Monitoring and Evaluating Medicaid Fee-for-Service Care Management Programs

User's Guide, Final Contract Report

This User's Guide is intended to help policymakers and others understand the evidence, methodology, and issues related to evaluating the costs, quality and impact of care management programs. It was prepared by AcademyHealth for the Agency for Healthcare Research and Quality (AHRQ) under Contract No. 290-04-0001.

Prepared by Sharon B. Arnold, Ph.D.; Amanda Folsom, M.P.H.; and Emily Bosk 

Contents

Disclaimer and Copyright Information
Foreword
Chapter 1. Introduction to Care Management Programs
   Background
   Promises of Care Management
   Importance of Evaluating Care Management
Chapter 2. Getting Started
   Action Step 1. Identify Core Program Goals and Evaluation Questions
   Action Step 2. Identify Which Data You Need and Which Data Are Available
   Action Step 3. Establish an Evaluation Timeframe
   Action Step 4. Determine How Much Funding Is Available
   Action Step 5. Select Evaluators
Chapter 3. Evaluation
   Action Step 1. Select a Reference Group or Groups
   Action Step 2. Structure the Evaluation
   Action Step 3. Select Analytic Methods
   Action Step 4. Identify and Address Potential Confounding
   Action Step 5. Select Measures
   Action Step 6. Identify and Address Data Issues
   Action Step 7. Consider Sample Size
Chapter 4. Presenting Your Findings
   Action Step 1. Analyze Your Audience and Your Objective
   Action Step 2. Develop a Dissemination Strategy
   Action Step 3. Make the Case
   Action Step 4. Translate the Data
Chapter 5. Conclusions and Future Implications
   How States Have Used Their Evaluations
   Continued Evaluation Is Necessary for the Evolution of CM Programs
References
Acknowledgements
Appendixes
Appendix 1: Example Measures for Evaluating the Impact of Medicaid Care Management
Appendix 2: Glossary of Evaluation Terms
Appendix 3: Additional Resources 

Disclaimer and Copyright Information

The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of copyright holders.