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Medicaid and the Effective Health Care Program

Medicaid and the Effective Health Care Program. William Lawrence, MD, MS Center for Outcomes and Evidence. Effective Health Care Program. To improve the quality, effectiveness, and efficiency of health care delivered through Medicare, Medicaid, and S-CHIP programs

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Medicaid and the Effective Health Care Program

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  1. Medicaid and the Effective Health Care Program William Lawrence, MD, MS Center for Outcomes and Evidence

  2. Effective Health Care Program • To improve the quality, effectiveness, and efficiency of health care delivered through Medicare, Medicaid, and S-CHIP programs • Focus is on what is known now: ensuring programs benefit from past investments in research and what research gaps are critical to fill • Focus is on clinical effectiveness

  3. Program Infrastructure Translate evidence into improvements (Eisenberg Clinical Decisions & Communications Science Center) Review / compare existing evidence (Evidence Practice Centers) Accelerate practical studies (DEcIDE, CERTs)

  4. Comparative Effectiveness Reviews (CERs) • Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer - 2/5/2008 • Comparative Effectiveness of Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis – 12/17/2007 • Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes – 7/17/2007 • Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression - 1/24/2007 • Efficacy and Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics - 1/17/2007 • Comparative Effectiveness of Management Strategies for Renal Artery Stenosis - 10/24/2006

  5. Comparative Effectiveness Reviews • Concise Executive Summary • Full Report • Available on-line in HTML and PDF Formats Effectivehealthcare.ahrq.gov

  6. Facilitate Informed Transparent Health Care Decisions by: • Patients • Providers • Policymakers Eisenberg Clinical Decisions and Communication Science Center Scientific Evidence Translation Understandable and Usable Information

  7. MMDLN • Learning collaborative of state Medicaid Medical Directors – AHRQ acts as convener • 1st F2F meeting 11/05 – 21 states represented • In person workshops, topic oriented conference calls, web-based discussion forum for common issues • Now 39 states involved, Steering Committee Elected • Key focus on using evidence to support policy

  8. Working with the MMDLN • What are the most salient topics to study? • Long-term more than short-term • When can evidence inform a decision? • Ongoing educational relationships – on both sides • Informed researchers • Informed consumers

  9. Improving Evidence Reports • A core issue in usability of EPC reports – “Partner does not know how to conceptualize and articulate needs, objectives, and specifications of the [statement of work]” • Suggested solution – “Establish an ongoing relationship between partners, EPC, and AHRQ early in the process” Matchar DB et. al. Developing a Methodology for Establishing A Statement of Work For a Policy-Relevant Technical Analysis. January, 2006

  10. Examples • Stakeholder Panel • Priority Conditions List • Topic Development • Translation Products

  11. Important Conditions Affecting Medicare Beneficiaries • FY 04-07 - develop state-of-the-art information about effectiveness of interventions, including prescription drugs: Arthritis and non-traumatic joint disorders Cancer Chronic obstructive pulmonary disease/asthma Dementia, including Alzheimer’s disease Depression and other mood disorders Diabetes mellitus Ischemic heart disease Peptic ulcer/dyspepsia Pneumonia Stroke, including control of hypertension

  12. Priority Conditions – Updated List • Arthritis and non-traumatic joint disorders • Cancer • Cardiovascular disease, including stroke and hypertension • Dementia, including Alzheimer Disease • Depression and other mental health disorders • Developmental delays, attention-deficit hyperactivity disorder and autism • Diabetes Mellitus • Functional limitations and disability • Infectious diseases including HIV/AIDS • Obesity • Peptic ulcer disease and dyspepsia • Pregnancy including pre-term birth • Pulmonary disease/Asthma • Substance abuse

  13. Topic Development Process

  14. Eisenberg Center Publications Clinician Guides Consumer Guides Policy Maker Guides

  15. effectivehealthcare.ahrq.gov

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