Description of Research Expertise

I am a general internist and a health services researcher. My research aims to understand variation in the quality of physician (and other prescribing clinician) services to improve care for aging adults with multiple chronic conditions. To this end, I have examined several domains of physician care quality in primary care: timeliness, effectiveness, patient-centeredness, equity, and efficiency. My research agenda requires complex linkages of survey, Medicare claims, and other secondary datasets, and necessary methodological expertise in rigorous quantitative techniques to estimate causal effects using secondary data. I also have expertise in mixed-methods research including primary data collection via surveys of clinicians and interviews with patients and caregivers.


My ongoing work evaluates the role of physician integration within nursing homes in healthcare utilization and functional outcomes of older adults. Using billing data from Medicare, I developed a rich database of clinical information for a cohort of patients that received post-acute care in skilled nursing facilities between 2012 and 2019. I also developed and tested claims-based measures of physician practice organization, including a widely adopted measure of physician specialization in skilled nursing facility-based practice.

Selected Publications

Ryskina KL, Liang J, Ritter A, Spetz J, Barnes H.: State scope of practice restrictions and nurse practitioner practice in nursing homes: 2012-2019 Health Affairs Scholar : 2024.

Tian Y, Shultz K, Ryskina K.: Emergency department visits by older adults receiving postacute care in skilled nursing facilities J Hosp Med : 2023.

Ryskina KL, Geng Z, Raghavan S, Waddell KJ, Burke RE.: Association between Timing of Clinical Evaluation by a Physician or Advanced Practitioner and Risk of Rehospitalization in Older Adults Admitted to a Skilled Nursing Facility Following Hospitalization: A Cohort Study J Am Med Dir Assoc 24 (12): 2023.

Ryskina K, Lo D, Zhang T, Gerlach L, Bynum J, Shireman TI.: Potentially Harmful Medication Prescribing by the Degree of Physician Specialization in Nursing Home Practice: An Observational Study J Am Med Dir Assoc 24 (8): 2023.

Kim S, Brown R, Jung HY, Ryskina KL: Advanced Provider Specialization in Skilled Nursing Facility (SNF)-Based Practice and Functional Outcomes of Post-Acute Care for Older Adults with Dementia Poster presentation at Academy Health Annual Research Meeting, Seattle, WA : 2023.

Tian Y, Ayyappan V, Hemmert K, Myers J, Gitelman Y, Ryskina K.: Potentially avoidable emergency department use by patients discharged to skilled nursing facilities J Hosp Med 18 (6): 2023.

Kim S, Ryskina KL, Jung HY.: Use of Clinicians Who Focus on Nursing Home Care Among US Nursing Homes and Unplanned Rehospitalization JAMA Netw Open 6 : e2318265,2023.

Cohen S, Shultz K, Ryskina KL: Community Detection Based Approach to Defining US Nursing Home Markets. Poster presentation at the Academy Health Annual Research Meeting : 2023.

Tian Y, Shultz K, Ryskina K, Eberly L: ED Visits for Cardiovascular Conditions After Hospital Discharge to Skilled Nursing Facilities J Am Coll Cardiol 81 (S8): 1731,2023.

Aysola J, Ryskina KL.: “Are skilled nursing facility patients getting the specialty care they need?” LDI Blog : 2023.

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Academic Contact Information

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