OOIR: Observatory of International Research

Papers

(The TQCC of Population Health Management is 4. The table below lists those papers that are above that threshold based on CrossRef citation counts [max. 250 papers]. The publications cover those that have been published in the past four years, i.e., from 2021-05-01 to 2025-05-01.)

Article	Citations
One Year Out: The Five Ds of COVID-19	66
A Population Health Proposal for Increasing Breast Cancer Screening to Reduce Racial Disparities in Breast Cancer: Getting the Village Back Together	52
Impact of Social Capital on the Availability of Health Care Services	48
Health Equity Is Key to Better Population Health	33
More Patient Data? Be Careful What You Wish for…AI’s Role in Making Clinical Data Exchange Useful	32
COVID-19 Vaccination, Morbidity, and Mortality During a 12-Month Period in Israel: Can We Maintain a “Herd Immunity” State?	30
COVID-19 and the Urgent Need for New Therapies for Obesity	26
Implementation of Medications for Alcohol and Opioid Use Disorders in a Value-Based Organization-Unlocking Value by Addressing Unmet Needs for Medicaid and Dually-Eligible Beneficiaries	25
Improve Patient-Centered Care, Decrease Provider Burnout, Maximize Z Codes, Minimize Hierarchical Condition Category Codes	24
A Scoping Review of Behavioral Interventions Addressing Medical Financial Hardship	22
Examining the Association of Social Needs with Future Health Care Utilization in an Older Adult Population: Which Needs Are Most Important?	22
Optimizing Hierarchical Condition Category-Risk Adjustment Factor Management in Population Health Using Rapid Process Improvement Methods	21
Evaluation of the Impact of Discharge Clinic Follow-Up Interventions on 30-Day Readmission Rates	19
Call for Special Issue Papers: Reducing Health Disparities in Underserved Populations	18
A Tale of 4 Babies: Health Equity at the Center of the Quadruple Aim	17
Perceived Stigma in Health Care Settings Mediates the Relationships Between Depression, Diabetes, and Hypertension	17
Letter to the Editor: Pivoting Care Coordination Efforts Based on Risk and Return	17
Social Needs Screening in Academic Health Systems: A Landscape Assessment	15
Medicaid Acceptance Varies by Physician Seniority and Specialty in California	14
Prior Authorization: Process Redesign with a Focus on Value-Based Care	14
The Impact of the Affordable Care Act on Disparities in Utilization of Cardiovascular Preventive Services by Socioeconomic Status	14
COVID-19 Deaths and the Impact of Health Disparities, Hospital Characteristics, Community, Social Distancing, and Health System Competition	14
Leveraging Digital Medicine to Support Providers and Their Patients in Managing Serious Mental Illness	13
The Impact of Personal and Historical Factors That Contribute to Medicare Readmissions	13
Innovations in Population Health: Improving Outcomes for Patients with Chronic Kidney Disease	12

COVID-19 Vaccine Equity: Codesigning Public Health Interventions with Community Partners	12
Impact of COVID-19 on Behavioral Health Services Use Among Medicaid Enrollees with Chronic Behavioral Needs by Race and Ethnicity	12
Ambulatory Care Utilization Among Medicare Beneficiaries with Depression	11
Operation Allies Welcome Medical Response Unit at Philadelphia International Airport: A Framework for Medical Triage of High Volume of Displaced Persons Arriving by Air	11
Social Intervention by the Numbers: Evidence Behind the Specific Public Health Guidelines in the COVID-19 Pandemic	11
A Conceptual Framework for Building Individual and Team Capabilities to Provide Effective Longitudinal, Relationship-Based Clinical Case Management	10
Transitional Care for Older Adults: Demonstration of the Role of a Partnership Payvider	10
What Are the Roles of Community Health Workers in Medicaid Managed Care? Results from a National Study	10
Successful Implementation of an All-or-None Diabetes Measure in 10 US Health Systems	10
Evaluating the Financial Sustainability of the School-Based Telemedicine Asthma Management Program	9
Measuring What Matters: Beyond Quality Performance Measures in Caring for Adults with Obesity	9
Cost-Effectiveness of Outreach Strategies for Stool-Based Colorectal Cancer Screening in a Medicaid Population	9
Using Quality Measures to Drive Improvements in Immunization Rates: Findings from a Real-World Evaluation from 3 US Health Care Organizations	9
Use of a Blood Biomarker Test Improves Economic Utility in the Evaluation of Older Patients Presenting with Cognitive Impairment	9
Using Health Plan Authorization Data to Predict Hospitalizations and Readmissions in a Combined Commercial and Medicaid Population	9
Bridging the Digital Divide: A Practical Roadmap for Deploying Medical Artificial Intelligence Technologies in Low-Resource Settings	9
Evaluation of Risk Factors for Hepatitis C Virus Infection Among Philadelphia's Shelter-Bound, Homeless Population: Data from a Student-Run Hepatitis C Virus Screening Initiative	8
The Payvider: An Evolving Model	8
Body Mass Index and All-Cause and Cardiovascular Mortality in United States Adults With and Without Atherosclerotic Cardiovascular Disease: Findings from the National Health Interview Survey	8
Leveraging Technology for Value-Based Kidney Care	8
Reimagining Diabetes Quality Measurement to Advance Quality Care	8
Enhanced Primary Care for Severe Mental Illness Reduces Inpatient Admission and Emergency Room Utilization Rates	8
Limitations to Health Care Quality Measurement: Assessing Hospital Variation in Risk of Cardiac Events After Noncardiac Surgery	7
What Is Old Needs to Be New Again	7
Engaging Stakeholder Advisors Around Health-Related Social Needs Research, Policy, and Practice Priorities	7
Individual- and Community-Level Predictors of Hospital-at-Home Outcomes	7
Construction of a Pediatrics Risk Score to Predict High Health Care Costs Among a Community Health Center Cohort	7
The Cost of Unhealthy Days: A New Value Assessment	7
Reducing Health Disparities in Underserved Populations: A Spotlight on Health Inequities	7
Interventions to Increase Affordable Care Act Marketplace Enrollment: A Systematic Review and Meta-Analysis	7
A Review of the MINDSPACE Framework for Nudging Health Promotion During Early Stages of the COVID-19 Pandemic	7
Health Insurance Status of Adults with Hepatitis in the United States: Implications of Results from the National Health Interview Survey, 2013–2018	6
Health Resources and Services Administration-Funded Health Centers Reduce Health Care Expenditures of California Medicaid Managed Care Beneficiaries with Complex Needs	6
What Is a Center of Excellence?	6
Cost Reduction and Utilization Patterns in a Medicare Accountable Care Organization Using Home-Based Palliative Care Services	6
Correction to: Addressing Social Needs in Clinical Settings: Early Lessons from Accountable Health Communities, by Laura B. Beidler, et al. Popul Health Manag 2023; (vol. 26, no. 5; 283-	6
Medicaid Cost Savings from Provision of Contraception to Beneficiaries in South Carolina, 2012–2018	6
Value-Based Pay-for-Performance Gaps in the Care Delivery Framework for a Large-Scale Health System	6
Health Inequality Among Older Adults with Percutaneous Coronary Intervention and Universal Health Coverage in Japan	6
Impact of COVID-19 on the Quadruple Aim	6
Transitioning from In-Person to Telemedicine Within Primary Care Behavioral Health During COVID-19	6
The Future of Population Health	6
Assessing the Added Value of Blood Pressure Information Derived from Electronic Health Records in Predicting Health Care Cost and Utilization	6
Social Isolation Associated with Future Health Care Utilization	5
The Academic Payvider Model: Commentary	5
Evidence and Implications of the Affordable Care Act for Racial/Ethnic Disparities in Diabetes Health During and Beyond the Pandemic	5
For Profit, but Socially Determined: The Rise of the SDOH Industry	5
Major Economic Losses Associated with Inadequate Control of High Blood Pressure: Time for a Major Change	5
Mistrust, Neighborhood Deprivation, and Telehealth Use in African Americans with Diabetes	5
Impact of Pan-Ethnic Expanded Carrier Screening in Improving Population Health Outcomes: Proceedings from a Multi-Stakeholder Virtual Roundtable Summit, June 25, 2020	5

An Increase in the Use of ICD-10 Z-Codes for Social Risks and Social Needs: 2015 to 2019	5
Challenge of Managing Chronic Kidney Disease: Patient and Caregiver Perspectives	5
Patient Post-discharge Transitions and Inpatient Readmissions Impose Costly Burdens for Employers and Carriers	5
Multisector Partnerships and Service Colocation to Increase Adoption of Influenza Vaccines and Address Food Insecurity	5
Addressing Social Determinants of Health in Family Medicine Practices	5
Neighborhood-level Social Determinants of Health Improve Prediction of Preventable Hospitalization and Emergency Department Visits Beyond Claims History	5
Implementation of E-Consults in an Integrated Health System for a Value Population	5
An Analysis of Ambulance Transport and Out-of-Network Emergency Department Utilization in an Accountable Care Organization	4
Reducing the Emergency Department Revolving Door Syndrome for the Poor, Uninsured, and Chronically Ill Patient in Los Angeles: Process Improvement Recommendations from a County Health Program Evaluati	4
Systematic Review of Care Coordination Interventions Linking Health and Social Services for High-Utilizing Patient Populations	4
Estimating Cost Savings of Care Coordination for Older Adults: Evidence from the Iowa Return to Community Program	4
Addressing Social Needs in Clinical Settings: Early Lessons from Accountable Health Communities	4
Impact of Health Literacy on Medication Adherence Among Black Medicaid Beneficiaries with Hypertension in Delaware: A Cross-Sectional Study	4
The Future of Chronic Disease Management	4
The Minority and Rural Coronavirus Insights Study: Design and Baseline Characteristics of a Minority Cohort	4
Social Determinants of Health and Comorbidities Among Individuals with Atherosclerotic Cardiovascular Disease: The Behavioral Risk Factor Surveillance System Survey	4
Assessing the Relationship Between Behavioral Health Integration and Alcohol-Related Treatment Among Patients with Medicaid	4
Hospital-at-Home: The Good, the Bad, and the Ugly	4
Developing a Strategy to Increase Lung Cancer Screening in Areas of Need	4
Hospital Safety-Net Burden is Associated with Perioperative Outcomes in Primary Total Hip Arthroplasty: A Multistate Retrospective Analysis, 2015–2020	4
Sickle Cell Disease in an Older Adult Population: A Retrospective Review of Health Care Resource Utilization	4
A Path to Risk: Critical Elements of a Structured Approach	4
Letter to the Editor: Public Health Reform Efforts Should More Effectively Engage Public Health Professionals and the General Public	4
Home-Based Primary Care: A Solution for Our Frail Elderly Patients	4
The Unfortunate State of Population Health: Its Omnipresent Promise and Industry's Continued Failure of Vision and Commitment	4