On behalf of the Centers for Medicare & Medicaid Services, Abt Associates conducted mixed-methods evaluations of ten Hospital-Setting Health Care Innovation Awards (HCIAs). HCIAs were awarded to test innovative new ideas to deliver better health, improved care and lower costs for Medicare, Medicaid and Children's Health Insurance Program (CHIP) beneficiaries.
This report covers the third and final evaluation of all ten hospital-based HCIAs that focused on high-acuity patients, and ranged from improving critical (ICU) and ED care, to screening for emerging acute conditions in hospital and nursing home patients, to team-based inpatient and outpatient services for high-risk patients.
Many innovations relied on IT to improve adherence to evidence-based best practices, revise pharmacy and laboratory automated order sets, or continuously monitor ICU patients. Although each innovation had unique goals, objectives, and patient populations, all shared the common goal of improving efficiency and reducing follow-up health care utilization such as rehospitalizations and repeat ED visits.
All of the hospital-setting innovations focused on Medicare patients, and most included those with other forms of insurance as well. The mixed-methods evaluations were designed to explore the core research domains as defined by CMS:
- Implementation effectiveness;
- Program effectiveness;
- Workforce issues;
- Contextual factors;
- Impact of the innovations on better care, better health, and lower costs to CMS; and
- Lessons learned for sustainability and spread.
Qualitative data were analyzed to understand the care improvement/ redesign processes, use of IT, staff training, and other elements of each initiative. Secondary claims data and surveys were used to measure Medicare utilization and spending, and patient satisfaction with care.
Read more about the HCIA evaluation.