Leslie A. Weems, LMSW, Senior Policy Analyst and Project Manager, Medicaid/CHIP Division, Texas Health and Human Services Commission discusses Texas Medicaid Health Home Pilot Project Evaluation Methods at the New Tactics for Building Medical Homes in State Medicaid and CHIP Programs webinar

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2. Project Goal
Assess the impact of varied models of health homes in
increasing access and quality of both primary and
specialty care in a cost-effective manner that is also
patient/family-centered, population-based, coordinated,
clinically managed, team-based and comprehensive.
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3. Pilot Overview
• up to 8 pilot projects, and each may have multiple
practice sites
• assess over a 24-month period the performance of
each pilot using a common evaluation methodology
• primary care case management (PCCM), capitated
managed care programs, and fee for service
• >5,000 Medicaid beneficiary children per pilot project
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4. Evaluation
*Methodology designed by Health and Human Services Commission (HHSC)
consultant Bailit Health Purchasing, LLC
• Domain I: adoption of health home practices
• Domains II & III: patient access and patient
experience
• Domain IV: practice experience and satisfaction
• Domain V: service utilization
• Domain VI: clinical care quality
• Domain VII: annual and trended PMPM cost
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5. Domain I: Adoption of Health Home Practices
• Medical Home Implementation Quotient (MHIQ) by
TransforMed (excluding the Health Information
Technology segment and the Practice Management
segment)
• self-report survey results
• results reported at beginning of project and at 6, 12,
18, and 24 months
• no comparison groups
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6. Domains II & III: Patient Access and Experience
• pre/post evaluation methodology
• Consumer Assessment of Healthcare Providers
and Systems (CAHPS) Clinician & Group Survey V
1.0 using a 4-point scale with some additional
questions
• children’s parents or guardians will receive a
survey at the beginning of implementation and at
month 24
• will not match the pre- and post-survey takers
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7. Domain IV: Practice Experience and Satisfaction
• pre/post survey methodology
• Harvard School of Public Health: Survey of Practice
Environment and Satisfaction in PCMH Pilots
• performed over telephone at beginning of project
and again at month 24
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8. Domains V, VI, and VII:
Service Utilization, Clinical Care Quality, and PMPM Cost
• pre/post with comparison group evaluation methodology
• claims data for children identified as served by pilot providers
and claims data for a control group
• compare changes in performance over time
• pilot practices will also be tracked quarterly using a subset of
the formal evaluation measures
The primary analyses will be conducted within each pilot.
Comparison across pilots will be qualitative in nature, because
they are expected to vary in fundamental ways (e.g.,
geography, practice type) that will make identifying causes of
differential impact difficult at best.
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