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School of Public Health

David Grembowski

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In health services research, we want to understand better how our complex health care system works, ultimately to improve its performance and create a system that we can be proud of.
Professor, Health Services
Professor, Oral Health Sciences
Adjunct Professor, Sociology


PhD   University of Washington, 1982   (Urban Planning)
MA   Washington State University, 1975   (Sociology)
BA   Washington State University, 1973   (Sociology)

Contact Info


office:   H-670H, Health Sciences Building

University of Washington
1959 NE Pacific Street
Seattle, WA 98195-7660

campus box:   357660
voice:   206-616-2921
fax:   206-543-3964


David Grembowski serves as Director of the PhD Program in Health Services. Professor Grembowski's evaluation interests address prevention and the performance of health care systems, as well as the social determinants of population health and health inequalities. His studies have examined health care for adults with chronic conditions, efforts to improve quality by increasing access to care in integrated delivery systems; managed care and physician referrals; managed care and patient-physician relationships; cost-effectiveness of preventive services for older adults; fluoridation effects on oral health and dental demand; financial incentives and dentist adoption of preventive technologies; effects of dental insurance on dental demand, and the link between mother and child access to dental care.

Design and performance of health care systems; prevention; technology diffusion; program evaluation; survey research

Conrad DA, Vaughn M, Grembowski D, Marcus-Smith M. Implementing Value-Based Payment Reform: A Conceptual Framework and Case Examples. Med Care Res Rev. 2016 Aug;73(4):437-57. doi: 10.1177/1077558715615774.  PMID: 26545852

Grembowski D, Ralston JD, Anderson ML. Health Outcomes of Population-Based Pharmacy Outreach to Increase Statin Use for Prevention of Cardiovascular Disease in Patients with Diabetes. J Manag Care Spec Pharm. 2016 Aug;22(8):909-17. doi: 10.18553/jmcp.2016.22.8.909.  PMID: 27459653

Wheat CL, Clark-Snustad K, Devine B, Grembowski D, Thornton TA, Ko CW. Worldwide Incidence of Colorectal Cancer, Leukemia, and Lymphoma in Inflammatory Bowel Disease: An Updated Systematic Review and Meta-Analysis. Gastroenterol Res Pract. 2016;2016:1632439. doi: 10.1155/2016/1632439. Epub 2016 May 16. Review.  PMID: 27293427    PMCID: PMC4884856

Hernandez SE, Taylor L, Grembowski D, Reid RJ, Wong E, Nelson KM, Liu CF, Fihn SD, Hebert PL. A First Look at PCMH Implementation for Minority Veterans: Room for Improvement. Med Care. 2016 Mar;54(3):253-61. doi: 10.1097/MLR.0000000000000512.  PMID: 26871643

Helfrich CD, Sylling PW, Gale RC, Mohr DC, Stockdale SE, Joos S, Brown EJ, Grembowski D, Asch SM, Fihn SD, Nelson KM, Meredith LS. The facilitators and barriers associated with implementation of a patient-centered medical home in VHA. Implement Sci. 2016 Feb 24;11(1):24. doi: 10.1186/s13012-016-0386-6.  PMID: 26911135

Chair, dissertation committee for Jeremy Snider
Assessing variation in personal health service delivery and workplace smoking ban enforcement by Local Health Departments

Member, capstone for Ernesto Sosa
Colorectal cancer control program: Measuring and evaluating improvements in colorectal cancer screening

Chair, thesis committee for Daniel Stutman
Time delays on the identification of the need for CPR for limited English proficient 9-1-1 callers

Chair, dissertation committee for Lindsay White
Interpersonal continuity of care in older adults with multiple chronic conditions

Chair, thesis committee for Jen-Ting Yang
Evaluation of the quality improvement project for anesthetic care of stroke codes undergoing endovascular therapy

Chair, dissertation committee for Alison Brenner
Development and assessment of algorithms for delivering tailored or targeted patient decision support in two disease models

Chair, dissertation committee for Charles Cange
A post-conflict assessment of chronic disease in Kuwait

Value-Based Payment Reform and Statewide System Transformation in Vermont
Robert Wood Johnson Foundation
PI:   Grembowski           Dates:    3/1/2016 - 8/31/2016

WWAMI Practice Transformation Network
Centers for Medicare and Medicaid Services (CMS)
PI:   Flum           Dates:    5/1/2015 - 4/30/2019

Northwest Roybal Center: Improving Healthcare for Cognitively Impaired Elders and their Caregivers (NRC)
National Institute on Aging (NIA)
PI:   Teri           Dates:    10/1/2014 - 9/30/2019

Developing a national system to support Public Health Activities and Services Tracking—The PHAST Study
Robert Wood Johnson Foundation
PI:   Bekemeier           Dates:    1/1/2014 - 12/31/2015

Value-Based Payment Reform: Phase II in State and Regional Innovation
Robert Wood Johnson Foundation
PI:   Conrad           Dates:    11/1/2013 - 10/31/2015

Abridged Topic Development of PCORI Research Topics: Improving Health Systems
Oregon Health and Science University (OHSU)
PI:   Carlson           Dates:    9/6/2013 - 9/5/2014

Unhealthy Drinking in Older Adults: 30-day Readmissions and Emergency Care
Agency for Healthcare Research and Quality (AHRQ)
PI:   Grembowski           Dates:    9/1/2013 - 8/31/2014

Data De-identification Services
King County Executive
PI:   Grembowski           Dates:    2/1/2013 - 1/31/2015

Payment Reform Evaluation Project: Lessons from State and Regional Payment Reform

This project, funded by the Robert Wood Johnson Foundation (Douglas Conrad, PI; David Grembowski, Co-PI), will perform cross-cutting evaluation of eight payment reform efforts designed to promote high-value health care outcomes through leveraging existing market knowledge, partnerships and resources in different states and regions of the United States.

Physician Networks and Children with Chronic Conditions

Funded by the Agency for Health Care Research and Quality. For children with asthma or diabetes, the purposes of this study are to examine whether out-of-network benefits and cost-sharing of managed health plans are associated with the likelihood of seeing an in-network vs. out-of-network physician, and secondly, to examine whether health quality and expenditures are similar or different for children seeing in-network vs. out-of-network physicians.

Linking Mother and Child Access to Dental Care

In Washington state's Medicaid population of children aged 3-6 years old, the aim is to determine whether having a mother with a regular source of dental care is associated with greater utilization of dental care and oral health in children in four racial/ethnic groups: White (non-Hispanic), Hispanic, African American, and other groups. Funded by the National Institute of Dental and Craniofacial Research.

Caries Prevention Study

Although new, effective technologies have emerged for controlling caries in children, only a minority of dentists have adopted them. A randomized trial is being conducted to determine whether financial incentives and provider education can increase dentist adoption of these technologies, and in turn, whether adoption results in reduced caries incidence and restorative services among at risk children with capitation dental insurance. Funded by NIDCR and Washington Dental Service.

Improving Access to Improve Quality: Evaluation of an Organizational Innovation

Funded by the Robert Wood Johnson Foundation, the study is an evaluation of Group Health Cooperative's "Access Initiative." This innovation includes offering patients same-day appointments to primary care physicians, allowing them direct access to most specialists, and providing physicians with a $40 million clinical information system that offers up-to-the-minute patient health information. The study will determine how the initiative affects factors such as cost, utilization of services, quality of care, member enrollment, and patient and provider satisfaction.