Thomas D'Aunno

Professor of Public Health, NYU School of Global Public Health

Professor of Management, NYU Wagner Graduate School of Public Service

Professional overview

Thomas D'Aunno, Ph.D., is Professor of Management at New York University’s Wagner Graduate School of Public Service and Professor of Public Health at NYU’s School of Global Public Health. His research interests include institutional theory, organizational change, and the performance of healthcare organizations.  D’Aunno was previously a faculty member at Columbia University, the University of Chicago, the University of Michigan, and INSEAD, where he held the Novartis Chair in Healthcare Management. He is published in leading management and health journals, including Administrative Science Quarterly, the Academy of Management Journal, Academy of Management Review, Annals of the Academy of Management, the Journal of the American Medical Association, Milbank Quarterly, American Journal of Public Health and Health Affairs. He served as Editor-in-Chief of Medical Care Research and Review, 2014-2018.  He also is a past chair of the Academy of Management Division of Health Care Management, and a recipient of its Provan Award for distinguished career contributions to research in healthcare management and the Fottler award for distinguished service to the field. 

Education

Ph.D., Organizational Psychology, University of Michigan, Ann Arbor, Michigan

University of Maryland, Community-Clinical Psychology, Baltimore County, Maryland

B.A., Psychology, Magna Cum Laude, University of Notre Dame, Notre Dame, Indiana

Publications

Publications

Telehealth Disparities in Outpatient Substance Use Disorder (SUD) Treatment among Medicaid Beneficiaries during COVID-19

Telehealth Disparities in Outpatient Substance Use Disorder (SUD) Treatment among Medicaid Beneficiaries during COVID-19

Innovation in the Delivery of Behavioral Health Services

Innovation in the Delivery of Behavioral Health Services

Is 70% Achievable? Hospital-Level Variation in Rates of Cardiac Rehabilitation Use Among Medicare Beneficiaries

Lost in transition : A protocol for a retrospective, longitudinal cohort study for addressing challenges in opioid treatment for transition-age adults

AN INTELLECTUAL HISTORY OF INSTITUTIONAL THEORY : LOOKING BACK TO MOVE FORWARD

Clinics Optimizing MEthadone Take-homes for opioid use disorder (COMET) : Protocol for a stepped-wedge randomized trial to facilitate clinic level changes

Connecting government officials & behavioral scientists to promote evidence-based decision-making : An interview with Bill de Blasio

Factors associated with the adoption of evidence-based innovations by substance use disorder treatment organizations : A study of HIV testing

Health Systems and Social Services - A Bridge Too Far?

Internal and Environmental Predictors of Physician Practice Use of Screening and Medications for Opioid Use Disorders

Predicting and responding to change : Perceived environmental uncertainty among substance use disorder treatment programs

Frimpong, J., Guerrero, E. G., Kong, Y., Khachikian, T., Wang, S., D’Aunno, T., D’Aunno, T., & Howard, D. L. (n.d.).

Publication year

2023

Journal title

Journal of Substance Use and Addiction Treatment

Volume

145

10.1016/j.josat.2022.208947

Abstract

Abstract

Introduction: Substance use disorder (SUD) treatment programs offering addiction health services (AHS) must be prepared to adapt to change in their operating environment. These environmental uncertainties may have implications for service delivery, and ultimately patient outcomes. To adapt to a multitude of environmental uncertainties, treatment programs must be prepared to predict and respond to change. Yet, research on treatment programs preparedness for change is sparse. We examined reported difficulties in predicting and responding to changes in the AHS system, and factors associated with these outcomes. Methods: Cross-sectional surveys of SUD treatment programs in the United States in 2014 and 2017. We used linear and ordered logistic regression to examine associations between key independent variables (e.g., program, staff, and client characteristics) and four outcomes, (1) reported difficulties in predicting change, (2) predicting effect of change on organization, (3) responding to change, and (4) predicting changes to make to respond to environmental uncertainties. Data were collected through telephone surveys. Results: The proportion of SUD treatment programs reporting difficulty predicting and responding to changes in the AHS system decreased from 2014 to 2017. However, a considerable proportion still reported difficulty in 2017. We identified that different organizational characteristics are associated with their reported ability to predict or respond to environmental uncertainty. Findings show that predicting change is significantly associated with program characteristics only, while predicting effect of change on organizations is associated with program and staff characteristics. Deciding how to respond to change is associated with program, staff, and client characteristics, while predicting changes to make to respond is associated with staff characteristics only. Conclusions: Although treatment programs reported decreased difficulty predicting and responding to changes, our findings identify program characteristics and attributes that could better position programs with the foresight to more effectively predict and respond to uncertainties. Given resource constraints at multiple levels in treatment programs, this knowledge might help identify and optimize aspects of programs to intervene upon to enhance their adaptability to change. These efforts may positively influences processes or care delivery, and ultimately translate into improvements in patient outcomes.

Variation in Risk-Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations : Implications for Quality Measurement

D’Aunno, T., D’Aunno, T., Chuzi, S., Lindenauer, P. K., Faridi, K., Priya, A., Pekow, P. S., D’aunno, T., Mazor, K. M., Stefan, M. S., Spatz, E. S., Gilstrap, L., Werner, R. M., & Lagu, T. (n.d.).

Publication year

2023

Journal title

Journal of the American Heart Association

Volume

12

Issue

13

10.1161/JAHA.122.029758

Abstract

Abstract

BACKGROUND: Accountable care organizations (ACOs) aim to improve health care quality and reduce costs, including among patients with heart failure (HF). However, variation across ACOs in admission rates for patients with HF and associated factors are not well described. METHODS AND RESULTS: We identified Medicare fee-for-service beneficiaries with HF who were assigned to a Medicare Shared Savings Program ACO in 2017 and survived ≥30 days into 2018. We calculated risk-standardized acute admission rates across ACOs, assigned ACOs to 1 of 3 performance categories, and examined associations between ACO characteristics and performance categories. Among 1 232 222 beneficiaries with HF, 283 795 (mean age, 81 years; 54% women; 86% White; 78% urban) were assigned to 1 of 467 Medicare Shared Savings Program ACOs. Across ACOs, the median risk-standardized acute admission rate was 87 admissions per 100 people, ranging from 61 (minimum) to 109 (maximum) admissions per 100 beneficiaries. Compared to the overall average, 13% of ACOs performed better on risk-standardized acute admission rates, 72% were no different, and 14% performed worse. Most ACOs with better performance had fewer Black beneficiaries and were not hospital affiliated. Most ACOs that performed worse than average were large, located in the Northeast, had a hospital affiliation, and had a lower proportion of primary care providers. CONCLUSIONS: Admissions are common among beneficiaries with HF in ACOs, and there is variation in risk-standardized acute admission rates across ACOs. ACO performance was associated with certain ACO characteristics. Future studies should attempt to elucidate the relationship between ACO structure and characteristics and admission risk.

Efficiency and Arbitrage in Health Services Innovation

Mixed-methods study to examine the response of opioid addiction treatment programmes to COVID-19 : a study protocol

Primary Care Nurse Practitioner Work Environments and Hospitalizations and ED Use Among Chronically Ill Medicare Beneficiaries

The Relationship Between Governing Board Composition and Medicare Shared Savings Program Accountable Care Organizations Outcomes : an Observational Study

D’Aunno, T., D’Aunno, T., Reimold, K. E., Faridi, M. K., Pekow, P. S., Erban, J., Flannelly, C., Luikart, Y., Lindenauer, P. K., DeJong, C., D’Aunno, T., & Lagu, T. (n.d.).

Publication year

2022

Journal title

Journal of general internal medicine

Volume

37

Issue

10

Page(s)

2462-2468

10.1007/s11606-021-07053-4

Abstract

Abstract

Background: Early studies of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) suggested that physician leadership was an important driver of ACO success, but it is unknown whether the demographic and professional composition of current MSSP ACO governing boards is associated with ACOs’ publicly reported outcomes. Objective: To investigate whether governing boards with higher physician participation and greater female involvement have better outcomes. Design: Cross-sectional observational study. Participants: All 2017 MSSP ACOs identified by the Center for Medicare and Medicaid Services ACO Public Use Files (PUF). Main Measures: We collected governing board composition from ACO websites in 2019. Outcome metrics included risk-standardized readmission and unplanned admissions rates. We used descriptive statistics and linear regression models to examine the association between board composition and outcomes. Key Results: Of the 339 ACOs that still existed in 2019 and had available data, 77% had physician-majority boards and 11.5% had no women on their boards. Eighty-nine percent reported a Medicare beneficiary on their board, of which about one-third had a woman representative. The average number of members on MSSP ACO boards was 12, with a mean of 67% physicians and 24% women. Board composition varied minimally by ACO characteristics, such as geographic region, number of beneficiaries, or type of participants. Higher levels of physician participation in ACO governing boards were associated with lower all-cause unplanned admission rates for patients with heart failure (p = − 0.26, p < 0.001) and for patients with multiple chronic conditions (p = − 0.28, p = 0.001). The number of women on the board was not associated with any outcome differences. Conclusions: MSSP ACO governing boards were predominately male and physician-led. Physician involvement may be important for achieving quality goals, while lack of female involvement showcases an opportunity to diversify boards.

Workforce Diversity and disparities in wait time and retention among opioid treatment programs

Critical issues in alliances between management partners and accountable care organizations

INTERPERSONAL RELATIONSHIPS, DYNAMIC REINFORCEMENT, AND ALLIANCE PERFORMANCE : A CASE STUDY FROM HEALTH CARE

INTERPERSONAL RELATIONSHIPS, DYNAMIC REINFORCEMENT, AND ALLIANCE PERFORMANCE : A CASE STUDY FROM HEALTH CARE

Methodology for a six-state survey of primary care nurse practitioners

Bundling Rapid Human Immunodeficiency Virus and Hepatitis C Virus Testing to Increase Receipt of Test Results : A Randomized Trial

Editors’ note