VISIT STATE HEALTH COMPARE
Publication
Health Care Utilization and Cost Impacts of Delivery System Innovations: An Updated Review of the Evidence
This issue brief provides an updated review of the evidence about the impacts of delivery system interventions with a focus on outcomes related to health care utilization and costs. The original issue brief was provided in the fall of 2013 to recipients grant funding from the federal State Innovation Models (SIM) initiative. Since that time, the volume of research on the topic areas covered in the original brief has increased significantgly: The 2013 version of the brief included 38 sources; the revised version includes findings from 131 sources. An evidence review table accompanying the brief provides a scan of the evidence from these sources and is sortable by type of intervention, care setting, disease/condition, payer, age, and study duration.
Download a PDF of the brief, or download the evidence review table (Excel).
This brief was prepared by SHADAC for the State Innovation Models (SIM) pgorgram under contract with NORC at the University of Chicago. SIM is funded by the Center for Medicare and Medicaid Innovation (CMMI).
Blog & News
Call for Proposals for SHARE Grant Funding
May 12, 2017:Proposal Deadline: June 1, 2016 (3:00 p.m. ET)
The Robert Wood Johnson Foundation (RWJF) is soliciting proposals to fund studies of state-level health reform through the State Health Access Reform Evaluation (SHARE) grant program.
Background
States have played and continue to play a critical role in the implementation of health reform. States have made different choices in the roll out of the ACA, including whether to establish a State-Based Marketplace, use a Federal-State Partnership Model, or participate in the Federally-Facilitated Marketplace. States have also made different decisions regarding Medicaid expansion, with several states opting to implement an early (pre-2014) expansion for adults without dependent children, some states expanding in 2014, and several states negotiating unique Medicaid expansion approaches post-2014. Further, some states are experimenting with new payment and delivery systems that integrate health care services, and exploring opportunities to bridge health and social sectors to improve population health.
Under a new SHARE call for proposals, RWJF seeks to fund timely, policy-relevant studies with strong empirical designs to improve the collective understanding of health reform at the state level and to inform policy and the reform implementation process. Eligible studies may be of a single state or a group of states, or they maybe be national analyses that use state-level data.
Proposals could focus on a broad range of topics, including state insurance market regulation and/or the potential use of 1332 waivers to expand coverage; Medicaid policy, including expansion or waivers; and payment and delivery system reforms including efforts to control health care costs, improve competition, and/or promote transparency.
How much funding is available?
Up to $1.3 million will be available under this solicitation to accommodate eight to 12 studies, with individual project funding ranging from $50,000 to $150,000. Studies can be six to 12 months in length, but preference will be given to rapid-turnaround projects that can be completed within six months.
Who can apply?
Researchers, as well as practitioners and public and private policy-makers working with researchers, are eligible to submit proposals through their organizations. Projects may be generated from disciplines including health services research, economics, sociology, program evaluation, political science, public policy, public health, public administration, law, business administration, or other related fields.
When is the submission deadline?
The deadline to submit proposals under this call is June 1, 2016, at 3:00 p.m. ET.
Where can I learn more?
Click here to access the full call for proposals, with details about potential research questions, eligibility and selection criteria, and the application process. For a list of previously funded SHARE projects, publications, lessons learned, and policy impacts click here.
State Health Access Reform Evaluation (SHARE) is a national program of the Robert Wood Johnson Foundation that supports rigorous research on issues surrounding state health reform. The SHARE program is managed by the State Health Access Data Assistance Center (SHADAC), an RWJF-funded research center in the Division of Health Policy and Management, School of Public Health, University of Minnesota. Staff at AcademyHealth are conducting the call for proposals and the proposal review process, and staff at SHADAC will monitor the awarded grants and assist grantees with the translation, promotion, and dissemination of research findings.
Blog & News
SHARE Research in Health Affairs: Value-Based Insurance Design Influenced Consumer Behavior in Connecticut
October 03, 2018:In the April 2016 issue of Health Affairs, SHARE grantee Richard Hirth and his research team published findings on the effectiveness of a value-based insurance design (V-BID) program for Connecticut state employees. The SHARE-supported analysis focuses on the effects of Connecticut’s Health Enhancement Program (HEP), which is a voluntary program for state employees that incorporates V-BID principles by encouraging consumers to utilize high-value medical services. The authors found that among HEP enrollees relative to comparison groups the use of targeted services and adherence to medications for chronic conditions increased, while emergency department use decreased over a two-year time period.
Learn more at the Health Affairs briefing on Patients’ and Consumers’ Use of Evidence in Washington, D.C., on Thursday, April 7th at 9:00 a.m. ET. Use #patientevidence to follow University of Michigan V-BID Center Director Dr. Mark Fendrick’s discussion of the paper.
Blog & News
Engaging Commercial Payers on Multipayer Alignment
March 29, 2016:Engaging with commercial payers is a critical component of achieving multipayer alignment in payment and delivery system initiatives. A new issue brief produced by SHADAC outlines several key recommendations for states as they work to engage commercial payers. These include:
- • Recognize the other challenges that commercial payers are facing;
- • Focus on shared big picture objectives rather than alignment at a very detailed level;
- • Recognize that multipayer alignment and delivery system reform are long-term processes that require long-term commitments;
- • Developing clear definitions of success;
- • Strive for consistency while retaining flexibility for experimentation and innovation;
- • Understand that commercial payers may be resistant to some of the types of changes states are seeking.
This brief was produced by SHADAC with support from the Center for Medicare & Medicaid Innovation (the Innovation Center). SHADAC is part of a team led by NORC at the University of Chicago that serves as the State Innovation Model Resource Support Contractor. CHCS, SHADAC, and other technical assistance partners support states and the Innovation Center in designing and testing multi-payer health system transformation approaches.
Publication
Engaging Commercial Payers on Multipayer Alignment: Key Issues for SIM States
This brief provides some tips to states on how to productively engage with private payers on the goal of achieving multipayer alignment in payment reform and delivery system reform initiatives. In some states, Medicaid has been a very proactive purchaser and driver of delivery system reform, and is seeking ways to encourage commercial payers to follow this lead; in others, it is the commercial sector that has been more active in driving reform and Medicaid programs are trying to figure out how to implement reforms that align with existing private initiatives. In both cases, it will be necessary to foster an open and robust dialogue between states and commercial payers on where alignment is desired and how best to achieve it.
The key considerations for states include recognizing the other challenges that commercial payers are facing; focusing on shared big picture objectives rather than alignment at a very detailed level; recognizing that multipayer alignment and delivery system reform are long-term processes that require long-term commitments; having clear definitions of success; striving for consistency while retaining flexibility for experimentation and innovation; and understanding that commercial payers may be resistant to some of the types of changes states are seeking. Each of these factors is described in more detail below. The brief concludes with a list of key “do’s and don’ts” for engaging commercial payers.
