NIA

Cost-Sharing, Use and Outcomes of Post-Acute Care in Medicare Advantage

Evaluate the impact of changes in cost-sharing on the use and outcomes of post-acute care using a quasi-experimental research design and a national sample of Medicare enrollees in managed care plans.

Memberships

  • International Health Economics Association, American Economic Association

List of Publications

  • Jaquet D, Swaminathan S, Alexander GR, Czernichow P, Collin D, et al. Significant
    paternal contribution to the risk of small for gestational age. BJOG : an international journal of obstetrics and gynaecology. 2005; 112(2):153-9.
  • Scanlon DP, Swaminathan S, Chernew M, Bost JE, Shevock J. Competition and health
    plan performance: evidence from health maintenance organization insurance markets. Medical care. 2005; 43(4):338-46.
  • Swaminathan S, Alexander GR, Boulet S. Delivering a very low birth weight infant and the subsequent risk of divorce or separation. Maternal and child health journal. 2006; 10(6):473-9.
  • Scanlon DP, Swaminathan S, Chernew M, Lee W. Market and plan characteristics related to HMO quality and improvement. Medical care research and review : MCRR. 2006; 63(6 Suppl):56S-89S.
  • Scanlon DP, Chernew M, Swaminathan S, Lee W. Competition in health insurance markets: limitations of current measures for policy analysis. Medical care research and review : MCRR. 2006; 63(6 Suppl):37S-55S.
  • Mulvihill BA, Altarac M, Swaminathan S, Kirby RS, Kulczycki A, et al. Does access to a medical home differ according to child and family characteristics, including special-health-care-needs status, among children in Alabama? Pediatrics. 2007; 119 Suppl 1:S107-13.
  • Sen B, Swaminathan S. Maternal prenatal substance use and behavior problems among children in the U.S. The journal of mental health policy and economics. 2007; 10(4):189-206.
  • Scanlon DP, Swaminathan S, Lee W, Chernew M. Does competition improve health care quality? Health Services Research 2008;43(6):1931-51.
  • Swaminathan S, Chernew M, Scanlon DP. Persistence of HMO performance measures. Health services research. 2008; 43(6):2033-49.
  • Nabukera SK, Wingate MS, Kirby RS, Owen J, Swaminathan S, et al. Interpregnancy interval and subsequent perinatal outcomes among women delaying initiation of childbearing. The journal of obstetrics and gynaecology research. 2008; 34(6):941-7.
  • Trivedi AN, Swaminathan S, Mor V. Insurance parity and the use of outpatient mental health care following a psychiatric hospitalization. JAMA. 2008; 300(24):2879-85.
  • Nabukera SK, Wingate MS, Owen J, Salihu HM, Swaminathan S, et al. Racial disparities in perinatal outcomes and pregnancy spacing among women delaying initiation of childbearing. Maternal and child health journal. 2009; 13(1):81-9.
  • Wingate MS, Swaminathan S, Alexander GR. The influence of maternal mobility on birth outcomes of non-hispanic blacks. Maternal and child health journal. 2009; 13(1):48-55.
  • Nabukera SK, Wingate MS, Salihu HM, Owen J, Swaminathan S, et al. Pregnancy spacing among women delaying initiation of childbearing. Archives of gynecology and obstetrics. 2009; 279(5):677-84.
  • Swaminathan S, Mor V, Mehrotra R, Trivedi A. Medicare's payment strategy for end-stage renal disease now embraces bundled payment and pay-for-performance to cut costs. Health affairs (Project Hope). 2012; 31(9):2051-8. NIHMSID:NIHMS505730 PubMed [journal] PMID: 22949455, PMCID: PMC3766315
  • Thomas KS, Dosa D, Hyer K, Brown LM, Swaminathan S, et al. Effect of forced transitions on the most functionally impaired nursing home residents. Journal of the American Geriatrics Society. 2012; 60(10):1895-900.
  • Dore DD, Swaminathan S, Gutman R, Trivedi AN, Mor V. Different analyses estimate different parameters of the effect of erythropoietin stimulating agents on survival in end stage renal disease: a comparison of payment policy analysis, instrumental variables, and multiple imputation of potential outcomes. Journal of
    clinical epidemiology. 2013; 66(8 Suppl):S42-50
  • Leung LA, Swaminathan S, Trivedi AN. Diabetes diagnosis and exercise initiation among older Americans. Preventive medicine. 2014; 65:128-32.
  • Swaminathan S, Mor V, Mehrotra R, Trivedi AN. Effect of medicare dialysis payment reform on use of erythropoiesis stimulating agents. Health services research. 2015; 50(3):790-808.
  • Swaminathan S, Mor V, Mehrotra R, Trivedi AN. Initial session duration and mortality among incident hemodialysis patients. American Journal of Kidney Diseases. February 2017
  • Radhika J, Subramanian C, Swaminathan S. Are there social returns to education in developing countries: evidence from Indonesia. Forthcoming. Economic Development and Cultural Change
  • Bhattacharjee A, Shin JK, Subramanian C, Swaminathan S. Healthcare Investment and Income Inequality. Forthcoming. Journal of Health Economics.
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