Table of Contents
HCIA Disease-Specific Evaluation
Disease-Specific Awardees
Table of Contents
List of Exhibits
Executive Summary
Evaluation Goals and Methods
Conclusion
Introduction
Disease-Specific Innovation Awards
Data Sources and Methods
Qualitative Data and Methods
Quantitative Data and Methods
Implementation Effectiveness
Program Effectiveness
Overview of Qualitative Findings
Overview of Quantitative Findings
Awardee Specific Chapters
Awardee-Specific Findings
Christiana Care Health System
Introduction
Summative Findings of Program Effectiveness
Subgroup Analysis: Ramp-up Period
Qualitative Findings
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Duke University/Southeastern Diabetes Initiative
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Cross-Site Variation
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
FirstVitals Health and Wellness, Inc.
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Cross-Site Variation
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
The George Washington University
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Health Resources in Action
Introduction
Summative Findings of Program Effectiveness
Subgroup Analysis: Race and Ethnicity
Qualitative Findings
Cross-Site Variation
Workforce
Context
Sustainability, Scalability, and Spread
Planned Analyses for the No-Cost-Extension Period
Limitations
Conclusion and Policy Implications
Trustees of Indiana University
Introduction
Summative Findings of Program Effectiveness
Condition-specific Impact Estimates
Long-term Care Placement Analysis
Qualitative Findings
Cross-Site Variation
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Innovative Oncology Business Solutions, Inc.
Introduction
Summative Findings of Program Effectiveness
Cross-Site Variation
Subgroup Analysis: Cancer Type
Subgroup Analysis: End of Life
Qualitative Findings
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Joslin Diabetes Center, Inc.
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Workforce
Context
Sustainability, Replicability, and Spread
Limitations
Conclusion and Policy Implications
Le Bonheur Community Health and Well-Being
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Patient Experiences
Clinic
Home
Community
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Mountain Area Health Education Center, Inc.
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Cross-Site Variation
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Nemours Children’s Health System of Nemours Foundation
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Patient Experience
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Ochsner Clinic Foundation
Introduction
Summative Findings of Program Effectiveness
Subgroup Analysis: High-Risk
Subgroup Analysis: Stroke Mobile
Qualitative Findings
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
University of Alabama at Birmingham
Introduction
Summative Findings of Program Effectiveness
Cross-Site Variation
Subgroup Analysis: Cancer Type
Subgroup Analysis: End of Life
Qualitative Findings
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Regents of the University of California, Los Angeles
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Trustees of the University of Pennsylvania
Introduction
Summative Findings of Program Effectiveness
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Upper San Juan Health Service District
Introduction
Summative Findings of Program Effectiveness
Qualitative Findings
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusions and Policy Implications
The Rector and Visitors of the University of Virginia
Introduction
End-of-Life Analysis
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Vanderbilt University Medical Center
Introduction
Summative Findings of Program Effectiveness
Transitions Care Coordination Program
Outpatient Chronic Care Management Program
Qualitative Findings
Cross-Site Variation
Workforce
Context
Sustainability, Scalability, and Spread
Limitations
Conclusion and Policy Implications
Cross-Awardee Findings
Innovation in Care Coordination
Care Coordination Models
Care Coordination: Composition of Teams and Activities, and Evidence of Program Effectiveness
Descriptions of Care Coordination Teams
Care Coordination and Program Effectiveness
Limitations
Summary
Decreased Utilization and Improved Quality of Life for Pediatric Asthma Patients and Families
Research Questions
Data Sources
Program Components and Program Populations
Program Effectiveness
Drivers of Program Effectiveness
Implications for Future Programs
Limitations and Next Steps
Summary
Decreased Utilization and Improved Quality of Care Outcomes for Patients with Cancer
Research Question
Reductions in Utilization and Quality-of-Life Improvements
Methods
Limitations
Summary
Decreased Utilization and Improved Caregiver Quality of Life for Patients with Dementia
Research Questions
Data Sources
Program Components, Workforce Models, and Implementation
Program Effectiveness and Core Outcomes
Caregiver Experience
Implications for Future Programs
Summary
Improved Diabetes Outcomes in Large Health Systems
Consolidated Framework for Implementation Research: Assessing Barriers and Facilitators to Program Implementation
Research Questions
Data Sources and Methods
Adaptability and Complexity
Innovative Use of Technology
Partnerships
Key Findings: Program Effectiveness
Implications for Future Programs
Limitations
Conclusion
TECHNICAL APPENDICES
Appendix A: Quantitative Methods
Dataset Construction
Post-Acute Care Interventions
Ambulatory Care Interventions
Comparison Group Selection
Analytic Methods
Claims-Based Analysis:
Difference-in-Differences
Time Series Analysis
Awardee Data Analysis
Dosage Analysis
Program costs Analysis
Supplements for Awardee Chapters
Christiana Care Health System
Treatment and Comparison Group Creation
Second Year Analysis
Duke University’s Southeastern Diabetes Initiative
High-Risk Intervention Analysis
FirstVitals Health and Wellness, Inc.
Treatment and Comparison Group Creation
The George Washington University
Treatment and Comparison Group Creation
Health Resources in Action
Trustees of Indiana University
Treatment and Comparison Group Creation
Innovation Oncology Business Solutions, Inc.
Treatment and Comparison Group Creation
End-of-Life Analysis
Joslin Diabetes Center, Inc.
Le Bonheur Community Health and Well-Being
Treatment and Comparison Group Creation
Mountain Area Health Education Center, Inc.
Nemours Children’s Health System of Nemours Foundation
Treatment and Comparison Group Creation
Ochsner Clinic Foundation
Stroke Central
High-Risk Analysis
Stroke Mobile Analysis
University of Alabama at Birmingham
Treatment and Comparison Group Creation
End-of-Life Analysis
Regents of the University of California, Los Angeles
Treatment and Comparison Group Creation
The Rectors and Visitors of the University of Virginia
Treatment and Comparison Group Creation
End-of-Life Analysis
Vanderbilt University Medical Center
Transitions Care Coordination (TCC) Program
Treatment and Comparison Group Creation
Outpatient Chronic Care (OCC) Management Program
Treatment and Comparison Group Creation
Diabetes Cross-Awardee Supplement
Appendix B: Qualitative Methods
Data Collection
Qualitative Coding
