Lisa I Iezzoni1, Yuchiao Chang2, Holly Matulewicz3, Dennis Heaphy4, Kimberley S Warsett5, Karen Donelan6. 1. Mongan Institute Health Policy Center, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA 02114, United States; Department of Medicine, Harvard Medical School, United States. Electronic address: liezzoni@mgh.harvard.edu. 2. Department of Medicine, Harvard Medical School, United States; Division of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA 02114, United States. Electronic address: yuchiao.chang@mgh.harvard.edu. 3. Mathematica Policy Research, 955 Massachusetts Ave, Room 801, Cambridge, MA 02139, United States. Electronic address: hmatulewicz@mathematica-mpr.com. 4. Disability Policy Consortium, 11 Dartmouth Street, Room 301, Malden, MA 02148, United States. Electronic address: dheaphy@DAOma.org. 5. Disability Policy Consortium, 11 Dartmouth Street, Room 301, Malden, MA 02148, United States. Electronic address: kwarsett@yahoo.com. 6. Mongan Institute Health Policy Center, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA 02114, United States; Department of Medicine, Harvard Medical School, United States. Electronic address: kdonelan@mgh.harvard.edu.
Abstract
BACKGROUND:In October 2013, Massachusetts initiated the One Care demonstration, which enrolls beneficiaries ages 21 to 64 dually-eligible for Medicare and Medicaid. Local disability advocates argued that persons with disability should assess their own One Care quality. OBJECTIVES: To test the comparative effectiveness for improving patient-reported health care experiences of two informational interventions in a 12-month period: (1) "YESHealth: Your Experience, Speak up for better health care," in which disability advocates developed brief topical surveys and gathered information from One Care enrollees with significant physical disability or serious mental illness; and (2) the Persons with Disability Quality Survey (PDQ-S), developed collaboratively with persons with disability. METHODS: This cluster randomized controlled trial randomly assigned 27 primary care practices with ≥50 One Care members to three study arms differing byinformation provided to practice directors and primary care providers (PCPs): (1) quarterly YESHealth reports plus results from baseline administration of PDQ-S to 720 enrollees before YESHealth implementation; (2) PDQ-S results only; and (3) no study information. We administered PDQ-S again one year later and used difference-in-differences analyses of results across the two years to assess intervention outcomes. RESULTS: Disability advocates conducting YESHealth reported substantial difficulties contacting practices and engaging PCPs. With few exceptions, no differences were found across the three study arms in enrollee-reported outcomes. CONCLUSIONS: Providing consumer-designed and generated quality information to PCPs had no measurable effect on enrollees' perceptions of One Care quality. Barriers to PCPs engaging with disability advocates could have contributed to YESHealth's failure to improve care.
RCT Entities:
BACKGROUND: In October 2013, Massachusetts initiated the One Care demonstration, which enrolls beneficiaries ages 21 to 64 dually-eligible for Medicare and Medicaid. Local disability advocates argued that persons with disability should assess their own One Care quality. OBJECTIVES: To test the comparative effectiveness for improving patient-reported health care experiences of two informational interventions in a 12-month period: (1) "YESHealth: Your Experience, Speak up for better health care," in which disability advocates developed brief topical surveys and gathered information from One Care enrollees with significant physical disability or serious mental illness; and (2) the Persons with Disability Quality Survey (PDQ-S), developed collaboratively with persons with disability. METHODS: This cluster randomized controlled trial randomly assigned 27 primary care practices with ≥50 One Care members to three study arms differing by information provided to practice directors and primary care providers (PCPs): (1) quarterly YESHealth reports plus results from baseline administration of PDQ-S to 720 enrollees before YESHealth implementation; (2) PDQ-S results only; and (3) no study information. We administered PDQ-S again one year later and used difference-in-differences analyses of results across the two years to assess intervention outcomes. RESULTS: Disability advocates conducting YESHealth reported substantial difficulties contacting practices and engaging PCPs. With few exceptions, no differences were found across the three study arms in enrollee-reported outcomes. CONCLUSIONS: Providing consumer-designed and generated quality information to PCPs had no measurable effect on enrollees' perceptions of One Care quality. Barriers to PCPs engaging with disability advocates could have contributed to YESHealth's failure to improve care.
Authors: Karen Donelan; Yuchiao Chang; Holly Matulewicz; Kimberly Warsett; Dennis Heaphy; Lisa I Iezzoni Journal: J Gen Intern Med Date: 2020-06-09 Impact factor: 5.128
Authors: Hanan Aboumatar; Samantha Pitts; Ritu Sharma; Asar Das; Brandon M Smith; Jeff Day; Katherine Holzhauer; Sejean Yang; Eric B Bass; Wendy L Bennett Journal: Syst Rev Date: 2022-03-05