Clients: Policy Analysis and Evaluation
Bailit Health has assisted over 150 clients since 1997 to improve methods for purchasing or regulating health and human services. A partial listing of these clients can be found below, as well as examples of the types of work that we have conducted for them.
Medicaid and CHIP Payment and Access Commission (MACPAC)
Client
Integrated Care of Kids (InCK)
Challenge
The Centers for Medicare & Medicaid Services (CMS), through their Center for Medicare and Medicaid Innovation, funded seven award recipients for nine years to implement and operate the Integrated Care for Kids (InCK) Model. The InCK Model aims to improve the integration of health and health-related services and address unmet needs for Medicaid beneficiaries (ages 0 – 20). Other goals of the model include reducing Medicaid expenditures and avoidable out-of-home placements. Abt was hired by CMS to evaluate the implementation of this program and Bailit works on this project as a subcontractor to Abt for the implementation evaluation of awardees in two states, Ohio and New Jersey.
Response
In the role of evaluator on the Abt implementation team, Bailit Health has performed many functions to support data collection for this project, including developing interview protocols, arranging and conducting numerous interviews, both virtual and in-person during a site visit. These interviews included the award recipient's lead organization, their key partners, community-based organizations, the Medicaid agency, providers and some beneficiaries. Bailit Health has also developed evaluation case studies resulting from the virtual and in-person site visits for the Ohio and New Jersey award recipients which are part of Abt’s evaluation reports to CMS-Integrated Care for Kids (InCK) Model | CMS. Other activities include reviewing routine quarterly reports submitted by the award recipients, report data extraction and analysis, and listening in to monthly calls with the award recipients and CMS project officer.
Client
Medicaid and CHIP Payment and Access Commission (MACPAC)
Challenge
MACPAC, the independent source of information on Medicaid and CHIP, sought assistance to examine the External Quality Review (EQR) process that state Medicaid programs must implement, including contracting with external quality review organizations (EQROs), to better understand how states are using existing tools to hold managed care plans accountable for outcomes and assess the need for additional federal guidance or flexibility.
Response
Bailit Health conducted a policy review of EQR-related federal rules and guidance, supplemented by a state-level environmental scan of EQR approaches. As a result of the environmental scan and Bailit Health´s experience working with Medicaid managed care states, Bailit Health recommended states for a more in-depth analysis of EQR-related activities and data and conducted semi-structured interviews with these states and other stakeholders, including representatives from the Centers for Medicare & Medicaid, EQROs, managed care organizations, consumer advocacy organizations, and national experts, to obtain their perspectives on key issues. Bailit Health´s policy research and analysis culminated in a comprehensive final report that summarized key findings and conclusions regarding MACPAC´s policy questions of interest and included short profiles of the states selected for an in-depth analysis. MACPAC used these findings to update the Commission and gain their input on future policy considerations.
