Domain

Analytic Methods

Type

Conceptual or Process Model/Framework

Theme

effectiveness; population; quality; operations

Start Date

7-6-2014 1:15 PM

End Date

7-6-2014 2:45 PM

Structured Abstract

Purpose: To develop a systematic approach to outcomes assessment of care management programs in health plan settings.

Background: A care management program refers to a regimen of organized activities that are designed to improve health in a targeted population with particular chronic conditions or risk profile. In practice, components of these programs focus on improving the quality of care, advancing health outcomes, and lowering healthcare costs. Although care management programs are an integral part of care continuum for population-based healthcare management, there is no accepted standard model for what constitutes a care management program, which makes comparisons across settings very challenging. Assessment of the comparative effectiveness of care management programs is crucial to their success and sustainability. To address this issue, we developed a care management analysis framework that enables a systematic approach to assessing their effects on clinical outcomes and healthcare services utilization. This approach will be demonstrated in the presentation using a real-world example of maternity care management program for Medicaid beneficiaries.

Innovation: (1) An analytic framework was developed that presents in graphical format the specific questions that need to be answered by the assessment. The framework serves as a roadmap for the assessment. (2) A formal assessment procedure was implemented that includes 9 steps in the following order: assembling an interdisciplinary project team, analyzing program operation process, constructing an analytic framework, formulating study questions, defining outcomes measures and potential covariates, developing analysis plan, collecting and managing data, conducting statistical analysis, disseminating the findings. (3) Practical methods for data collection and management were developed through using multiple data sources, electronic and non-electronic. (4) Useful methods and best practices in other disciplines, such as project management, systematic literature review, clinical trials, and software engineering, were adopted.

Discussion: We have conducted multiple outcomes assessment studies using this systematic approach. This approach allows us not only to objectively assess the clinical and utilization outcomes of care management programs with rigor, but also to identify areas for quality improvement in operation. The lessons that we have learned show that well-formulated study questions and clearly-defined outcome measures are essential for a valid assessment; diligent documentation is indispensable for quality control.

Conclusion: This systematic approach is practical and rigorous for outcomes assessment using operation-based data sources. The next step is to generalize it to care management as well as quality improvement programs in other healthcare settings.

Acknowledgements

This study was funded by Johns Hopkins HealthCare LLC.

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Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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Jun 7th, 1:15 PM Jun 7th, 2:45 PM

A systematic approach to outcomes assessment of care management programs

Purpose: To develop a systematic approach to outcomes assessment of care management programs in health plan settings.

Background: A care management program refers to a regimen of organized activities that are designed to improve health in a targeted population with particular chronic conditions or risk profile. In practice, components of these programs focus on improving the quality of care, advancing health outcomes, and lowering healthcare costs. Although care management programs are an integral part of care continuum for population-based healthcare management, there is no accepted standard model for what constitutes a care management program, which makes comparisons across settings very challenging. Assessment of the comparative effectiveness of care management programs is crucial to their success and sustainability. To address this issue, we developed a care management analysis framework that enables a systematic approach to assessing their effects on clinical outcomes and healthcare services utilization. This approach will be demonstrated in the presentation using a real-world example of maternity care management program for Medicaid beneficiaries.

Innovation: (1) An analytic framework was developed that presents in graphical format the specific questions that need to be answered by the assessment. The framework serves as a roadmap for the assessment. (2) A formal assessment procedure was implemented that includes 9 steps in the following order: assembling an interdisciplinary project team, analyzing program operation process, constructing an analytic framework, formulating study questions, defining outcomes measures and potential covariates, developing analysis plan, collecting and managing data, conducting statistical analysis, disseminating the findings. (3) Practical methods for data collection and management were developed through using multiple data sources, electronic and non-electronic. (4) Useful methods and best practices in other disciplines, such as project management, systematic literature review, clinical trials, and software engineering, were adopted.

Discussion: We have conducted multiple outcomes assessment studies using this systematic approach. This approach allows us not only to objectively assess the clinical and utilization outcomes of care management programs with rigor, but also to identify areas for quality improvement in operation. The lessons that we have learned show that well-formulated study questions and clearly-defined outcome measures are essential for a valid assessment; diligent documentation is indispensable for quality control.

Conclusion: This systematic approach is practical and rigorous for outcomes assessment using operation-based data sources. The next step is to generalize it to care management as well as quality improvement programs in other healthcare settings.