Mark Diana
Associate Professor & Chair
Biography
Mark Diana is an associate professor, chair of the Department of Health Policy and Management, and Drs. W. C. Tsai and P. T. Kung Professor in Health Systems Management at Tulane University’s School of Public Health and Tropical Medicine. His research focuses on the organizational impact of health information systems, primarily in hospitals in the U.S., and the performance of new care delivery models, such as patient-centered medical homes and accountable care organizations. Most of this work involves the use of large secondary data sets and research at the organizational level. He also has experience in funded evaluation work as the principle investigator (PI) on the external evaluation of the Louisiana Long-term Care Real Choice Systems Transformation Grant, through the Louisiana Department of Health; as the PI for an evaluation of an electronic health record implementation in Mexico, funded by the MEASURE Evaluation project of USAID; and as the PI for the evaluation of the Louisiana Health Information Exchange and the evaluation of Medicaid Expansion in Louisiana, among other projects.
Education
Virginia Commonwealth University
Virginia Commonwealth University
Shenandoah University
Shanandoah University
Accomplishments
The James P. Baker Award, Virginia Society for Respiratory Care
1997
Virginia Commonwealth University Department of Health Administration
2007
James W. Begun Award
Awarded for excellence in doctoral studies in health administration
Articles
Effects of Early Dual-Eligible Special Needs Plans on Health Expenditure.
2018
To determine the relationship between health status and the magnitude of black-white and Hispanic-white disparities in the likelihood of having any office-based or hospital outpatient department visits, as well as number of visits.
Analyzing Determinants of Hospitals' Accountable Care Organizations Participation: A Resource Dependency Theory Perspective
2015
Accountable care organizations (ACOs) are rapidly being implemented across the United States, but little is known about what environmental and organizational factors are associated with hospital participation in ACOs. Using resource dependency theory, this study examines external environmental characteristics and organizational characteristics that relate to hospital participation in Medicare ACOs. Results indicate hospitals operating in more munificent environments (as measured by income per capita: β = 0.00002, p < .05) and more competitive environments (as measured by Health Maintenance Organization penetration: β = 1.86, p < .01) are more likely to participate in ACOs. Organizational characteristics including hospital ownership, health care system membership, electronic health records implementation, hospital type, percentage of Medicaid inpatient discharge, and number of nursing home beds per 1,000 population over 65 are also related to ACO participation. Should the anticipated benefits of ACOs be realized, findings from this study can guide strategies to encourage hospitals that have not gotten involved in ACOs.
Factors related to health information exchange participation and use
2014
This study examines factors facilitating and delaying participation and use of the Health Information Exchange (HIE) in Louisiana. Semi-structured qualitative interviews were conducted with health care representatives throughout the state. Findings suggest that Meaningful Use requirements are a critical factor influencing the decision to participate in the HIE, specifically the mandate that hospitals be able to electronically transfer summary of care documents. Creating buy-in within a few large hospital networks legitimized the HIE and hastened interest in those markets. Fees charged by electronic health record (EHR) vendors to develop HIE interfaces have been prohibitive. Funding from the federal incentive program is intended to offset the costs associated with EHR implementation and increase the likelihood that HIEs can provide value to the population; however, costs and time delays of EHR interface development may be key barriers to fully integrated HIEs. State HIEs may benefit from targeted involvement of state health care leaders who can champion the potential value of the HIE.
Overcoming challenges to achieving meaningful use: insights from hospitals that successfully received Centers for Medicare and Medicaid Services payments in 2011.
2013
In an effort to understand better the federal electronic health record (EHR) incentive programme's challenges, this study compared hospitals that did and did not receive meaningful use (MU) payments in the programme's first year based on the challenges they anticipated a year before.
An assessment of Health Care Information and Management Systems Society and Leapfrog data on computerized provider order entry
2011
To assess the internal consistency and agreement between the Health Care Information and Management Systems Society (HIMSS) and the Leapfrog computerized provider order entry (CPOE) data.
Media Appearances
Morgan Stanley report suggests hundreds of hospitals are at-risk of closure
Louisiana has more hospitals per capita than most states, and rural areas hold a major share of the state’s hospitals, according to University of New Orleans health care economist Walter Lane. Additionally, the state’s rural areas hold a major share of Louisiana’s hospitals, according Mark Diana, Chair of the Department of Global Health Management and Policy of Tulane University’s School of Public Health.
"Probably half of the hospitals in Louisiana , acute care general hospitals are in rural settings and we’re generally a poorer state and so when you combine those two things it’s very difficult for hospitals, when you add the competitiveness it’s hard for them to survive particularly if they’re on their own,” Diana said.
Why is Louisiana’s Healthcare so Bad?
Mark Diana, PhD, chair of Tulane University Department of Global Health Management and Policy, told Healthline that while he’s not happy with the rankings, he’s not surprised by them.
“I think it’s true that it’s fairly consistent that Louisiana ranks near the bottom in most efforts to evaluate the general health of states,” he said. “Typically we go back and forth with Mississippi for 49 and 50.”
“Louisiana is a poor state, and it’s a very rural state,” said Diana. “Those two things tend to go hand in hand, and they also go hand in hand with poorer health outcomes.”
