Alexis M. Coulourides Kogan (Photo/Claire Norman)

Alexis M. Coulourides Kogan, PhD, has received the National Institutes of Health (NIH) Pathway to Independence Award (K99/R00) as an outstanding postdoctoral researcher to help her complete the needed mentoring and training to transition to an independent, tenure-track faculty position. This is a highly prestigious award offered to promising individuals at early stages in their career who wish to become independent investigators.

The award is a four-year grant where two years are spent as a postdoc and two years as an assistant tenure-track faculty member. It consists of specific trainings including formal coursework, modified mini-rotations for a non-clinical position, shadowing experiences, close mentoring and conducting a research study.

Career Development Awards (K awards) are one of the most successful NIH programs that have helped launched many productive investigator careers. Over the past five years, K award funding has steadily increased NIH-wide, and in 2011, overall K award success rates were 35 percent across all institutes. Kogan is the first individual to receive one in the Department of Family Medicine at the Keck School of Medicine of USC and also earned a perfect score on her submission (Impact score: 10).

NIH Career Awards foster the independence of promising new investigators by providing mentorship, salary support, and protected time to develop a research program. Researchers who receive K awards have longer careers as principal investigators and are more likely to lead center grants, program project grants, and training grants. Recipients of K awards are also more likely to direct large research projects, and publish more quality articles.

Kogan’s research project will investigate the provider and organizational-level impact of implementing home-based palliative care into fee-for-service primary care as a covered health benefit. This model will be implemented as a newly developed reimbursement stream within Blue Shield of California. A mixed-methods, matched case-control study with theoretical underpinnings will shed light on provider- and organizational-level factors impacting feasibility, barriers, and facilitators to translating reimbursable home-based palliative care into fee-for-service primary care. The goal of the study is to characterize a set of implementation strategies and elicit key mechanisms on how to widely replicate person-centered, reimbursable home-based palliative care in primary care settings across the country. Results of this study hold potential to help reform policy, practice, and payment structures for palliative care.

“This model of care is something that has never been done in fee-for-service, and it is new for us in the department and is a great fit with family medicine,” Kogan said following the notice of her award. “There are currently no financial incentives in fee-for-service to offer this type of care despite compelling evidence from managed care settings showing it is important for patient care. Now as we translate this model into fee-for-service, we need to understand the practitioner’s perspective and investigate the contextual factors at the provider and organizational-level to gain deeper understanding of implementing home-based palliative care and inform widespread replication. This is exactly what my study aims to do.”

Her mentors on this research are: Laura Mosqueda, MD, co-primary mentor and chair and professor of clinical family medicine at the Keck School; Karl Lorenz, MD, MSHS, co-primary mentor and professor at Veteran Affairs Palo Alto and Stanford School of Medicine; Dana Goldman, PhD, Distinguished Professor of Pharmacy, Public Policy, and Economics, and Leonard D. Schaeffer Director’s Chair at the Sol Price School of Public Policy; and Lawrence Palinkas, PhD, Frances L. and Albert G. Feldman Professor of Social Policy and Health Professor of Social Work, Chair, Department of Children, Youth and Families at the USC School of Social Work.

This team constitutes a collaboration across Family Medicine, Social Work, and the Schaeffer Center for Health Policy and Economics at USC, the VA in Palo Alto and Stanford University School of Medicine.

“The awarding of this grant signals that the NIH recognizes the value of palliative care research that holds key implications for policy and most importantly, patient care,” Kogan added. “It also means that they (NIH) trust the scientific community at USC and recognizes what the department brings to the table.”

— Claire Norman