The Health Care Innovation Awards (HCIA) funds 108 initiatives across the country that propose compelling new ideas to further the three-part aim of better care for the individual, better health for populations, and lower costs through improvement of the care delivery process. Eighteen (18) of these initiatives focus on a range of disease-specific models for Medicare, Medicaid, and CHIP beneficiaries. These disease-specific awards target fragile patients living in the community with specific chronic conditions given their costs, prevalence, seriousness, and the potential for improving treatment: Alzheimer's disease and dementia, cancer, cardiovascular disease and stroke, chronic pain, diabetes, end stage renal disease,and pediatric asthma. The Center for Medicare and Medicaid Innovation (CMMI) has asked NORC to evaluate how well this subset of awardees address the needs of these patients and fulfills the three-part aim. CMMI has also asked NORC to provide them, and the awardees, with rapid feedback on how to improve the design and implementation of the initiatives.
Specific goals of the evaluation are to:
- Determine implementation effectiveness--that is, how well the awardees establish and operate their interventions.
- Determine program effectiveness in terms of health outcomes, cost, quality of care (including patient safety), and cross-cutting and subgroup impacts.
- Assess the effectiveness of training programs and the deployment, satisfaction, and performance of health care professionals and direct-service workers in novel or redesigned roles.
- Examine the impact on priority populations in terms of outcomes and cost.
- Identify contextual factors, both endogenous for the awardee and exogenous or environmental, affecting performance.
This evaluation uses a mixed-methods approach, including collection of qualitative and survey data and quantitative analysis of claims data and self-monitoring data where available.
Our quantitative evaluation assesses the relationship between awardee programs and measure of health, quality of care, and health care costs and utilizations using Medicare and/or Medicaid claims. We focus on the following for core measures: all-cause hospitalizations, hospital readmissions, emergency department visits, and cost.