Our Focus Areas
SHADAC provides expertise in qualitative analysis for monitoring and evaluation as a complement to our quantitative expertise. SHADAC researchers conduct process, impact, and outcome evaluations using a variety of qualitative strategies including focus groups, key informant interviews, document review, and data scans.
SHADAC’s qualitative analyses include both standalone qualitative work and qualitative work conducted in an effort to provide detail and insight beyond what is available in an accompanying quantitative analysis.
Recent SHADAC Projects with Qualitative Analyses
Value-Based Payment Reform in the Medicaid Program
Under contract with the Medicaid and CHIP Payment and Access Commission (MACPAC) from 2013 to 2015, SHADAC conducted a synthesis of advanced payment models in four states, which involved site visits to Arkansas, Minnesota, Oregon, and Pennsylvania to better understand payment and delivery reform approaches under Medicaid. SHADAC staff successfully selected sites, developed interview protocols, obtained cooperation from Medicaid programs and stakeholders, conducted site visits and semi-structured interviews, analyzed interview data, and prepared a report entitled "Paying for Value in Medicaid: A A Synthesis of Advanced Payment Models in Four States and debriefing slides summarizing the findings from each state and synthesizing key themes across sites. After MACPAC supported continuation of this project in mid-2014, SHADAC facilitated site visits to three additional states (Connecticut, Maryland, and Oklahoma), monitored state progress in the four states mentioned above, hosted a roundtable of state officials from all seven states to discuss key policy issues, and developed a final report of findings across all activities.
View Julie Sonier's poster presentation, "Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four States," from the 2014 AcademyHealth Annual Research Meeting (ARM)
Behavioral and Physical Health Integration Efforts in the Medicaid Program
In early 2015, under contract with the Medicaid and CHIP Payment and Access Commission (MACPAC), SHADAC conducted a comprehensive 50-state environmental scan to document behavioral and physical health integration efforts within Medicaid programs. SHADAC compiled information about each program’s financing, target populations, regulatory authority, and extent and level of integration. SHADAC’s scan synthesizes descriptive information about core components across the initiatives and addresses key policy questions surrounding integration efforts. Study questions include the following:
- What populations are targeted by physical and behavioral health integration efforts?
- At what level—state, community, provider organization, clinic, clinician—is physical and behavioral health integration occurring and not occurring?
- How does integration of programs and financing at a state level facilitate clinical integration at the point of care for individuals?
- To what extent do existing evaluations of state integrated care programs address outcomes?
- Within unique state purchasing models, markets, and contexts, what strategies are used to: design and oversee vendor contracts and subcontracts, promote collaborative relationships with providers and between payers and providers; facilitate the exchange of data to monitor access to needed care; and align other payers around common goals like integrated care?
- How are integration initiatives that operate under different regulatory authorities (e.g., different waivers, State Plan Amendments (SPA)) alike, and how are they different?
To assess these questions, SHADAC conducted a comprehensive data scan for all states, followed by telephone interviews with officials from a subset of states. The focus was on integration programs that have been implemented or are currently underway that also have strong ties to Medicaid programs and funding.