HBHI is pleased to announce six pilot grant awardees for our 2025 cohort.  We sought pilots which advance HBHI’s mission to incubate or accelerate collaborative research within the domains of at least one of the HBHI strategic pillars:

Market competition and healthcare policy

Health delivery performance

Health of populations and health equity

Innovation – health technology and systems

Read about the winning pilots and teams below.  Congratulations on such excellent proposals!

How Often Do Medical Device Manufacturers Engage in “Killer Acquisitions" to Prevent Competition?

PIs: Emmanuel Drabo, PhD, BSPH; Kadija Ferryman, PhD, BSPH; John Jackson, ScD, BSPH;

Co-Is: Katie Hauschildt, PhD, BCPA, JHU/SOM; Theodore Iwashyna, MD, PhD, Bloomberg Distinguished Professor and JHU/SOM

Project Description: 

The objective of this pilot study is to develop a robust and reproducible measurement strategy to classify medical device and/or company acquisitions as potential “killer acquisitions” or not. This classification strategy is a critical step in estimating the welfare impacts of “killer acquisitions” in the medical device market. We will provide robust preliminary findings to support an R01 application investigating the welfare effects of medical device acquisitions, a topic less studied than in pharmaceuticals or software, while developing an analytic approach translatable to government case-finding to identify and remediate anti-competitive behavior.

The Impact of Litigation on Nursing Home Staffing and Quality

PIs: Yaa Owusua Akosa Antwi, PhD, Carey Business School and Karen Shen, PhD, BSPH

Project Description: 

The long-term goal of this project is contribute to the literature nursing home staffing and patient outcomes by providing a comprehensive analysis of how litigation influences staffing and quality across affected nursing homes and nursing homes in its geographic area. Understanding the impact of litigation on staffing and quality of care is important for policymakers and nursing home administrators, seeking to understand the impacts of litigation on the quality of long-term care. For this pilot grant, we are seeking funds to hire research assistants (law students) to construct a database of nursing home litigation in the US and to use one state as a case study to study the impact of negligent and class action lawsuits on staffing and quality of care at nursing homes.

Establishing a High Performing, Financially Sustainable, Transgender Healthcare Delivery Model

PI: Fan Liang, MD, Assistant Professor, JHU/SOM

Co-PIs: Peter Najjar, MD, PhD, Assistant Professor, JHU/SOM; K. Davina Frick, PhD, Carey Business School; Errol Fields, MD, PhD, MPH, Associate Professor, JHU/SOM; Jennifer Parks, MPH, JHHS

Project Description: 

This project seeks to develop a scalable, high-quality, comprehensive model for gender affirming care (GAC), as a foundational step in establishing a comprehensive Transgender Center of Excellence (CoE). There are an estimated 1.6 million transgender and nonbinary (TGNB) adults in the United States1 and the majority of them seek gender-affirming care.2 That said, the delivery of transgender and non-binary healthcare is notably under resourced, understudied, and inconsistent across healthcare systems. We therefore aim to establish a CoE in TGNB health at the Johns Hopkins Hospital & Health System, built on the pillars of clinical, educational, and investigative excellence, while demonstrating financial sustainability. We anticipate that doing so will position the Johns Hopkins Center for Transgender and Gender Expansive Health (CTH) as a leading entity in developing evidence-based standards of care,
and allow for expansion of gender affirming practices nationwide.

Predicting Financial Toxicity in Cancer Patients: Leveraging Real-World Insights

PIs: Leila J. Mady, MD, PhD, MPH, Assistant Professor, JHU/SOM; and Sudip Gupta, PhD, Professor, Carey Business School

Project Description: 

This proposal represents a unique opportunity to leverage large-scale, longitudinal, nationally diverse
regulatory-grade EHR linked to social drivers of health (SDOH), mortality, and claims data to systematically examine the
prevalence of FT and determinants across different demographic, socioeconomic and clinical backgrounds. This data-driven,
multi-disciplinary approach addresses current limitations by moving beyond cross-sectional and intuitionally limited studies. Our proposal aims to develop a predictive risk assessment model for FT, allowing care teams and healthcare systems to proactively identify high-risk patients and tailor financial support interventions. Insights gained from this investigation can provide a foundation for scalable, sustainable, and automated platforms to integrate FT screening into standard oncology care and develop tailored, patient-centered interventions to mitigating the adverse effects of FT. The predictive model will provide foundation to design suitable financial instruments to help mitigate the risk of FT.

Understanding how resources are allocated for language access serving immigrants with limited English proficiency

PI: Ligia Paina, PhD, MHS, Assistant Professor, BSPH

Co-Is: Monica Guerrero Vasquez, MS, MPH, DrPH Candidate, BSPH; Rheanna Platt, MD, MPH, Assistant Professor, JHU/SOM; Christina Yuan, PhD, MPH, BSPH; Christina Love, PsyD, Assistant Professor, JHU/SOM; Katherine Lim, Research Assistant

Project Description:

We propose to build upon the emerging themes arising from recently collected qualitative data for an HBHI pilot examining how health care systems allocate resources to language access services in Baltimore, MD, using JHMI’s health care system as a case study. We are interested in how the broader policy environment creates incentives for language access services and the health systems-level standards and/or practices regarding how many in-person interpreters are hired and deployed, where their presence is prioritized (i.e., what type of service, what type of patient), how much time is contracted with companies that do video/remote interpretation. We are also interested in informing decision-making practices about which type of language access model to utilize (e.g., in-person vs virtual interpretation).

If It Ain’t Broke(r), Don’t Fix it? The Welfare Effects of Intermediation in Employer-Sponsored Insurance

PI: Nicholas Tillipman, PhD, Assistant Professor, Carey Business School

Co-Is: Anran Li, PhD, Assistant Professor, Cornell University; Tong Liu, PhD, MIT; Anthony LoSasso, PhD, DePaul University

Project Description: 

In this project, we document and analyze the effects of a little-understood source of employer
decision-making: health insurance brokers. Almost all employers work with third-party insurance brokers to choose products, indirectly affecting 54% of the US population. For small, constrained employers with highly variable risk pools, brokers may reduce the administrative, hassle, and search
costs of finding an insurance plan. However, these brokers have established (and sometimes
exclusive) contracts with insurance carriers that highly vary in terms of reimbursement rates, thus giving them an incentive to recommend plans that pay higher commissions. We therefore ask how the presence of these third-party intermediaries affect employer choices, insurance access, health plan quality, and prices.