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• « Business Case / Return on Investment

To help Medicaid stakeholders identify interventions with the potential to both improve quality and reduce health care costs, the Center for Health Care Strategies (CHCS) engaged Mathematica Policy Research to conduct a review of published quality improvement studies that reported cost or utilization outcomes. The resulting ROI Evidence Base includes a selection of studies for clinical conditions of high priority within Medicaid populations, including asthma, congestive heart failure, depression, diabetes, and high-risk pregnancy. Studies are categorized: (1) by clinical condition and (2) by whether reported outcomes indicate decreases or increases in cost and utilization. Users may browse the ROI Evidence Base to assess the relevance of included studies based on intervention strategies, target population characteristics, intervention settings, and overall study quality.

The ROI Evidence Base is part of a set of tools developed by CHCS to help Medicaid stakeholders identify where opportunities may exist to realize both quality improvement and cost containment goals. An additional tool, the ROI Forecasting Calculator for Quality Initiatives, was developed by CHCS to Medicaid stakeholders assess the potential of proposed quality improvement initiatives to generate a positive return on investment. The tool is currently being piloted by a select group of states and will be released publicly in early 2008.

Both the ROI Evidence Base and the upcoming ROI Forecasting Calculator for Quality Initiatives were made possible through support from the Robert Wood Johnson Foundation (RWJF) and are being tested in a CHCS Purchasing Institute that is co-funded by RWJF and The Commonwealth Fund.