The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children's Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g., those eligible for Medicare and Medicaid and complex patients) who have unique characteristics or health care needs that could be related to poor outcomes. In addition, the initiative seeks to identify new models of workforce development and deployment, as well as models that can be rapidly deployed and have the promise of sustainability. This report describes a strategy for evaluating the results. The goal for the evaluation design process is to create standardized approaches for answering key questions that can be customized to similar groups of awardees and that allow for rapid and comparable assessment across awardees. The evaluation plan envisions that data collection and analysis will be carried out on three levels: at the level of the individual awardee, at the level of the awardee grouping, and as a summary evaluation that includes all awardees. Key dimensions for the evaluation framework include implementation effectiveness, program effectiveness, workforce issues, impact on priority populations, and context. The ultimate goal is to identify strategies that can be employed widely to lower cost while improving care.

Table of Contents

  • Chapter One

    Background, Evaluation Goals, and Overview

  • Chapter Two

    Strategies for Evaluation at Three Levels

  • Chapter Three

    Evaluation Dimensions, Measures, and Designs

  • Chapter Four

    Summary Evaluation and Decision Strategy

  • Appendix A

    Relationship of Evaluation Dimensions to HCIA Evaluation Questions

  • Appendix B

    Sample Size Requirements for Estimating HCIA Impacts

The research described in this report was sponsored by the Centers for Medicare and Medicaid Services, and was produced within RAND Health, a division of the RAND Corporation.

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