The Business Case for Quality, Phase 2

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In the first phase, the investigators worked with 10 Medicaid managed care organizations to launch quality improvement interventions and determine whether the investment could generate net financial savings. Initial findings indicate that the strongest potential for a short-term return on investment lies in those interventions that focus on patients who use the most services and on conditions that account for a high share of hospital claims. For this next phase, five state-based teams will be chosen to design and implement larger-scale, evidence-based quality improvement initiatives that target high-cost, high-risk patients (asthma or congestive heart failure) and would be applicable to commercially insured populations. The results will aid policymakers in developing reforms that align financial incentives with high-quality care across multiple stakeholders. The Robert Wood Johnson Foundation will provide cofunding. The Fund may be asked to support a third and final phase.

Grant Details

Grantee Organization:
Center for Health Care Strategies, Inc.
Principal Investigator:
Melanie Bella, M.B.A., and Stephen A. Somers, Ph.D.
Award Amount:
$199,429.00
Approval Date:
July 10, 2007

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