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
The Medicaid and CHIP Payment and Access Commission (MACPAC) and SHADAC conducted site visits in 2013-2014 to a total of seven states—Arkansas, Connecticut, Maryland, Minnesota, Oklahoma, Oregon, and Pennsylvania—to learn about different payment and delivery system reforms aimed at improving value in Medicaid such as shared savings approaches, episode-based payment initiatives, and global budgeting. SHADAC produced an interim report reflecting the cross-state learnings from four of these site visits, entitled “Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four States,” for MACPAC’s Commissioners and Congressional audiences.
Behavioral and Physical Health Integration Efforts in the Medicaid Program
SHADAC is currently serving as a contractor to The Medicaid and CHIP Payment and Access Commission (MACPAC) on a project to document behavioral and physical health integration efforts in Medicaid. Study questions include:
- 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 is conducting a comprehensive data scan for all states, followed by telephone interviews with officials from a subset of states. The focus is on integration programs that have been implemented or are currently underway that also have strong ties to Medicaid programs and funding.