Special Project Announcement

Two new special projects of the Medicaid Medical Directors’ Learning Network will focus on specific topics of broad interest to members and, hopefully, will produce practical tools or materials that can help them improve State Medicaid programs. Each will be driven by a small project team typically including several medical directors, AHRQ staff, AcademyHealth staff, and a possible outside researcher or other expert. Teams will meet via conference call, the Internet, and/or in-person, and their findings/products will be disseminated to all members of the learning network. Please email Amanda Brodt at amanda.brodt@academyhealth.org to volunteer to participate in either project team outlined below.   

 

a. Resource Book on Using Evidence in Coverage Decision-Making

States are interested in developing more thorough and consistent processes for using evidence in making coverage and benefit decisions for their Medicaid programs. This project will produce a compendium, or notebook, of materials for Medicaid medical directors to help them examine and strengthen their current approaches to evidence-based decision-making. The resource book may include the following kinds of elements: a background discussion of what is evidence-based decision making and why it is relevant for Medicaid programs, a framework for examining current State processes for making coverage and benefit design decisions, a list of key questions to ask about a State’s process, (a “self- assessment” guide), a list of sources of evidence, including public and private organizations that produce technology assessments, background information on defining “medical necessity” under Medicaid, including EPSDT programs, and brief case examples of State decision-making processes.

·         Possible Project Team members:  Jeff Thompson (WA), who suggested the idea of developing this kind of a notebook/resource book, Ron Steingard (MA), and Jim Figge (NY) have already volunteered to help. AHRQ staff who have already signaled their willingness to help include Elise Berliner (Director, AHRQ Technology Assessment Program), and Bill Lawrence (Medical Director, Center for Outcomes and Evidence).

 

b. Medicaid Data sharing and Benchmarking

Several members of the Medicaid Medical Directors’ Learning Network have expressed interest in sharing data, especially related to quality measurement/improvement, for the purpose of assessing their state’s performance. They would like to know what measures other states are using and be able to set useful benchmarks to guide their own program changes. The project will provide an opportunity for a small group of medical directors and other experts to brainstorm about these issues and determine if further work is warranted in this area.