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306136
A pragmatic approach to guide the design of a mixed methods evaluation of a Medicaid 1115(a) waiver: The Texas healthcare transformation and quality improvement program
Wednesday, November 19, 2014
: 8:50 AM - 9:10 AM
Sarah Roper-Coleman, MA
,
Strategic Decision Support, Texas Health and Human Services Commission, Austin, TX
Monica Wendel, Dr.P.H., M.A.
,
School of Rural Public Health, Texas A&M Health Science Center, College Station, TX
Rebecca Wells, PhD
,
Department of Health Policy and Management, Texas A&M Health Science Center School of Rural Public Health, College Station, TX
Tenaya Sunbury, PhD
,
Strategic Decision Support, Texas Health and Human Services Commission, Austin, TX
Angela Cummings, DrPH
,
Strategic Decision Support, Texas Health and Human Services Commission, Austin, TX
In December 2011, Centers for Medicare and Medicaid Services (CMS) approved a five-year 1115(a) demonstration waiver designed to expand Medicaid managed care statewide, restructure the payment system for uncompensated care, and create a Delivery System Reform Incentive Payment (DSRIP) pool to incentivize local health system reform. This presentation describes evaluation plan development. The Texas Health and Human Services Commission and Texas A&M School of Rural Public Health formed a governmental-academic partnership and took a pragmatic approach to design an interdisciplinary mixed methods evaluation. The CMS evaluation requirements guided the development of 11 evaluation goals and 17 research questions from which an evaluation plan was developed. The overall plan consists of mixed methods, specific to each research question, measuring process indicators and intermediate outcomes in a pre/post design. This multi-faceted approach focuses on high impact outcomes at the global level (e.g., quality of care) while operationalizing them as specific outcomes (e.g., hospital admissions among asthmatic children) using validated data sources. Additionally, primary data collection will provide stakeholder perspectives of the Program and determine the extent to which the Program incentivized health system reform and increased collaboration among local organizations. Evaluation of complex programs necessitates collaboration and a pragmatic mixed-methods approach to capture changes at the system and individual levels. Strengths of this evaluation approach include its ability to examine outcomes at both population and health delivery system levels and give valuable feedback to CMS and the state regarding how to evolve these programs in the future.
Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Learning Objectives:
Demonstrate the application of pragmatism to fulfill Centers for Medicare and Medicaid Services (CMS) requirements in the development of a mixed-methods evaluation plan of a statewide 1115(a) Medicaid waiver in Texas.
Discuss the development of a mixed methods evaluation of statewide public health systems innovations.
Keyword(s): Evaluation, Medicaid
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a member of the Strategic Decision Support Evaluation Team at Texas Health and Human Services Commission. I am responsible for evaluation activities of the Texas Healthcare Transformation and Quality Improvement Program (1115(a) Medicaid waiver), including evaluation planning, data analysis and reporting of evaluation results.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
