Genevra Murray
Genevra Murray
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Assistant Professor of Public Health Policy and Management
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Professional overview
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Genevra F. Murray, PhD is an Assistant Professor in the Department of Public Health Policy and Management. Her research and teaching focus is on the organization and management of health care services, examining the organizational dimensions of payment and delivery system reform and its impact on racial, ethnic and socioeconomic disparities.
Dr. Murray’s current projects are focused on primary care delivery, with an emphasis on the health care safety net; the social determinants of health, particularly the integration of social services and medical care; advance care planning and palliative care integration; and global health systems and governance, particularly related to sexual and reproductive health care. She uses a mix of research methods with expertise in longitudinal qualitative methods.
Prior to joining the faculty at GPH, Dr. Murray was a fellow at Boston Medical Center and a research scientist at The Dartmouth Institute for Health Policy and Clinical Practice. She has published in leading journals such as Health Affairs, Milbank Quarterly and Health Care Management Review.
Dr. Murray received her PhD in medical anthropology from the University of Pennsylvania, having graduated from there summa cum laude with a BA in anthropology.
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Education
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PhD Anthropology, University of PennsylvaniaBA Anthropology, University of Pennsylvania
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Honors and awards
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Ruth L. Kirschstein National Research Service Award Recipient (202020212022)Fulbright Scholar (20052006)William Penn Fellowship (2002200320042005)Summa Cum Laude, University of Pennsylvania (2001)Phi Beta Kappa, University of Pennsylvania (2001)Valedictorian, Department of Anthropology, University of Pennsylvania (2001)
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Publications
Publications
Advancing equity in challenging times: A qualitative study of telehealth expansion and changing patient–provider relationships in primary care settings during the COVID-19 pandemic
AbstractAijaz, M., Lewis, V. A., & Murray, G. F. (n.d.).Publication year
2024Journal title
Digital HealthVolume
10AbstractObjective: The patient–provider relationship is critical for achieving high-quality care and better health outcomes. During the COVID-19 pandemic, primary care practices rapidly transitioned to telehealth. While telehealth provided critical access to services for many, not all patients could optimally utilize it, raising concerns about its potential to exacerbate inequities in patient–provider relationships. We investigated technical and workforce-related barriers to accessing telehealth and the impacts on patient–provider relationships for vulnerable populations. Methods: Qualitative, semi-structured interviews from May 2021 to August 2021 with 31 individuals (medical directors, physicians, and medical assistants) working at 20 primary care practices in Massachusetts, North Carolina, and Texas. Thematic analysis to better understand how barriers to using telehealth complicated patient–provider relationships. Results: Interviewees shared challenges for providers and patients that had a negative effect on patient–provider relationships, particularly for vulnerable patients, including older adults, lower socio-economic status patients, and those with limited English proficiency. Providers faced logistical challenges and disruptions in team-based care, reducing care coordination. Patients experienced technological challenges that made accessing and engaging in telehealth difficult. Interviewees shared challenges for patient–provider relationships as commonly used telephone-only telehealth reduced channels for non-verbal communication. Conclusion: This study indicates that barriers to virtual interaction with patients compared to in-person care likely led to weaker personal relationships that may have longer-term effects on engagement with and trust in the healthcare system, particularly among vulnerable patient groups. Additional support and resources should be available to primary care providers to optimize telehealth utilization.Enrollment Patterns of Medicare Advantage Beneficiaries by Dental, Vision, and Hearing Benefits
AbstractGupta, A., Silver, D., Meyers, D. J., Murray, G., Glied, S., & Pagán, J. A. (n.d.).Publication year
2024Journal title
JAMA Health ForumVolume
5Issue
1Page(s)
E234936AbstractImportance: Most Medicare beneficiaries now choose to enroll in Medicare Advantage (MA) plans. Racial and ethnic minority group and low-income beneficiaries are increasingly enrolling in MA plans. Objective: To examine whether dental, vision, and hearing supplemental benefits offered in MA plans are associated with the plan choices of traditionally underserved Medicare beneficiaries. Design, Setting, and Participants: This exploratory observational cross-sectional study used data from the 2018 to 2020 Medicare Current Beneficiary Survey linked to MA plan benefits. The nationally representative sample comprised primarily community-dwelling MA beneficiaries enrolled in general enrollment MA plans. Data analysis was performed between April and October 2023. Exposures: Beneficiary self-identified race and ethnicity and combined individual and spouse income and educational attainment. Main Outcomes and Measures: Binary indicators were developed to determine whether beneficiaries were enrolled in a plan offering any dental, comprehensive dental, any vision, eyewear, any hearing, or hearing aid benefit. Mixed-effects logistic regression models were estimated to report average marginal effects adjusted for beneficiary-level demographic and health characteristics, plan attributes, and plan availability. Results: This study included 8139 (weighted N = 31 million) eligible MA beneficiaries, with a mean (SD) age of 77.7 (7.5) years. More than half of beneficiaries (54.9%) were women; 9.8% self-identified as Black, 2.0% as Hispanic, 83.9% as White, and 4.2% as other or multiple races or ethnicities. Plan choices by dental benefits were examined among 7516 beneficiaries who were not enrolled in any dental standalone plan, by vision benefits for 8026 beneficiaries not enrolled in any vision standalone plan, and by hearing benefits for 8131 beneficiaries not enrolled in any hearing standalone plan. Black beneficiaries were more likely to enroll in plans with any dental benefit (9.0 percentage points [95% CI, 3.4-14.4]; P <.001), any comprehensive dental benefit (11.2 percentage points [95% CI, 5.7-16.7]; P <.001), any eye benefit (3.0 percentage points [95% CI, 1.0 to 5.0]; P =.004), or any eyewear benefit (6.0 percentage points [95% CI, 0.6-11.5]; P =.03) compared with White beneficiaries. Lower-income individuals (earning ≤200% of the federal poverty level) were more likely to enroll in a plan with a comprehensive dental benefit (4.4 percentage-point difference [95% CI, 0.1-7.9]; P =.01) compared with higher-income beneficiaries. Beneficiaries without a college degree were more likely to enroll in a plan with a comprehensive dental benefit (4.7 percentage-point difference [95% CI, 1.4-8.0]; P =.005) compared with those with higher educational attainment. Conclusions and Relevance: The results of this study suggest that racial and ethnic minority individuals and those with lower income or educational attainment are more likely to choose MA plans with dental or vision benefits. As the federal government prepares to adjust MA plan star ratings for health equity, implements MA payment cuts, and allows increasing flexibility in supplemental benefit offerings, these findings may inform benefit monitoring for MA.."I'm in My Feelings Now": Examination of Advance Care Planning Video Declarations by People with Advanced Cancer from a Safety Net Hospital
A Decade of ACOs in Medicare: Have They Delivered on Their Promise?
Evaluating a social risk screening and referral program in an urban safety-net hospital emergency department
Problematic Integration: Racial Discordance in End-of-Life Decision Making
Structural Barriers to Well-grounded Advance Care Planning for the Seriously Ill: a Qualitative Study of Clinicians’ and Administrators’ Experiences During a Pragmatic Trial
Structure and integration of specialty palliative care in three NCI-designated cancer centers: a mixed methods case study
Cross-Sector Strategic Alliances Between Health Care Organizations and Community-Based Organizations: Marrying Theory and Practice
Screening for Social Risk at Federally Qualified Health Centers: A National Study
Survey of Information Exchange and Advanced Use of Other Health Information Technology in Primary Care Settings Capabilities In and Outside of the Safety Net
Systemic Therapy Decision Making in Advanced Cancer: A Qualitative Analysis of Patient-Oncologist Encounters
Actual and Missed Opportunities for End-of-Life Care Discussions with Oncology Patients: A Qualitative Study
Avoiding medicaid: Characteristics of primary care practices with no medicaid revenue
Critical issues in alliances between management partners and accountable care organizations
FQHC Designation and Safety Net Patient Revenue Associated with Primary Care Practice Capabilities for Access and Quality
Role of norms in variation in cancer centers' end-of-life quality: Qualitative case study protocol
The Role of Value-Based Payment in Promoting Innovation to Address Social Risks: A Cross-Sectional Study of Social Risk Screening by US Physicians
Upstream with a small paddle: How acos are working against the current to meet patients’ social needs
Care Transformation Strategies and Approaches of Accountable Care Organizations
Prevalence of Screening for Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence by US Physician Practices and Hospitals
Trust, Money, and Power: Life Cycle Dynamics in Alliances Between Management Partners and Accountable Care Organizations
Mask use, hand hygiene, and seasonal influenza-like illness among young adults: A randomized intervention trial
More than just a communication medium: What older adults say about television and depression
A mixed-methods approach to understanding loneliness and depression in older adults