Payment Reform Evaluation Project 2

(2013 - 2015)

Overview

This project will perform cross-cutting evaluation of four 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.

The evaluation is oriented to policymakers (at local, state, and federal levels) and leaders in the private sector: employers, labor, health plans, health care providers, and consumer groups.

Grant Period: November 1, 2013 - October 31, 2015

Funder: Robert Wood Johnson Foundation (Grant #71209)

Aims

The primary aim of the evaluation is to draw general lessons by comparing and contrasting implementation processes and intermediate outcomes of the state and regional projects.

The evaluation will:

  • Examine implementation of payment reform projects with differing market environments, resources, implementation strategies, and stakeholders
  • Identify barriers and facilitators to successful value-based payment reforms in differing contexts -- distilling general lessons for national health care policy and practice
  • Combine original qualitative key informant data with existing qualitative and quantitative data to compare and contrast probable effects of specific payment reform projects on utilization, cost, and quality of health services, as well as patient experience and provider satisfaction.

Main Activities

  • Annual site visits to introduce the evaluation team and objectives to major stakeholders, coupled with follow-up key informant phone interviews with stakeholders at each site
  • Creation of an evaluation template for combining data from interviews, surveys, publicly available performance reports, publicly available administrative databases (e.g., from health plan claims), and document review on health services utilization and cost (spending), patient experience, provider satisfaction, quality of health care, and outcomes
  • Form an Advisory Group composed of national experts in payment reform, and convene annually.
  • Analysis of existing data across all sites based on common measures, as appropriate
  • Monthly calls with Robert Wood Johnson Foundation program officers
  • Quarterly conference calls between evaluation team and project site leaders
  • Dissemination of findings:
    • Periodic policy briefs based on project-specific results and cross-cutting lessons from qualitative key informant interviews and analyses of existing aggregate quantitative data from the individual project sites.
    • Peer-reviewed publications in the health services policy, research, and economics literature.
    • Presentations at national policy and research conferences and in other venues
    • Policy and issue briefings to the Foundation.

Methods

The evaluation approach is based on a conceptual framework that refines the Aligning Forces for Quality (AF4Q) Logic Model. Our approach seeks to capture payment reform interventions in addition to the four AF4Q components: consumer engagement, performance measurement and public reporting, quality improvement, and benefit design innovation.

Methods include key informant interviews, document review, qualitative analysis, and inferences from existing quantitative data assembled by the individual project sites.

Sites

California
Pacific Business Group on Health

Oregon
Oregon Primary Care Association

Pennsylvania
UPMC For You, Inc.

Vermont
Green Mountain Care Board

Advisory Group

Larry Casalino, MD, PhD
The Livingston Farrand Professor of Public Health
Cornell University

Michael Chernew, PhD
Harvard Medical School

Carrie H. Colla, PhD
Assistant Professor
The Dartmouth Institute for Health Policy and Clinical Practice

Hector Rodriguez, PhD, MPH
Associate Professor, Health Policy and Management
University of California, Berkeley

Meredith Rosenthal, PhD
Professor of Health Economics and Policy
Harvard University

Dennis Scanlon, PhD
Professor of Health Policy and Administration
The Pennsylvania State University

Leif Solberg, MD
Director of Care Improvement Research
HealthPartners Institute for Education and Research

Stephen Shortell, PhD, MPH, MBA
Blue Cross of California Distinguished Professor of Health Policy and Management
University of California, Berkeley

Site Reports

Access the full Report and the Executive Summary for each site.

For additional information about the Robert Wood Johnson Foundation’s support of this topic, visit its Health Care Payment Reform page.

California

Pittsburgh

Oregon

Vermont

Contacts

Principal Investigator: Douglas Conrad, PhD
dconrad@uw.edu

Co-Investigator: David Grembowski, PhD
grem@uw.edu

Project Manager: Miriam Marcus-Smith, RN, MHA