From Knowledge to Action: Building Research and Evaluation Capacity in the RI Medicaid Program Susan M. Allen, Ph.D. Associate Professor and Deputy Director Center for Gerontology and Health Care Research Brown University June, 2005

Significance In this era of scarce resources, there is a need to expand access and improve quality yet control costs Research capacity is crucial to problem identification and monitoring success in achieving program goals

Popular Strategies to Meet Medicaid Program Research Needs Independent Evaluators – sporadic, response to RFP’s Ongoing Affiliations - established relationship between state and research organization or university Dedicated university programs or departments developed specifically to meet states’ policy analysis needs

Drawbacks Researchers and policy makers still operating in separate spheres Medicaid program may become dependent on outside research organization or university to meet research needs, little incentive to create in-house capacity All too often, little understanding of each other’s culture and priorities

Contrasting Cultures, or Are Researchers Really from Mars? Technical jargon impedes communication Scientific rigor vs. timeliness Presentation of findings not transparent Emphasis on caveats, hesitant to elucidate key messages for policy End result: Minimizes the usefulness of research to policy decisions

A Better Approach: The Researcher/Policy Maker Partnership Ongoing collaborative relationship –Builds trust and credibility –Promotes understanding of the needs, language, and culture of the “other” –Long term research strategy

The Rhode Island Model Research and Evaluation workgroup Medicaid Data Archive Health Indicator System Focus Groups, Surveys, Other

RI Medicaid Research and Evaluation Workgroup Membership: –Medicaid Program Leadership –Medicaid Program Staff –Program Development Consultants –Public Health Researchers –University-Based Researchers –Student RAs and Interns

RI Medicaid Research and Evaluation Workgroup Monthly two hour meetings Held on-site at Medicaid program offices Open to Medicaid staff Ongoing research agenda Agenda includes both MCH and adult health research issues Allows for researcher input into program and policy Allows for program input into research process

Bringing Data In-House: The Medicaid Data Archive MMIS RI Surveys –BRFS –RI Health Interview Survey Public Health Data Sets –Vital statistics –Hospital Discharge Data

Institutionalizing A Systematic Approach: Medicaid Health Indicators Ongoing monitoring of utilization and other outcomes for subgroups of the Medicaid population Highly flexible, responsive to the heterogeneity of the Medicaid population and need to monitor multiple programs

Focus Groups and Surveys Used to more fully understand problems identified through analysis of administrative data Also used to address information needs not available from analysis of administrative data Results influential in shaping program development

Products of the Partnership Ongoing data series Health Indicator reports Periodic policy briefs Papers for publication

Benefits of the RI Model For Researchers: –Better understanding of how to conduct research that is responsive to program needs –Enhances ability to effectively communicate research findings to program administrators and policy makers –Facilitates access to data –Opportunities for publication –Gratification associated with making a difference

Benefits of the RI Model For the Medicaid Program: –University-based researcher with relevant expertise brings broader, national perspective on issues –Facilitates translation of data findings into actionable messages –Promotes better understanding of the value of research for achieving program goals

Key elements to success In-house location of research activity Continuity in collaborative partnership Systematic approach to population monitoring Long term research strategy