August 14, 2007

Evaluation of the Medicaid Value Program: Health Supports for Consumers With Chronic Conditions

Mathematica Policy Research, Inc., conducted a review of outcomes of 10 demonstration projects targeted toward Medicaid-eligible adults with multiple chronic conditions. The Medicaid Value Program (MVP) was designed by the Center for Health Care Strategies. It is the first national effort to examine novel approaches to improve care for adults with multiple chronic conditions. The two-year initiative brought together 10 diverse organizations, including health plans, state Medicaid agencies, provider organizations, and others. The study aimed to determine what interventions were being made and the explicit purpose of those interventions, their success or failure in implementation and achieving the desired effects, the reasons behind their successes or failures, and the commonalities among the programs.

The study found that all programs were successfully implemented, although they were not completed as quickly as planned. The grantees noted several sources of program success or failure, including: leadership commitment from the head of the organization; competition or constraint on resources; staff, patient, and provider buy-in; support and leadership by the Medicaid agency; and ability to standardize operations within the program. Most of the organizations continued their initiatives after MVP formally ended; many of these programs also appeared to replicable.

They concluded that MVP was successful in discovering new ways to improve care for adults with chronic conditions. However, the program was unsuccessful in empirical testing of the effectiveness of these new initiatives. Despite this downfall, MVP generally proved itself a prime example of the promise of integrated care across the range of available services (primary care, mental health, substance abuse, and long-term care). Finally, the review suggested investing in resources needed for proper design and evaluation of interventions and advocated multi-site tests of the best interventions in order to help the greatest number of people and subsequently better understand the program impacts.