Domain of Focus. The Evaluation Design must, at a minimum, address the research questions/topics listed below and the goals of the demonstration as outlined in Section I of the STCs. For questions that cover broad subject areas, the state may propose a more narrow focus of the evaluation.
i. What is the impact of the managed care expansion on access to care, the quality, efficiency, and coordination of care, and the cost of care, for each demonstration population or relevant population group?
ii. What is the impact of including LTSS in the capitated managed care benefit, with a sub-focus on the inclusion of HCBS in capitated managed care?
iii. How did the Ombudsman’s program assist the KanCare program and its beneficiaries?
iv. What did the state learn from the ID/DD Pilot Project that could assist the state in moving ID/DD HCBS services into managed care?
v. How did the UC Pool impact care under Medicaid in the state?
vi. An assessment of the impact of DSRIP payments to participating providers, including:
1. Were the participating hospitals able to show statistically significant improvements on measures within Categories 1 through 3 related to the goals of the three part aim as discussed in STC 69?
2. Were the participating hospitals able to show improvements on measures within Category 4 related to the goals of the three part aim as discussed in STC 69?
3. What is the impact of health care delivery system and access reform measures on the quality of care delivered by participating providers?
4. What is the impact of DSRIP on managing short and long term per- capita costs of health care?
5. How did the amount paid in incentives compare with the amount of improvement achieved?
Domain of Focus. The Evaluation Design must, at a minimum, address the research questions/topics listed below and the goals of the demonstration as outlined in Section I of the STCs. For questions that cover broad subject areas, the state may propose a more narrow focus of the evaluation.
i. The impact of rebalancing the LTC system in favor of HCBS;
ii. The costs and benefits of providing early intervention for individuals with, or at-risk, for having LTC needs; and
iii. The cost-effectiveness and efficiency of DSHP-Plus in ensuring that appropriate health care services are provided in an effective and coordinated fashion.
Domain of Focus. The Evaluation Design must, at a minimum, address the research questions/topics listed below and the goals of the demonstration as outlined in Section I of the STCs. For questions that cover broad subject areas, the state may propose a more narrow focus of the evaluation.
i. The impact of rebalancing the LTC system in favor of HCBS;
ii. The costs and benefits of providing early intervention for individuals with, or at-risk, for having LTC needs;
iii. The cost-effectiveness and efficiency of DSHP-Plus in ensuring that appropriate health care services are provided in an effective and coordinated fashion;
iv. Effectiveness of the coordination of the MCO and DSAMH case managers, as well as the services provided by the MCO with the enhanced behavioral health services provided by PROMISE; and
v. The extent to which the PROMISE services improve the overall health status and quality of life of the individuals enrolled in PROMISE.
vi. The extent to which including former xxxxxx care youth who “aged out” of xxxxxx care in a different state increases and strengthens overall coverage for former xxxxxx care youth and improves health outcomes for these youth.
Domain of Focus. The Evaluation Design must, at a minimum, address the research questions/topics listed below and the goals of the demonstration as outlined in Section II of the STCs. For questions that cover broad subject areas, the state may propose a more narrow focus for the evaluation.
i. The impact of the demonstration in covering the uninsured in the County, including the estimated numbers of eligible uninsured individuals who did and did not enroll in the demonstration;
ii. The number of demonstration-enrolled individuals accessing health care services in comparison to the number of demonstration eligibles in need of services;
iii. The state must address the following evaluation questions and topics in the draft evaluation plan:
1. How has the demonstration bridged the gap in Medicaid coverage in the low income population;
2. How has the demonstration addressed unmet healthcare needs and provided a regular source of coordinated care for enrollees;
3. How has the demonstration influenced health seeking behavior in a manner that could help manage costs;
4. How has the demonstration informed the state’s progress in understanding the service utilization and costs of the uninsured;
5. How effective have the PCMHs been in providing high-quality, coordinated care? (The state must propose quality measures that would be used to evaluate the effectiveness of the PCMHs);
6. What is the impact on enrollment of eligible individuals of using alternate methods, other than through electronic data matches, for verifying social security numbers and income?
iv. The limitations, challenges, opportunities and best practices in provider capacity and care delivery for the demonstration population.
v. An analysis of service utilization and trends identified over time;
vi. The decrease in uncompensated care provided by hospitals and federally qualified health centers (FQHCs) serving individuals who would have received discounted medical services through the MetroHealth in the absence of the demonstration;
vii. The number of demonstration-enrolled individuals who would have received discounted medical services through MetroHealth participating hospitals and FQHCs in the absence of the demonstration;
viii. The cost-effectiveness and efficiency of the demonstration program in ensuring that appropriate health care services are provided in a cost-effective and coordinated fashion;
ix. Provider network capacity to serve the health care needs of the demonstration population; and
x. Trends in bene...
